Body fat, cardiovascular risk factors and polymorphism in the FTO gene: randomized clinical trial and different physical exercise for adolescents

Abstract Objective: To investigate the effects of different physical exercise programs and polymorphisms of the FTO (fat mass and obesity-associated gene) on body composition and cardiovascular risk factors in adolescents with overweight and obesity. Methods: A randomized, parallel, double-blind clinical trial consisting of the adolescent overweight from the state public network, in a simple representative random sample, who participated in an aerobic exercise or weight training intervention for 10 weeks. Anthropometry, body composition, biochemical markers, sexual maturation, and rs9939609 polymorphism in the FTO gene were assessed. 347 adolescents had their characterization of nutritional status. 72 individuals with overweight and obesity were invited to participate. 39 remained for the start of the program and were randomly allocated to both types of intervention. In the end, 26 subjects participated in the intervention programs, with 12 and 14 in the aerobic and weight training programs, respectively. Results: Heterozygous and homozygous bearers of risk allele A participating in the aerobic program showed improvements in glycemia (p = 0.002) and total cholesterol (p = 0.023) and a reduction in body fat mass (p = 0.041). The weight training program reduced glycemia in patients with the risk allele A (p = 0.027). Cameron's stage four sexual maturation participants were 2.1 times more likely to improve their body fat (CI = 1.31-3.39). Conclusion: Aerobic exercises produced exclusively a significant decrease in fat mass and total cholesterol in patients with risk allele A. Distinct physical exercise programs may cause diverse changes in risk variables related to the health of adolescents.

Body fat, cardiovascular risk factors and polymorphism in the FTO gene: randomized clinical trial and different physical exercise for adolescents.

OBJECTIVE: To investigate the effects of different physical exercise programs and polymorphisms of the FTO (fat mass and obesity-associated gene) on body composition and cardiovascular risk factors in adolescents with overweight and obesity. METHODS: A randomized, parallel, double-blind clinical trial consisting of the adolescent overweight from the state public network, in a simple representative random sample, who participated in an aerobic exercise or weight training intervention for 10 weeks. Anthropometry, body composition, biochemical markers, sexual maturation, and rs9939609 polymorphism in the FTO gene were assessed. 347 adolescents had their characterization of nutritional status. 72 individuals with overweight and obesity were invited to participate. 39 remained for the start of the program and were randomly allocated to both types of intervention. In the end, 26 subjects participated in the intervention programs, with 12 and 14 in the aerobic and weight training programs, respectively. RESULTS: Heterozygous and homozygous bearers of risk allele A participating in the aerobic program showed improvements in glycemia (p = 0.002) and total cholesterol (p = 0.023) and a reduction in body fat mass (p = 0.041). The weight training program reduced glycemia in patients with the risk allele A (p = 0.027). Cameron's stage four sexual maturation participants were 2.1 times more likely to improve their body fat (CI = 1.31-3.39). CONCLUSION: Aerobic exercises produced exclusively a significant decrease in fat mass and total cholesterol in patients with risk allele A. Distinct physical exercise programs may cause diverse changes in risk variables related to the health of adolescents.

Intra-abdominal fat measurement by ultrasonography: association with anthropometry and metabolic syndrome in adolescents / Gordura intra-abdominal medida por ultrassonografia: relação com antropometria e síndrome metabólica em adolescentes

Abstract Objective: To associate intra-abdominal fat thickness measured by ultrasonography to the factors related to metabolic syndrome and to determine cutoff points of intra-abdominal fat measurement associated with a greater chance of metabolic syndrome in adolescents. Methods: This was a cross-sectional study, with 423 adolescents from public schools. Intra-abdominal fat was measured by ultrasonography. Anthropometric data were collected, and biochemical analyses were performed. Results: Intra-abdominal fat was measured by ultrasonography, showing a statistically significant association with the diagnosis of metabolic syndrome (p = 0.037), body mass index (p < 0.001), elevated triglyceride levels (p = 0.012), decreased plasma HDL levels (p = 0.034), and increased systemic blood pressure values (p = 0.023). Cutoff values of intra-abdominal fat thickness measurements were calculated by ultrasound to estimate the individuals most likely to develop metabolic syndrome. In the logistic regression models, the cutoff values that showed the highest association with metabolic syndrome in males were 4.50, 5.35, 5.46, 6.24, and 6.50 cm for the ages of 14, 15, 16, 17, and 18/19 years, respectively. In the female gender, the cutoff values defined for the same age groups were 4.46, 4.55, 4.45, 4.90, and 6.46 cm. In an overall analysis using the ROC curve, without gender and age stratification, the cut-off of 3.67 cm showed good sensitivity, but low specificity. Conclusion: Ultrasonography is a useful method to estimate intra-abdominal adipose tissue in adolescents, which is associated with the main factors related to obesity and metabolic syndrome.

Resumo Objetivo: Relacionar a espessura da gordura intra-abdominal medida pela ultrassonografia aos fatores ligados à síndrome metabólica. Determinar pontos de corte da medida da gordura intra-abdominal associados a uma maior chance de síndrome metabólica em adolescentes. Métodos: Estudo seccional, com 423 adolescentes de escolas públicas. A gordura intra-abdominal foi medida pela ultrassonografia. Foram coletados dados antropométricos e feitas análises bioquímicas. Resultados: As medidas da gordura intra-abdominal por ultrassonografia apresentaram associação estatisticamente significativa com o diagnóstico de síndrome metabólica (p = 0,037), índice de massa corporal (p < 0,001), níveis elevados de triglicerídeos (p = 0,012), redução dos níveis plasmáticos de HDL (p = 0,034) e aumento da pressão arterial sistêmica (p = 0,023). Calcularam-se pontos de corte da medida da espessura da gordura intra-abdominal por ultrassom, para estimar os indivíduos com mais chance para o desenvolvimento de síndrome metabólica. Em modelos de regressão logística, os pontos de corte que apresentaram maior associação com a síndrome metabólica no sexo masculino foram de 4,50, 5,35, 5,46, 6,24 e 6,50 cm para as idades de 14, 15, 16, 17 e 18/19 anos, respectivamente. No sexo feminino, os pontos de corte definidos para as mesmas faixas etárias foram de 4,46, 4,55, 4,45, 4,90 e 6,46 cm. Em análise global por meio da curva ROC, sem estratificações por sexo e idade, o ponto de corte de 3,67 cm teve boa sensibilidade, porém apresentou baixa especificidade. Conclusão: A ultrassonografia é um método útil para a estimativa do tecido adiposo intra-abdominal em adolescentes, está associada com os principais fatores relacionados à obesidade e à síndrome metabólica.

Intra-abdominal fat measurement by ultrasonography: association with anthropometry and metabolic syndrome in adolescents.

OBJECTIVE: To associate intra-abdominal fat thickness measured by ultrasonography to the factors related to metabolic syndrome and to determine cutoff points of intra-abdominal fat measurement associated with a greater chance of metabolic syndrome in adolescents. METHODS: This was a cross-sectional study, with 423 adolescents from public schools. Intra-abdominal fat was measured by ultrasonography. Anthropometric data were collected, and biochemical analyses were performed. RESULTS: Intra-abdominal fat was measured by ultrasonography, showing a statistically significant association with the diagnosis of metabolic syndrome (p=0.037), body mass index (p<0.001), elevated triglyceride levels (p=0.012), decreased plasma HDL levels (p=0.034), and increased systemic blood pressure values (p=0.023). Cutoff values of intra-abdominal fat thickness measurements were calculated by ultrasound to estimate the individuals most likely to develop metabolic syndrome. In the logistic regression models, the cutoff values that showed the highest association with metabolic syndrome in males were 4.50, 5.35, 5.46, 6.24, and 6.50cm for the ages of 14, 15, 16, 17, and 18/19 years, respectively. In the female gender, the cutoff values defined for the same age groups were 4.46, 4.55, 4.45, 4.90, and 6.46cm. In an overall analysis using the ROC curve, without gender and age stratification, the cut-off of 3.67cm showed good sensitivity, but low specificity. CONCLUSION: Ultrasonography is a useful method to estimate intra-abdominal adipose tissue in adolescents, which is associated with the main factors related to obesity and metabolic syndrome.

Biotechnological Patents Applications of the Deuterium Oxide in Human Health.

BACKGROUND: Deuterium oxide is a molecule that has been used for decades in several studies related to human health. Currently, studies on D2O have mobilized a "Race for Patenting" worldwide. Several patents have been registered from biomedical and technological studies of D2O showing the potential of this stable isotope in industry and health care ecosystems. METHODS: Most of the patents related to the applications of the deuterium oxide in human health have been summarized in this review. The following patents databases were consulted: European Patent Office (Espacenet), the United States Patent and Trademark Office (USPTO), the United States Latin America Patents (LATIPAT), Patent scope -Search International and National Patent Collections (WIPO), Google Patents and Free Patents Online. RESULTS: With this review, the information was collected on recent publications including 22 patents related to deuterium oxide and its applications in different areas. CONCLUSION: This review showed that deuterium oxide is a promising component in different areas, including biotechnology, chemistry and medicine. In addition, the knowledge of this compound was covered, reinforcing its importance in the field of biotechnology and human health.

Prevalence of traumatic dental injuries and its association with binge drinking among 12-year-olds: a population-based study.

OBJECTIVE: To determine the prevalence of traumatic dental injuries and its association with binge drinking among 12-year-old schoolchildren. METHODS: A cross-sectional study was carried out involving 588 students from a medium-sized city in Brazil. Data were collected through a clinical examination and self-administered questionnaires. Andreasen's classification was used for the determination of traumatic dental injuries. The consumption of alcoholic beverages and binge drinking were evaluated using the Alcohol Use Disorders Identification Test--Consumption. Socio-economic status, overjet, and inadequate lip seal were also analysed. Associations were tested using the multivariate logistic regression analysis. RESULTS: The prevalence rates of traumatic dental injuries, alcohol consumption in one's lifetime, and binge drinking were 29.9%, 45.6%, and 23.1%, respectively. The prevalence of traumatic dental injuries was significantly higher among those who engaged in binge drinking (PR = 1.410; 95% CI: 1.133-1.754) and even higher among those with inadequate lip protection and accentuated overjet (PR = 3.288; 95% CI: 2.391-4.522 and PR = 1.838; 95% CI: 1.470-2.298, respectively). CONCLUSIONS: A higher prevalence rate of traumatic dental injuries was found among 12-year-olds who engaged in binge drinking. The high rate of alcohol intake among adolescents is worrisome considering the vulnerability of this population due to the intense transformations that occur in the transition from childhood to adulthood.

Determinantes sociodemográficos, antropométricos e alimentares de dislipidemia em pré-escolares / Sociodemographic, anthropometric and dietary determinants of dyslipidemia in preschoolers

OBJETIVO: O objetivo deste estudo foi investigar os determinantes de dislipidemia em pré-escolares. MÉTODOS: A partir de um desenho transversal, foi avaliado um total de 227 pré-escolares com 5 anos de idade residentes em uma área urbana da cidade de Diamantina, Minas Gerais, Brasil. Foram avaliados: variáveis bioquímicas, antropométricas, condição socioeconômica e comportamental, a partir de um questinário; e ingestão alimentar, a partir de um questionário de fequência de consumo de alimentos. Os padrões alimentares denominados "dieta mista", "fast food" e "não saudável" foram identificados por meio de análise de componentes principais. Os determinantes de dislipidemia foram examinados através da análise de regressão de Poisson. RESULTADOS: A prevalência de dislipidemia, neste estudo, foi de 65,19%. Os pré-escolares que consumiam com menos frequência alimentos do padrão "dieta mista" tiveram um risco maior de concentrações mais altas de lipoproteína de baixa densidade (PR = 2,30; p = 0,004), em comparação com aqueles com um consumo mais frequente do padrão "dieta mista". Os pré-escolares cujas mães apresentaram uma escolaridade mais baixa tiveram menor risco de concentrações mais altas de lipoproteína de baixa densidade (PR = 0,43; p = 0,003), e os pré-escolares que estavam com sobrepeso/obesos apresentaram maior risco de concentrações mais altas de lipoproteína de baixa densidade (PR = 2,23; p = 0,003). CONCLUSÃO: Os determinantes de dislipidemia identificados neste estudo foram o consumo menos frequente de alimentos do padrão "dieta mista", índice de massa corporal mais alto e um maior nível de escolaridade materna. Este estudo mostra que, apesar da baixa idade do grupo em estudo, já estão apresentando alta prevalência de dislipidemia, que é um fator de risco importante para doença cardiovascular.

OBJECTIVE: To investigate the determinants of dyslipidemia in preschoolers. METHODS: A total of 227 preschoolers residing in an urban area of the city of Diamantina, Minas Gerais, Brazil were evaluated at age 5 years, using a cross-sectional design. Dietary intake from a food frequency questionnaire, anthropometric/biochemical parameters, and socioeconomic/behavioral information from a questionnaire were evaluated. 'Mixed diet', 'snack', and 'unhealthy' dietary patterns were identified using principal component analysis. The determinants of dyslipidemia were examined using Poisson regression analysis. RESULTS: The prevalence of dyslipidemia in this study was 65.19%. Preschoolers who less frequently consumed foods in the 'mixed diet' dietary pattern had a higher risk of high concentrations of low-density lipoprotein cholesterol (PR = 2.30; p = 0.004) when compared with those with more frequent consumption of the 'mixed diet' dietary pattern. Preschoolers whose mothers had lower levels of education presented a lower risk of high concentrations of low-density lipoprotein cholesterol (PR = 0.43; p = 0.003), and preschoolers who were overweight/obese presented with greater risk of high concentrations of low-density lipoprotein cholesterol (PR = 2.23; p = 0.003). CONCLUSION: The determinants of dyslipidemia identified in this study were less frequent consumption of foods in the 'mixed diet' dietary pattern, higher body mass index, and higher level of maternal education. This study shows that despite the young age of the group under study, they already present a high prevalence of dyslipidemia, which is an important risk factor for cardiovascular disease.

Sociodemographic, anthropometric and dietary determinants of dyslipidemia in preschoolers.

OBJECTIVE: To investigate the determinants of dyslipidemia in preschoolers. METHODS: A total of 227 preschoolers residing in an urban area of the city of Diamantina, Minas Gerais, Brazil were evaluated at age 5 years, using a cross-sectional design. Dietary intake from a food frequency questionnaire, anthropometric/biochemical parameters, and socioeconomic/behavioral information from a questionnaire were evaluated. 'Mixed diet', 'snack', and 'unhealthy' dietary patterns were identified using principal component analysis. The determinants of dyslipidemia were examined using Poisson regression analysis. RESULTS: The prevalence of dyslipidemia in this study was 65.19%. Preschoolers who less frequently consumed foods in the 'mixed diet' dietary pattern had a higher risk of high concentrations of low-density lipoprotein cholesterol (PR=2.30; p=0.004) when compared with those with more frequent consumption of the 'mixed diet' dietary pattern. Preschoolers whose mothers had lower levels of education presented a lower risk of high concentrations of low-density lipoprotein cholesterol (PR=0.43; p=0.003), and preschoolers who were overweight/obese presented with greater risk of high concentrations of low-density lipoprotein cholesterol (PR=2.23; p=0.003). CONCLUSION: The determinants of dyslipidemia identified in this study were less frequent consumption of foods in the 'mixed diet' dietary pattern, higher body mass index, and lower level of maternal education. This study shows that despite the young age of the group under study, they already present a high prevalence of dyslipidemia, which is an important risk factor for cardiovascular disease.

Risk factors for intestinal parasitic infections in preschoolers in a low socio-economic area, Diamantina, Brazil.

OBJECTIVE: To verify the prevalence of intestinal parasitic infections among preschoolers and to identify the associated risk factors. METHODS: The study is a cross-sectional study nested in a cohort of children who were born and resident in Diamantina, Minas Gerais, Brazil. At the time of the study, all children were aged 60 months ± five months. They were recruited after written informed consent was obtained from parents or guardians. The study was carried out between July 2009 and July 2010. In total 214 children provided a stool sample for examination on intestinal parasitic infections. Information on potential risk factors for parasitosis was obtained from parents and guardians of the children by a questionnaire. Logistic regression was used for analysis. RESULTS: Intestinal parasitic infections were found in 27·5% (n = 59) of children. The boys' infection prevalence (26·1%, n = 36) was slightly lower than the infection prevalence of the girls (30·3%, n = 23), but not statistically different (p = 0·51). Fourteen children, (23·7%) were infected with two or more parasite species and forty-five (76·3%) with single parasites. A low per capita income of family was strongly associated with an increased risk for an infection (OR = 2·89; P = 0.003). Preschoolers whose mothers did not work outside home had a significantly lower risk for infection (OR = 0·41; p = 0·01). CONCLUSION: Intestinal parasite infection is a health problem among Diamantina preschoolers. Poverty was implicated as an important risk factor for infection, while the presence of the mother at home full-time was a protective factor.

Association between different phases of menstrual cycle and body image measures of perceived size, ideal size, and body dissatisfaction.

The association between phases of the menstrual cycle and body image was investigated. 44 university women (M age = 23.3 yr., SD = 4.7) judged their perceived and ideal body size, and body dissatisfaction was calculated at each phase of the menstrual cycle, including premenstrual, menstrual, and intermenstrual. Participants selected one of nine figural drawings ranging from very thin to obese that represented their perceived size and ideal size. Body dissatisfaction was measured as the absolute difference between scores on perceived and ideal figural drawings. During each menstrual phase, anthropometric measures of weight, height, body mass index, circumference of waist and abdomen, and body composition were taken. There were no significant differences in any anthropometric measures between the three menstrual cycle phases. Perceived body size and body dissatisfaction were significantly different between menstrual phases, with the largest perceived body size and highest body dissatisfaction occurring during the menstrual phase. Ideal body size did not differ between menstrual phases, although participants desired a significantly smaller ideal size as compared to the perceived size.

Exclusive breastfeeding and other foods in the first six months of life: effects on nutritional status and body composition of Brazilian children.

OBJECTIVE: To evaluate the effect of exclusive breastfeeding and consumption of other foods in the first six months of life in the nutritional status and body composition of children. METHODS: A retrospective cohort study with 185 children aged from 4 to 7 years was monitored during the first months of life in a program of support to breastfeeding. We evaluated weight, height, waist circumference, and body composition by using DEXA. The nutritional status was assessed by the BMI/age index. The parameters of adiposity were classified by using as the cutoff point, the 85th percentile of the sample itself, according to gender and age. Confounding factors considered were variables related to maternal, pregnancy, birth, sociodemographic, health, lifestyle, and diet. Bivariate and multivariate analyses were performed, the latter by means of multiple logistic regression. RESULTS: The median exclusive breastfeeding was 3 months. Of the children, 42.7% received cow's milk and 35.7% received infant formula. Regarding nutritional status, 21.1% of the children showed changes. The variables of infant feeding were not independently associated with nutritional status and body composition of the children and there were no differences between the groups studied. CONCLUSION: Breastfeeding was not a protective factor to overweight and body fat in children.

Padrão alimentar de pré-escolares e fatores associados / Preschool children dietary patterns and associated factors

OBJETIVOS: Identificar padrões alimentares de pré-escolares e conhecer seus determinantes. MÉTODOS: Estudo transversal aninhado em uma coorte de nascidos entre os anos de 2004 e 2005 na cidade de Diamantina (MG). O instrumento utilizado para explorar os padrões alimentares foi um questionário de frequência de consumo alimentar. Foi utilizada análise fatorial de componentes principais para identificação dos padrões alimentares. Avaliaram-se ainda dados pessoais, socioeconômicos e medidas antropométricas de 232 pré-escolares no período entre julho de 2009 e julho de 2010. Os determinantes dos padrões alimentares foram identificados por meio da regressão logística. RESULTADOS: Três padrões foram obtidos, denominados de "dieta mista", "lanche" e "não saudável". Os pré-escolares filhos de mães com menor escolaridade têm mais chance (odds ratio - OR = 3,80; intervalo de confiança de 95% - IC95% = 1,90-7,60) de consumir alimentos do padrão "dieta mista" e menor chance (OR = 0,31; IC95% = 0,15-0,61) de consumir alimentos do padrão "lanches", enquanto os de maior renda per capita têm mais chance de consumir alimentos do padrão "não saudável" (OR = 2,43; IC95% = 1,13-5,24). CONCLUSÃO: Foram identificados três padrões alimentares na população estudada, os quais foram determinados pelo nível de escolaridade materna e renda per capita.

OBJECTIVES: To identify dietary patterns in pre-school children and to investigate its determinants. METHODS: Cross-sectional study nested in a cohort born between 2004 and 2005 in the municipality of Diamantina, state of Minas Gerais, Brazil. The instrument used to explore the dietary patterns was a frequency questionnaire for food consumption. Factor analysis was used for the identification of the dietary patterns. The study also assessed personal and socioeconomic data and anthropometric measurements of 232 preschoolers in the period between July 2009 and July 2010. The determinants of food patterns were identified by logistic regression. RESULTS: Three patterns were obtained, which were called: "mixed diet," "snack," and "unhealthy." The children of mothers with low education are more likely (odds ratio - OR = 3.80; confidence interval 95% - 95%CI = 1.90-7.60) to consume food from the "mixed diet" pattern, and less likely (OR = 0.31; 95%CI = 0.15-0.61) to consume food from the "snack" pattern, while those with higher per capita income are more likely to consume food from the "unhealthy" pattern (OR = 2.43; 95%CI = 1.13-5.24). CONCLUSION: Three dietary patterns were identified in the studied population, which were determined by the level of maternal education and per capita income.

Preschool children dietary patterns and associated factors.

OBJECTIVES: To identify dietary patterns in pre-school children and to investigate its determinants. METHODS: Cross-sectional study nested in a cohort born between 2004 and 2005 in the municipality of Diamantina, state of Minas Gerais, Brazil. The instrument used to explore the dietary patterns was a frequency questionnaire for food consumption. Factor analysis was used for the identification of the dietary patterns. The study also assessed personal and socioeconomic data and anthropometric measurements of 232 preschoolers in the period between July 2009 and July 2010. The determinants of food patterns were identified by logistic regression. RESULTS: Three patterns were obtained, which were called: "mixed diet," "snack," and "unhealthy." The children of mothers with low education are more likely (odds ratio - OR = 3.80; confidence interval 95% - 95%CI = 1.90-7.60) to consume food from the "mixed diet" pattern, and less likely (OR = 0.31; 95%CI = 0.15-0.61) to consume food from the "snack" pattern, while those with higher per capita income are more likely to consume food from the "unhealthy" pattern (OR = 2.43; 95%CI = 1.13-5.24). CONCLUSION: Three dietary patterns were identified in the studied population, which were determined by the level of maternal education and per capita income.

Body fat location and cardiovascular disease risk factors in overweight female adolescents and eutrophic female adolescents with a high percentage of body fat.

BACKGROUND: Excessive body fat, mainly abdominal fat, is associated with higher cardiovascular risk. However, a fat localisation measurement that would be more indicative of risk in adolescents has not yet been established. OBJECTIVE: This study was conducted in order to evaluate the correlation between body fat location measurements and cardiovascular disease risk factors in female adolescents. MATERIALS AND METHODS: A total of 113 girls - 38 eutrophic according to their body mass index but with a high percentage of body fat, 40 eutrophic with adequate body fat, and 35 with excessive weight - were evaluated using 15 anthropometrical measurements and 10 cardiovascular risk factors. RESULTS: The central skinfold was the best measurement for predicting variables such as glycaemia and high-density lipoprotein; waist circumference for insulin and homeostasis model assessment; coronal diameter for total cholesterol and low-density lipoprotein; sagittal abdominal diameter for triglycerides and leptin; hip circumference for blood pressure; and the central/peripheral skinfold ratio for homocysteine. The correlation between the measurements and the number of risk factors showed that waist circumference and the waist/stature ratio produced the best results. CONCLUSIONS: The results suggest that the body fat distribution in adolescents is relevant in the development of cardiovascular risk factors. Simple measurements such as waist circumference and the waist/stature ratio were the best predictors of a risk of disease and they should therefore be associated with the body mass index in clinical practice in order to identify those adolescents at higher risk.

Breastfeeding and obesity in Brazilian children.

BACKGROUND: The association between breastfeeding and obesity is inconsistent by the literature. This study aims to assess whether obesity is associated to occurrence of breastfeeding and to duration of total and exclusive breastfeeding in Brazilian children. METHODS: A cross-sectional study was conducted with 764 children enrolled in public and private schools from Viçosa, Minas Gerais, Brazil. Obesity (outcome variable) was defined as body mass index above the +2 standard deviations score using sex and age specific standards of World Health Organization. Exposure was the occurrence and duration of breastfeeding. Potential confounders were controlled by multiple logistic regression analysis and were divided in two groups: children (gender, age, birth weight, gestational age, order of birth, number of siblings, number of persons in the residence, type of school, physical activity patterns and time watching television) and mothers (age, nutritional status, level of education, weight gain during pregnancy, smokes currently and during the pregnancy). RESULTS: Prevalence of obesity was 10.7%; 6.8% of the children were not breastfed and 59.0% did not receive exclusive breastfeeding. After adjustment for confounding variables by logistic regression analysis, no statistically significant association was observed between obesity and the occurrence and/or duration of total and exclusive breastfeeding. There was no dose-response effect of duration of breastfeeding on prevalence of obesity. CONCLUSION: Our results do not support the hypothesis that breastfeeding promotion would reduce obesity in this population. Controversial findings regarding this association by literature indicate a need for further investigations.

Childhood obesity: evidence of an association between plasminogen activator inhibitor-1 levels and visceral adiposity.

BACKGROUND: Plasminogen activator inhibitor-1 (PAI-1) has been considered as a cardiovascular risk factor, mainly because of its strong association with insulin resistance. METHODS: To detect independent predictors of circulating PAI-1 levels in obese pediatric patients, we evaluated 86 subjects (mean age 10.7 +/- 2.8 years), 42 of whom were male (49%). Subjects were divided in two groups according to body mass index (BMI): obese subjects (n=61) and healthy non-obese controls (n=25). They were also divided by pubertal status. Besides anthropometric data, levels of PAI-1, leptin and biochemical markers of metabolic syndrome were measured. RESULTS: The obese group had higher levels of PAI-1, leptin and biochemical markers of metabolic syndrome than nonobese controls (p<0.05). However, multivariate regression analysis showed that only puberty progression (p=0.005) and abdominal circumference/height index (p=0.002) remained independent predictors of PAI-1 levels. CONCLUSION: In pediatric obesity, fat mass accumulation, mainly of visceral fat, and puberty progression were related to high PAI-1 levels, which might in turn contribute to cardiovascular risk.

Measurements of adiposity and high blood pressure among children and adolescents living in Belo Horizonte.

OBJECTIVE: To verify an association, if it exists, between obesity and blood pressure raised beyond the 90th percentile in children and adolescents, and to determine the measure of adiposity that best correlates with blood pressure in these subjects. DESIGN: Cross-sectional study. SETTING: A school-based study in Belo Horizonte, Brazil. PARTICIPANTS: We selected randomly 1,403 students, aged from 6 to 18 years, from 545,046 students attending 521 public and private schools. Those selected completed the study. MAIN MEASURES OF OUTCOME: We recorded the weight, height, skin fold in the triceps, subscapular, and suprailiac areas, waist and hip circumference, body-mass index, and resting systolic and diastolic blood pressures using a mercury sphygmomanometer. RESULTS: In univariate analyses, body mass index greater or lesser than 85th percentile, measurements of skin thickness in the subscapular and suprailiac areas, and the sum of all measurements of skinfold thickness, were associated with both systolic and diastolic measurements of blood pressure. After multivariate analyses that adjusted for all measurements of adiposity except itself, and age, race, and socioeconomic state, we found that the increased body mass index was associated with a 3.6-fold increased frequency of elevated systolic measurements of blood pressure, with 95% confidence intervals from 2.2 to 5.8, and a 2.7-fold increased frequency of elevated measurements of diastolic blood pressure, with 95% confidence intervals from 1.9 to 4.0. CONCLUSIONS: Body-mass index serves as a better predictor of elevated blood pressure among children than do local measurements of adiposity.

Self-medication in nursing mothers and its influence on the duration of breastfeeding / Automedicação em nutrizes e sua influência sobre a duração do aleitamento materno

OBJETIVO: Investigar a prática da automedicação em nutrizes, principais fármacos utilizados e influência sobre a duração do aleitamento materno. MÉTODOS: Estudo longitudinal tipo coorte realizado com 246 mulheres assistidas na maternidade do Hospital Manoel Gonçalves, em Itaúna (MG). O acompanhamento às mães e recém-nascidos foi realizado mensalmente nos primeiros 12 meses após o parto ou até a interrupção da amamentação. O efeito da prática da automedicação sobre o tempo de aleitamento materno foi analisado por análise multivariada, a partir do modelo de regressão de Cox, com covariáveis dependentes do tempo. RESULTADOS: A automedicação foi praticada por 52,4% das nutrizes. As classes farmacológicas mais utilizadas foram os analgésicos/antipiréticos (54,4%), anti-inflamatórios não-esteroides (15%), espasmolíticos (6,2%), laxantes (3,5%), benzodiazepínicos (3%), descongestionantes nasais (1,4%) e antibióticos (0,9%). Os fármacos mais utilizados foram dipirona (31,5%) e paracetamol (17,9%). A prática de automedicação associou-se à maior probabilidade de uso de medicamentos com risco de efeitos adversos sobre o lactente ou sobre a lactação (p = 0,000). Contudo, a prática da automedicação não foi associada ao desmame (p = 0,135). CONCLUSÕES: A elevada frequência de automedicação entre as nutrizes e o uso de medicamentos com risco de efeitos indesejáveis sobre o lactente e na produção láctea revelam a necessidade de melhor orientação sobre os riscos da automedicação pelas nutrizes. Contudo, a prática da automedicação não se revelou um fator de risco para o desmame.

OBJECTIVE: To investigate the practice of self-medication by nursing mothers, the main drugs used and the influence on the duration of breastfeeding. METHODS: A longitudinal cohort study involving 246 women seen at the maternity unit of Hospital Manoel Gonçalves in Itaúna, state of Minas Gerais, Brazil. A monthly follow-up of mothers and newborns was performed for the first 12 months postpartum or until weaning. The effect of the practice of self-medication on the duration of breastfeeding was evaluated by multivariate analysis using Cox's regression model with time-dependent variables. RESULTS: Self-medication was practiced by 52.4% of the nursing mothers. The most used pharmacological classes were: analgesics/antipyretics (54.5%), non-steroidal anti-inflammatories (15%), spasmolytics (6.2%), laxatives (3.5%), benzodiazepines (3%), nasal decongestants (1.4%), and antibiotics (0.9%). The most used drugs were dipyrone (31.5%) and paracetamol (17.9%). The practice of self-medication was associated with a higher probability of the use of drugs posing the risk of adverse effects for the infant or for lactation (p = 0.000). However, the practice of self-medication was not associated with weaning (p = 0.135). CONCLUSIONS: The high rates of self-medication among nursing mothers and the use of drugs posing risks of undesirable effects for the infant and for lactation reveal the need for better education on the risks of self-medication by nursing mothers. However, self-medication was not proven to be a risk factor for weaning.

Self-medication in nursing mothers and its influence on the duration of breastfeeding.

OBJECTIVE: To investigate the practice of self-medication by nursing mothers, the main drugs used and the influence on the duration of breastfeeding. METHODS: A longitudinal cohort study involving 246 women seen at the maternity unit of Hospital Manoel Gonçalves in Itaúna, state of Minas Gerais, Brazil. A monthly follow-up of mothers and newborns was performed for the first 12 months postpartum or until weaning. The effect of the practice of self-medication on the duration of breastfeeding was evaluated by multivariate analysis using Cox's regression model with time-dependent variables. RESULTS: Self-medication was practiced by 52.4% of the nursing mothers. The most used pharmacological classes were: analgesics/antipyretics (54.5%), non-steroidal anti-inflammatories (15%), spasmolytics (6.2%), laxatives (3.5%), benzodiazepines (3%), nasal decongestants (1.4%), and antibiotics (0.9%). The most used drugs were dipyrone (31.5%) and paracetamol (17.9%). The practice of self-medication was associated with a higher probability of the use of drugs posing the risk of adverse effects for the infant or for lactation (p = 0.000). However, the practice of self-medication was not associated with weaning (p = 0.135). CONCLUSIONS: The high rates of self-medication among nursing mothers and the use of drugs posing risks of undesirable effects for the infant and for lactation reveal the need for better education on the risks of self-medication by nursing mothers. However, self-medication was not proven to be a risk factor for weaning.

Fatores associados com a duração do aleitamento materno / Factors associated with duration of breastfeeding

OBJETIVOS: Determinar os índices de aleitamento materno exclusivo e complementado e identificar variáveis que interferem na prática da amamentação no município de Itaúna (MG). MÉTODOS: Estudo longitudinal realizado com 246 mulheres assistidas na maternidade do Hospital Manoel Gonçalves, no município de Itaúna (MG). O acompanhamento das mães e recém-nascidos foi realizado mensalmente nos primeiros 12 meses após o parto ou até a interrupção da amamentação. A análise da duração do aleitamento materno exclusivo e complementado foi realizada utilizando procedimentos de análise de sobrevivência. O efeito das co-variáveis sobre o tempo de aleitamento foi avaliado através do modelo de regressão de Cox. RESULTADOS: A prevalência de aleitamento materno exclusivo no sexto mês foi de 5,3 por cento, e de aleitamento materno aos 12 meses, 33,7 por cento. A mediana de aleitamento materno exclusivo foi de 40 dias, e a mediana de aleitamento materno, 237 dias. A análise multivariada mostrou associação negativa (p < 0,05) entre o tempo de aleitamento materno exclusivo e as variáveis: intenção de amamentar (< 12 meses), peso do recém-nascido (< 2.500 g) e uso de chupeta. O menor tempo de aleitamento materno foi associado (p < 0,05) com idade materna (< 20 anos), número de consultas de pré-natal (< 5 e > 9 consultas), uso de álcool ou tabaco, tempo da primeira mamada (> 6 horas) e uso de chupeta. CONCLUSÕES: Os índices de aleitamento materno no município de Itaúna (MG) estão muito abaixo daqueles preconizados pela Organização Mundial da Saúde. As principais variáveis relacionadas negativamente ao tempo de aleitamento materno exclusivo e complementado estão associadas à assistência materno-infantil, sendo, portanto, passíveis de intervenção.

OBJECTIVES: To determine rates of exclusive breastfeeding and of complementary feeding and to identify variables that interfere with breastfeeding in the municipality of Itaúna, MG, Brazil. METHODS: A longitudinal study was undertaken enrolling 246 women who gave birth at the maternity unit of the Manoel Gonçalves Hospital, in Itaúna, MG. The mothers and their infants were seen monthly for the first 12 months after birth or until they stopped breastfeeding. Survival analysis procedures were used to study the duration of exclusive breastfeeding and of complementary feeding. The impact on breastfeeding duration of a series of co-variables was assessed by means of Cox regression modeling. RESULTS: The prevalence of exclusive breastfeeding at 6 months was 5.3 percent, and for breastfeeding at 12 months it was 33.7 percent. The median duration of exclusive breastfeeding was 40 days, and median breastfeeding duration was 237 days. Multivariate analysis demonstrated a negative association (p < 0.05) between duration of exclusive breastfeeding and the following variables: intended breastfeeding duration (< 12 months), birth weight of child (< 2,500 g) and use of a pacifier. Shorter breastfeeding duration was associated (p < 0.05) with maternal age (< 20 years), number of prenatal consultations (< 5 and > 9 consultations), use of alcohol or tobacco, delay before first feed (> 6 hours) and use of a pacifier. CONCLUSIONS: Breastfeeding rates in Itaúna (MG) are well below those recommended by the World Health Organization. The principal variables with a negative relationship with duration of exclusive breastfeeding and of complementary feeding are related to mother and baby health care and, therefore, interventions are possible.