Systems Nutrology of Adolescents with Divergence between Measured and Perceived Weight Uncovers a Distinctive Profile Defined by Inverse Relationships of Food Consumption.

Changes in food consumption, physical inactivity, and other lifestyle habits are potential causes of the obesity epidemic. Paradoxically, the media promotes idealization of a leaner body appearance. Under these circumstances, self-perception of weight by adolescents may be affected. Here, we performed a cross-sectional study, between June and December 2009, to evaluate the interaction between anthropometric status, perceived body weight, and food consumption profiles in 1496 adolescents from public schools in Salvador, Brazil. Data on socio-epidemiological information, anthropometric status, and dietary patterns were analyzed using multidimensional statistical approaches adapted from systems biology. There were dissimilarities between anthropometric status and perception of body weight related to sex. Four dietary patterns were identified based on the food intake profile in the study participants. The distinct dietary patterns were not influenced by divergence between measured and perceived weight. Moreover, network analysis revealed that overestimation of body weight was characterized by a selectivity in ingestion of food groups that resulted in appearance of inverse correlations of consumption. Thus, misperception of body weight is associated with inverse correlations of consumption of certain food groups. These findings may aid individualized nutritional interventions in adolescents who overestimate body weight.

Multidimensional Analysis of Food Consumption Reveals a Unique Dietary Profile Associated with Overweight and Obesity in Adolescents.

There is a significant increase in overweight and obesity in adolescents worldwide. Here, we performed a cross-sectional study to examine the potential association between food consumption profiles and overweight in a large number of adolescents from Brazil. Sampling by clusters and conglomerates was carried out in students of public schools in Salvador, Brazil, between June and December 2009 and 1496 adolescents were evaluated. Data on socio-epidemiological data, anthropometric status and food consumption were captured. Multivariate analyses, such as hierarchical clustering and correlation networks, were used to perform a detailed description of food consumption profiles. There were differences in age and anthropometric status related to sex. Four clusters of food groups were identified based on the intake profile in the study population. No disparities in food intake were observed in individuals stratified by sex or anthropometric status. Furthermore, network analysis revealed that overweight or obesity were hallmarked by a selectivity in the ingestion of food groups that resulted in the appearance of inverse correlations of consumption, which was not present in eutrophic adolescents. Thus, overweight and obesity are associated with preferential choices of ingestion of specific food groups, which result in the appearance of inverse correlations of consumption. Such knowledge may serve as basis for future targeted nutritional interventions in adolescents.

Factors associated with body image dissatisfaction among adolescents in public schools students in Salvador, Brazil.

OBJECTIVE: To identify the prevalence of body image dissatisfaction and associated factors among students in Salvador, Brazil. METHODS: A cross-sectional study involving a random sample of 1,494 (852 girls and 642 boys) adolescents between 11 and 17 years of age who were students in the public schools in Salvador, Brazil. Participants completed the Body Shape Questionnaire and the Eating Attitudes Test-26. Body image was characterized as satisfactory or unsatisfactory. We obtained demographic, anthropometric and economic information and information regarding the stage of maturation, self-perception of body weight, and consumption of sweetened beverages and diet soft drinks. To identify associated factors we used Poisson regression analysis. RESULTS: Body image dissatisfaction was present in 19.5% of the adolescents, with a prevalence of 26.6% among the girls and 10% among the boys. Independent of sex, the prevalence of body image dissatisfaction was higher among adolescents who were overweight or obese (girls, PR: 1.38, CI: 1.09-1.73 and boys, PR: 2.26, CI: 1.08-4.75), higher among those who perceived themselves as fat (girls, PR: 2.85, CI: 2.07-3.93 and boys, PR: 3.17, CI: 1.39-7.23), and higher among those who had negative attitudes toward eating (girls, PR: 2.42, CI: 1.91-3.08 and boys, PR: 4.67, CI: 2.85-7.63).. A reduction in body image dissatisfaction was only identified among underweight girls (PR: 0.12, CI: 0.03-0.49). CONCLUSIONS: A high occurrence of body image dissatisfaction was observed among the adolescents, and biological and behavioral factors were associated with this dissatisfaction.

Objetivo: Identificar la prevalencia de insatisfacción corporal y factores asociados entre estudiantes de Salvador en Brasil. Métodos: Estudio transversal realizado en una muestra aleatoria de 1494 adolescentes (852 niñas y 642 niños) de entre 11 y 17 años de edad estudiantes de escuelas públicas en Salvador (Brasil). Los participantes completaron los cuestionarios: Cuestionario de La Figura Corporal y el Inventario de Actitudes Alimentarias. La imagen corporal pudo ser considerada satisfactoria o insatisfactoria. Se obtuvieron datos demográficos, antropométricos y económicos e información sobre la etapa de maduración sexual, la auto-percepción del peso corporal y el consumo de bebidas azucaradas y gaseosas. Para identificar los factores asociados se utilizó el análisis de regresión de Poisson. Resultados: La insatisfacción corporal estuvo presente en el 19,5% de los/as adolescentes, con una prevalencia del 26,6% entre las chicas y el 10% entre los chicos. Independientemente del sexo, la prevalencia de la insatisfacción corporal fue superior entre los/as adolescentes con sobrepeso u obesos (en las niñas, PR: 1,38, IC: 1,09-1,73 y en los niños, PR: 2,26, IC: 1,08-4,75), mayor entre los/as que percibían a sí mismos como "gordos" (en las niñas, PR: 2,85, IC: 2,07-3,93 y en los niños, PR: 3,17, IC: 1,39- 7,23), y entre los/as que tenían actitudes alimentarias negativas (en las niñas, PR: 2,42, IC: 1,91-3,08 y en los niños, PR: 4,67, IC: 2,85-7,63). Una reducción en la insatisfacción corporal se identificó sólo entre las niñas con bajo peso (RP: 0,12, IC: 0,03-0.49).Conclusiones: Se observó una alta ocurrencia de la insatisfacción corporal entre los adolescentes, y que factores biológicos y del comportamiento se asocian con dicha insatisfacción.

Factors associated with body image dissatisfaction among adolescents in public schools students in Salvador, Brazil / Los factores asociados con la insatisfacción corporal en adolescentes de escuelas públicas en Salvador, Brasil

OBJECTIVE: To identify the prevalence of body image dissatisfaction and associated factors among students in Salvador, Brazil. METHODS: A cross-sectional study involving a random sample of 1,494 (852 girls and 642 boys) adolescents between 11 and 17 years of age who were students in the public schools in Salvador, Brazil. Participants completed the Body Shape Questionnaire and the Eating Attitudes Test-26. Body image was characterized as satisfactory or unsatisfactory. We obtained demographic, anthropometric and economic information and information regarding the stage of maturation, self-perception of body weight, and consumption of sweetened beverages and diet soft drinks. To identify associated factors we used Poisson regression analysis. RESULTS: Body image dissatisfaction was present in 19.5% of the adolescents, with a prevalence of 26.6% among the girls and 10% among the boys. Independent of sex, the prevalence of body image dissatisfaction was higher among adolescents who were overweight or obese (girls, PR: 1.38, CI: 1.09-1.73 and boys, PR: 2.26, CI: 1.08-4.75), higher among those who perceived themselves as fat (girls, PR: 2.85, CI: 2.07-3.93 and boys, PR: 3.17, CI: 1.39-7.23), and higher among those who had negative attitudes toward eating (girls, PR: 2.42, CI: 1.91-3.08 and boys, PR: 4.67, CI: 2.85-7.63).. A reduction in body image dissatisfaction was only identified among underweight girls (PR: 0.12, CI: 0.03-0.49).CONCLUSIONS:A high occurrence of body image dissatisfaction was observed among the adolescents, and biological and behavioral factors were associated with this dissatisfaction (AU)

Objetivo: Identificar la prevalencia de insatisfacción corporal y factores asociados entre estudiantes de Salvador en Brasil. Métodos: Estudio transversal realizado en una muestra aleatoria de 1494 adolescentes (852 niñas y 642 niños) de entre 11 y 17 años de edad estudiantes de escuelas públicas en Salvador (Brasil). Los participantes completaron los cuestionarios: Cuestionario de La Figura Corporal y el Inventario de Actitudes Alimentarias. La imagen corporal pudo ser considerada satisfactoria o insatisfactoria. Se obtuvieron datos demográficos, antropométricos y económicos e información sobre la etapa de maduración sexual, la auto-percepción del peso corporal y el consumo de bebidas azucaradas y gaseosas. Para identificar los factores asociados se utilizó el análisis de regresión de Poisson. Resultados: La insatisfacción corporal estuvo presente en el 19,5% de los/as adolescentes, con una prevalencia del 26,6% entre las chicas y el 10% entre los chicos. Independientemente del sexo, la prevalencia de la insatisfacción corporal fue superior entre los/as adolescentes con sobrepeso u obesos (en las niñas, PR: 1,38, IC: 1,09-1,73 y en los niños, PR: 2,26, IC: 1,08-4,75), mayor entre los/as que percibían a sí mismos como “gordos” (en las niñas, PR: 2,85, IC: 2,07-3,93 y en los niños, PR: 3,17, IC: 1,39- 7,23), y entre los/as que tenían actitudes alimentarias negativas (en las niñas, PR: 2,42, IC: 1,91-3,08 y en los niños, PR: 4,67, IC: 2,85-7,63). Una reducción en la insatisfacción corporal se identificó sólo entre las niñas con bajo peso (RP: 0,12, IC: 0,03-0.49).Conclusiones: Se observó una alta ocurrencia de la insatisfacción corporal entre los adolescentes, y que factores biológicos y del comportamiento se asocian con dicha insatisfacción (AU)

Hypertriglyceridemic waist phenotype: association with metabolic abnormalities in adolescents.

OBJECTIVE: This study aimed to identify the prevalence of hypertriglyceridemic waist (HTW) phenotype, and to evaluate its association with metabolic abnormalities in adolescents of low socioeconomic status. METHOD: This was a cross-sectional study with a random sample of 1,076 adolescents between 11 and 17 years, of both genders, from public schools. The participants underwent anthropometric measurements (weight, height, and waist circumference), and levels of total cholesterol, low-density-lipoprotein cholesterol (LDL-C), high-density-lipoprotein cholesterol (HDL-C), non-HDL cholesterol, triglyceride (TG), and fasting glucose were measured. Information regarding the socioeconomic status of the participants' families was obtained. The HTW phenotype was defined by the simultaneous presence of increased waist circumference (≥ 90(th) percentile for age and gender) and serum triglyceride levels (≥ 100mg/dL). A logistic regression analysis was used to evaluate the associations of interest. RESULTS: The prevalence of HTW phenotype was 7.2% among the adolescents, being higher in the presence of obesity (63.4%) and high levels of non-HDL cholesterol (16.6%) and LDL-C (13.7%). The bivariate analysis indicated that, of the metabolic variables, only blood glucose was not associated with the HTW phenotype. Multivariate analysis adjusted for age and gender indicated that the HTW phenotype was positively associated with high non-HDL cholesterol (odds ratio: 7.0; 95% CI: 3.9-12.6) and low HDL-C levels (odds ratio: 2.7; 95% CI: 1.5-4.8). CONCLUSIONS: This study demonstrated that the HTW phenotype was associated with an atherogenic lipid profile, and this phenotype is suggested as a screening tool to identify adolescents with metabolic alterations.

Fenótipo cintura hipertrigliceridêmica: associação com alterações metabólicas em adolescentes / Hypertriglyceridemic waist phenotype: association with metabolic abnormalities in adolescents

OBJETIVO: O presente estudo objetivou identificar a prevalência do fenótipo cintura hipertrigliceridêmica (CHT) e avaliar sua associação com alterações metabólicas em adolescentes de baixa condição econômica. MÉTODO: Estudo transversal com amostra probabilística de 1.076 adolescentes entre 11 e 17 anos, de ambos os sexos, estudantes de escolas públicas. Os participantes foram submetidos à avaliação antropométrica (peso, altura e circunferência da cintura) e à dosagem dos níveis de colesterol total, LDL-C, HDL-C, colesterol não HDL, triglicérides (TG) e glicemia de jejum. Foram obtidas informações referentes às condições econômicas das famílias dos participantes.O fenótipo CHT foi definido pela presença simultânea da circunferência da cintura aumentada (> percentil 90 por idade e sexo) e dos níveis séricos de triglicérides elevados (> 100 mg/dL). A análise de regressão logística foi utilizada para avaliação das associações de interesse. RESULTADOS: A prevalência do fenótipo CHT foi de 7,2% entre os adolescentes, sendo mais elevada na presença de obesidade (63,4%), do colesterol não HDL (16,6%) e do LDL-C (13,7%) altos. A análise bivariada indicou que, das variáveis metabólicas, apenas a glicemia não se associou ao fenótipo CHT. A análise multivariada, ajustada por sexo e idade, indicou que o fenótipo CHT se associou positivamente com o colesterol não HDL alto (odds ratio, 7,0; IC 95% 3,9-12,6) e com o HDL-C baixo (odds ratio, 2,7; IC 95%, 1,5-4,8). CONCLUSÕES: Este estudo mostrou que o fenótipo CHT se associou com um perfil lipídico aterogênico e sugere esse fenótipo como uma ferramenta de screening que pode ser utilizada para identificar adolescentes com alterações metabólicas.

OBJECTIVE: This study aimed to identify the prevalence of hypertriglyceridemic waist (HTW) phenotype, and to evaluate its association with metabolic abnormalities in adolescents of low socioeconomic status. METHOD: This was a cross-sectional study with a random sample of 1,076 adolescents between 11 and 17 years, of both genders, from public schools. The participants underwent anthropometric measurements (weight, height, and waist circumference), and levels of total cholesterol, low-density-lipoprotein cholesterol (LDL-C), high-density-lipoprotein cholesterol (HDL-C), non-HDL cholesterol triglyceride (TG), and fasting glucose were measured. Information regarding the socioeconomic status of the participants' families was obtained. The HTW phenotype was defined by the simultaneous presence of increased waist circumference (> 90th percentile for age and gender) and serum triglyceride levels (> 100 mg/dL). A logistic regression analysis was used to evaluate the associations of interest. RESULTS: The prevalence of HTW phenotype was 7.2% among the adolescents, being higher in the presence of obesity (63.4%) and high levels of non-HDL cholesterol (16.6%) and LDL-C (13.7%). The bivariate analysis indicated that, of the metabolic variables, only blood glucose was not associated with the HTW phenotype. Multivariate analysis adjusted for age and gender indicated that the HTW phenotype was positively associated with high non-HDL cholesterol (odds ratio: 7.0; 95% CI: 3.9-12.6) and low HDL-C levels (odds ratio: 2.7; 95% CI: 1.5-4.8). CONCLUSIONS: This study demonstrated that the HTW phenotype was associated with an atherogenic lipid profile, and this phenotype is suggested as a screening tool to identify adolescents with metabolic alterations.

Biochemical and immunologic predictors of efficacy of treatment or reinfection risk for Schistosoma mansoni.

Most Schistosoma mansoni infections are egg-negative after a single dose of oxamniquine. A cohort of 661 infected children was treated at 6-month intervals and assessed for nutritional and parasitological status. Initial biochemical and immunologic markers were measured in a subset of 84 children. All were treated at the start of therapy and at 6 months. Immunoglobulins only served as markers for active infection. No markers were predictive of cure or reinfection, except initial infection intensity and serum low-density lipoprotein. Ten percent were persistently infected and had no change in infection intensity at any time-point. Several factors suggest that this group was biologically different. In addition to failing to reduce their worm burden, they had significantly higher initial intensity of infection (100 versus 65 eggs/g, P = 0.001) and significantly lower initial serum low-density lipoprotein (72 versus 104 mg/dL, P = 0.045). The biologic plausibility of this observation is discussed.

Moderate- and low-intensity co-infections by intestinal helminths and Schistosoma mansoni, dietary iron intake, and anemia in Brazilian children.

To determine the role of moderate- and low-intensity infections with Schistosoma mansoni and intestinal helminths (hookworm, Trichuris trichiura, Ascaris lumbricoides) on the prevalence of anemia and their relationship to iron consumption, a cross-section of 1,709 children in rural Brazil was studied. All participants were selected for infection with one or multiple helminthic parasites, and demographic, anthropometric, and dietary intake were surveyed. The prevalence and intensity were as follows: hookworm infection, 15.7% and 8.6 eggs/g; T. trichiura, 74.8% and 190.5 eggs/g; A. lumbricoides, 63% and 1,905.5 eggs/g; S. mansoni, 44.5% and 60.3 eggs/g. There was no increase in odds ratio for anemia with any combination of intestinal helminths without S. mansoni infection. By logistic regression, the odds ratio for having anemia when infected with S. mansoni and two intestinal helminths was 1.7 (95% CI, 1.1-2.5) and for S. mansoni and three intestinal helminths was 2.4 (95% CI, 1.2-4.6) compared with children with a single parasite species. Children with an adequate intake of iron had no increased odds of anemia independent of the combination of parasite infections.

Fatores de risco para anemia por deficiência de ferro em crianças e adolescentes parasitados por helmintos intestinais / Risk factors for iron-deficiency anemia in children and adolescents with intestinal helminthic infections

OBJETIVO: Investigar os fatores de risco para anemia por deficiência de ferro em crianças e adolescentes (7 a 17 anos) infectados por helmintos. MÉTODOS: Foi realizado um estudo transversal com 1709 crianças e adolescentes residentes na cidade de Jequié, Estado da Bahia, Brasil, que apresentavam infecçäo leve ou moderada por Schistosoma mansoni, Ascaris lumbricoides, Trichuris trichiura e ancilostomídeos. Foram obtidos dados sobre níveis de hemoglobina (hemoglobinômetro portátil), consumo alimentar (inquérito recordatório de 24 horas), infecçäo parasitária (método Kato-Katz), condiçöes ambientais e domiciliares, renda e escolaridade dos responsáveis. Os fatores de risco para anemia na populaçäo foram estudados com base em um modelo hierárquico de causalidade. RESULTADOS: A prevalência de infecçäo por T. trichiura, A. lumbricoides, S. mansoni e ancilostomídeos foi de 74,8, 63,0, 55,5 e 15,7 por cento, respectivamente. Constatou-se que 32,2 por cento das crianças e adolescentes eram anêmicos. Depois do ajuste para variáveis de confusäo, os resultados da análise multivariada mostraram que a renda familiar per capita abaixo de um quarto do salário mínimo (27 dólares), o sexo masculino, a faixa etária de 7 a 9 anos e a ingestäo inadequada de ferro biodisponível foram significativamente associados à anemia. CONCLUSÖES: As açöes para controle da anemia no grupo de maior risco, conforme identificado no presente estudo, devem visar o aumento do consumo de alimentos ricos em ferro e da biodisponibilidade do ferro ingerido, bem como a melhoria das condiçöes sócio-ambientais.

[Risk factors for iron-deficiency anemia in children and adolescents with intestinal helminthic infections]. / Fatores de risco para anemia por deficiência de ferro em crianças e adolescentes parasitados por helmintos intestinais.

OBJECTIVE: To investigate risk factors for iron-deficiency anemia in children and adolescents (7 to 17 years of age) with intestinal helminthic infections. METHODS: A cross-sectional study was carried out with 1 709 children and adolescents living in Jequié, a town in the state of Bahia, Brazil, who had mild to moderate infection by Schistosoma mansoni, Ascaris lumbricoides, Trichuris trichiura, or hookworms. We obtained data concerning hemoglobin levels (using a portable hemoglobinometer), dietary habits (24-hour dietary recall), parasitic infections (Kato-Katz method), sanitary conditions (water supply, sewage connection, garbage collection), housing conditions (type of construction, number of persons per room), income, and amount of schooling of the parents or guardians. The risk factors for anemia were studied based on a hierarchical model of causality. RESULTS: The prevalence of parasitic infection was 74.8% for T. trichiura, 63.0% for A. lumbricoides, 55.5% for S. mansoni, and 15.7% for hookworms. Among the children and adolescents studied 32.2% were anemic. After adjustment for confounding variables, the results of the multivariate analysis showed that the following variables were significantly associated with anemia: per capita family income below US$ 27 (equal to one fourth of the Brazilian minimum wage), male sex, age of 7 to 9 years, and inadequate intake of bioavailable iron. CONCLUSIONS: The initiatives to control anemia in the group at greatest risk, as identified in this study, should seek to increase the consumption of iron-rich foods, boost the bioavailability of the iron ingested, and improve socioenvironmental conditions.