The aims of this study were to identify dietary patterns (DPs) of children and adolescents participating in three cross-sectional surveys (2013–2015) and to test their associations with sociodemographic variables, physical activity (PAS), screen-based sedentary activity (SA), and weight status. One-day data were obtained from 5,364 schoolchildren (7–12 years) from public schools of Florianopolis (South of Brazil), using the validated questionnaire Web-CAAFE (Food Intake and Physical Activity of Schoolchildren). DPs were derived from the frequency of daily consumption of 32 foods/beverages by latent profile analysis. Multinomial logistic regression analysis was used to estimate the association of the DPs with sociodemographic variables, physical activity, screen activity and weight status. ‘Traditional’, ‘Monotonous’, and ‘Mixed’ DPs were identified. The percentages of children and adolescents within these profiles were 41.3, 36.3, and 22.4%, respectively. Children and adolescents in the highest tertiles of both PAS and daily frequency of SA had a higher probability to present a ‘Mixed’ DP compared to peers with less PAS and SA. Children and adolescents who reported having a school meal were significantly more likely to present the ‘Traditional’DP, while boys who did not report having a school meal had a higher probability to present the ‘Monotonous’ DP. The DPs were not associated with the year of survey, age, family income, or weight status.
Several studies reported that the timing of eating events has critical implications in the prevention of obesity, but dietary patterns regarding the time-of-day have not been explored in children. The aim of this study was to derive latent food patterns of daily eating events and to examine their associations with overweight/obesity among schoolchildren. A population-based cross-sectional study was conducted with 7-10-year-old Brazilian schoolchildren (n 1232) who completed the Previous Day Food Questionnaire, illustrated with twenty-one foods/beverages in six daily eating events. Latent class analysis was used to derive dietary patterns whose association with child weight status was evaluated by multivariate multinomial regression. Four mutually exclusive latent classes of dietary patterns were identified and labelled according to the time-of-day of eating events and food intake probability (FIP): (A) higher FIP only at lunch; (B) lower FIP at all eating events; (C) higher FIP at lunch, afternoon and evening snacks; (D) lower FIP at breakfast and at evening snack, higher FIP at other meals/snacks. The percentages of children within these classes were 32·3, 48·6, 15·1 and 4·0 %, respectively. After controlling for potential confounders, the mean probabilities of obesity for these classes were 6 % (95 % CI 3·0, 9·0), 13 % (95 % CI 9·0, 17·0), 12 % (95 % CI 6·0, 19) and 11 % (95 % CI 5·0, 17·0), in the same order. In conclusion, the children eating traditional lunch with rice and beans as the main meal of the day (class A) had the lowest obesity risk, thus reinforcing the importance of both the food type and the time-of-day of its intake for weight status.
ObjetivoIdentificar o estado nutricional, segundo o índice de massa corporal, e fornecer informações sobre medidas antropométricas de idosos institucionalizados no município de Florianópolis (SC). MétodosEstudo transversal, no qual a população em estudo foi composta por 232 idosos, com idade a partir de 60 anos, residentes em instituições geriátricas do município de Florianópolis (SC). A avaliação antropométrica foi realizada obtendo-se o valor do índice de massa corporal, da prega cutânea triciptal e da circunferência da panturrilha. O diagnóstico do estado nutricional foi realizado utilizando-se os pontos de corte preconizados pela Organização Pan-Americana de Saúde para índice de massa corporal. Os dados são apresentados sob a forma de média e desvio-padrão. Foi realizado o teste t de Student para verificar a diferença entre os valores médios das variáveis entre os sexos. ResultadosA amostra constituiu-se de 167 idosos de ambos os sexos. Encontrou-se uma prevalência de 45,5% de baixo peso, 33,5% de peso normal, 7,8% de pré-obesidade e 13,2% de obesidade. Para todas as variáveis antropométricas, o valor médio das mulheres foi superior ao dos homens. ConclusãoOs resultados encontrados indicaram a prevalência de 66,5% da amostra com estado nutricional inadequado, evidenciando a necessidade de medidas de promoção ou reabilitação da saúde dos idosos. Os dados mostram
The aim of this study was to determine the contribution of individual and school characteristics to the variability in body mass index (BMI) z-scores of 7 to 10 years old children. Anthropometric and sociodemographic data from two cross-sectional studies conducted with schoolchildren from the 2nd to the 5th grades of elementary schools were analyses (n = 2,936 in 2002, and n = 1,232 in 2007). Multilevel modeling was used to estimate variations in BMI at child and school levels. The contribution of the school context to the overall variability of BMI z-score was small but significant in 2002 (3.3%-4.4%) and in 2007 (2.4%-5.3%), showing that schoolchildren from private schools had a higher BMI compared to those from public schools. The monthly family income showed, in general, a negative association with BMI z-score in 2002 and a positive association in 2007, for both sexes. The consumption of sweets showed a negative effect in the BMIs of children. In both surveys, overweight/obese mothers and excessive birth weight were positively associated with BMI z-score. Mother's weight status had a higher influence on the overall variability of BMI in both surveys. In conclusion, school and child characteristics contributed to the variance in children's weight status. The results imply that overweight/obesity childhood prevention programs should focus on strategies of family engagement to be more effective.
Objective: To estimate reporting bias of WebCAAFE, a web-based questionnaire for the assessment of food intake (recall of frequency of intake of thirty-two food items the day before) and physical activity in schoolchildren. Design: Cross-sectional study. Self-reported food intake on WebCAAFE was compared with direct observation of school meals in five public schools. Additional data included school grade, sex, BMI, socio-economic status and access to Internet at home. Poisson regression was used to calculate the reporting bias (WebCAAFE v. direct observation) and the sample size necessary to detect a statistically significant difference between WebCAAFE reports and at least 75 % compliance with the recommendations for a healthy diet. Setting: Intentional sample of five elementary public schools in Florianopolis, Brazil. Subjects: Schoolchildren (n 629) from 2nd to 5th grades. Results: Moderate bias magnitude was found for most food groups of interest. Frequency of consumption was not related to the bias. Sample sizes necessary to detect the compliance with dietary recommendations varied between four and seventy-four individuals for the different groups investigated. Conclusions: After adjusting for moderate bias, WebCAAFE may be used as a food questionnaire for evaluation of schoolchildren's food compliance on a group level, even with a relatively small sample size. The Strategic Action Plan to Tackle Non-Communicable Chronic Diseases in Brazil, 2011Brazil, -2022 , launched by the Ministry of Health in 2010, defined and prioritized actions and investments necessary to address non-communicable diseases in the next 10 years based on three principles: (i) surveillance, information, evaluation and monitoring; (ii) health promotion; and (iii) integral care. The aim is to diminish obesity rates in 5-9-year-old children and adolescents and to halt the rise of obesity in adults (≥18 years old) (1,2) . In Brazil, there are surveillance systems for adolescents (3) and adults (4) but none for 5-9-year-old-children whose overweight (including obesity) prevalence tripled between 1974 and 2009, from 11 % to over 33 % (5) . Therefore it is necessary to develop surveillance and monitoring systems to determine compliance with the obesity prevalence targets for 5-9-year-old children, set at 8 % for boys and 5 % for girls (2) .Periodic population-based surveys are the principal source of time trends in nutritional status and associated lifestyle factors such as diet and physical activity. Monitoring these parameters over the past decades has shown a dramatic increase in excess weight worldwide, especially in younger generations and children (6)(7)(8) . In many countries, the number and complexity of survey items covering these issues have also increased, incurring higher costs (9) . To strike the right balance between the rising costs and a growing need to update our knowledge on population diet and physical activity, it is of utmost importance to clarify what sort of decision could be made on the basis of such surveys an...
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