RESUMO
The double burden of malnutrition (DBM) is a condition in which malnutrition coexists with overweight, reflecting a new layer of malnutrition. Our objectives were to assess prevalence; test associations between DBM and 24-hour movement behaviors; and investigate whether DBM is associated with clusters of social determinants. Methods: This multicenter cross-sectional study included 1152 adolescents (12 to 17 years old) from four Brazilian cities. Body mass index (BMI, kg/m2) was used to estimate overweight, and the adopted cutoff points took into account the curves established for age and sex: Z-score > 1 and ≤2 (overweight) and Z-score > 2 (obesity). The serum concentration of 25-hydroxyvitamin D [25(OH)D] was stratified into three levels: vitamin D deficiency ≤ 20 ng/mL; vitamin D insufficiency = 21-29 ng/mL; optimal vitamin D ≥ 30 ng/mL. We used multilevel Poisson regression models to estimate prevalence ratios (PRs) and their respective 95% confidence intervals (95%CI) and to analyze the association between DBM and covariates. A significance level of p < 0.05 was considered. Cluster analyses were performed by applying a combination of hierarchical and non-hierarchical methods. Results: A population prevalence of DBM of 7.3% (95% CI: 5.9-8.9) was revealed. A percentage of 19.2% (95% CI: 17.0-21.6) of adolescents were overweight, and 8.3% (95% CI: 6.8-10.1) were obese. A total of 41.5% (95% CI: 38.7-44.4) had vitamin D deficiency, and 25.8% (95% CI: 23.4-28.4) had vitamin D insufficiency. However, 24-hour movement behaviors were not associated with DBM. Adolescents living in the southern region of the country, from public schools whose mothers have higher education, have a 1.94 [PR = 2.94 (95% CI: 1.20-7.23)] times greater chance of developing DBM. These results highlight the importance of specific factors to improve the nutritional health of adolescents, considering the specific social determinants identified in this study.
RESUMO
Sleep restriction in children can trigger the development of problems such as impaired cognition, behavioral problems, cardiovascular problems, and obesity. In addition, the inflammatory profile of children can also be influenced by sleep restriction. The aimed to review and analyze the association between time and sleep quality with inflammatory biomarkers in children and adolescents. Three electronic databases (MEDLINE, Web of Science and Scopus) were searched from August 30, 2022. The search strategy used the following descriptors: children and adolescents; sleep, and inflammatory profile. This review protocol is registered in the PROSPERO database (CRD42020188969). We obtained 2.724 results of articles with potentially relevant titles. Sixteen percent of the articles were excluded because they were duplicates, 84.3% were excluded after reading the title, and 0.9% were studied from systematic reviews or textbooks (0.9%). Accelerometers are the most commonly used method for the objective measurement of sleep time, while the PSQI questionnaire is the most commonly used subjective method to measure sleep quality. The results indicated an inconsistent association between sleep time and CRP in the literature. Sixty percent of studies used the Pittsburgh Sleep Quality Index (PSQI) for subjective assessment of sleep quality and possible sleep disorders. However, only one retrieved study showed significant association between sleep quality and CRP. Thus, sleep time does not present significant association with inflammatory biomarkers; whereas, poor sleep quality shows positive association with CRP with a lower magnitude.
RESUMO
O objetivo do estudo foi avaliar as alterações, após um programa de exercícios aquáticos, dos parâmetros antropométricos e de qualidade de vida relacionada à saúde (QVRS) em crianças com sobrepeso ou obesidade. Trata-se de um ensaio clínico não-randomizado e controlado realizado na cidade de Uberaba, Minas Gerais com participação de 33 crianças com média de idade de 9,10 ± 1,00 anos, de ambos os sexos. As crianças foram alocadas em grupo controle (GC, n = 21) e grupo experimental (GE, n = 12). O GE realizou 21 semanas de exercícios aquáticos de caráter aeróbio recreativo, 54 sessões de 60 minutos cada. No baseline e pós-intervenção, foram avaliados massa corporal, estatura, IMC e QVRS por meio do Questionário Pediátrico de Qualidade de Vida (Pedsql versão 4.0). Observou-se efeito significativo do tempo no aspecto emocional da QVRS relatada pelos filhos (p = 0,009), houve redução dos escores do GE e aumento nos escores do GC. Na dimensão atividade escolar houve tendência para interação tempo*grupo (p = 0,059), em que observamos redução dos escores no GE e aumento no GC após 21 semanas. Em relação à antropometria e QVRS relatada pelos pais, não foram observadas diferenças significativas em ambos os grupos. Em conclusão, houve alterações significativas na dimensão emocional relatado pelas crianças, porém, a intervenção não alterou significativamente a antropometria e demais dimensões da QVRS de crianças com sobrepeso ou obesidade
The aim of this study was to evaluate the changes in anthropometric parameters and health-related quality of life (HRQoL), post aquatic program intervention among overweight and obese children. This non-ran-domized controlled clinical trial was performed in Uberaba, Minas Gerais with 33 children, mean age of 9.10 ± 1.00 years, of both sex. Children were allocated in control group (CG; n = 21) and experimental group (EG; n = 12). The EG performed 21 weeks of the aerobic recreative aquatic exercise, 54 sessions each 60 minutes. At baseline and post intervention, body mass, height, BMI and the HRQoL by Pediatric Quality of life Inventory (Pedsql version 4.0) were assessed. A significant time effect in the emotional aspect to HRQL reported by children (p = 0.009) was observed, that is, there was a score reduction in EG and a score increase in CG. There was tendency to time*group interaction effect (p = 0.059) for the school activities dimension, with a score reduction in EG and score increase in CG after 21 weeks. No significant change was observed in the anthropometry or HRQL reported by parents in both groups. In conclusion, there was significant change in emotional dimension reported by children, however, the intervention did not significantly change the anthropometry and other HRQoL dimensions in overweight or obesity of children