Objetivo: O objetivo do presente estudo foi investigar os determinantes associados ao estado nutricional dos alunos, com idade de 7 a 10 anos, das escolas da rede pública estadual de Porto Alegre, Rio Grande do Sul. Materiais e métodos: Trata-se de um estudo transversal com 574 escolares. O estado nutricional foi determinado a partir do Índice de Massa Corporal (segundo o escore-z da referência da Organização Mundial da Saúde, 2007. Foi realizada análise descritiva, bivariada e multivariada de regressão de Poisson para avaliar fatores independentemente associados ao excesso de peso. Resultados: A prevalência de excesso de peso foi de 37,1% para ambos os sexos. Na análise de regressão de Poisson foi possível identificar que a circunferência da cintura, baixo escore de atividade física, não tomar café da manhã, realizar um número maior de refeições diárias e ter um percentual de refeições com alimentos não saudáveis, acima de 50% das refeições totais do dia, são preditores (p<0,05) para o risco de sobrepeso e obesidade. Conclusão: As prevalências de sobrepeso e obesidade da população estudada encontram-se elevadas e essas evidências reforçam a importância de uma maior atenção das gestões de políticas públicas de atendimento à criança.

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Background and aimsEarly child interventions focused on the family prevented neurodevelopmental and behavioral delays and can provide more knowledge regarding responsive feeding, thus creating learning opportunities to promote better quality nutrition and preventing failure to thrive. The aim is to verify the impact of a continuous program of early home-based intervention on the body composition of preschool infants who were born preterm with very low birth weight (VLBW).MethodsThis is a longitudinal analysis from a randomized controlled trial, including VLBW preterm children, born in a tertiary hospital in Southern Brazil and followed up at the high-risk institutional ambulatory clinic. Participants were divided into the intervention group (IG): skin-to-skin care with the mother (kangaroo care), breastfeeding policy, and tactile-kinesthetic stimulation by mothers until hospital discharge. Subsequently, they received a program of early intervention with orientation and a total of 10 home visits, independently from the standard evaluation and care that was performed following the 18 months after birth; conventional group (CG): standard care according to the routine of the newborn intensive care unit (NICU), which includes kangaroo care, and attending to their needs in the follow-up program. Body composition estimation was performed using bioelectrical impedance analyses (BIA), and physical activity and feeding practices questionnaires were evaluated at preschool age, as well as anthropometric measurements and biochemical analysis.ResultsData of 41 children at 4.6 ± 0.5 years old were evaluated (CG n = 21 and IG n = 20). Body weight, height, body mass index, waist and arm circumferences, and triceps and subscapular skinfold did not differ between groups. The IG presented higher segmented fat-free mass (FFM) when compared to the CG (right arm FFM: 0.74 vs. 0.65 kg, p = 0.040; trunk FFM: 6.86 vs. 6.09 kg, p = 0.04; right leg FFM: 1.91 vs. 1.73 kg, p = 0.063). Interaction analyses showed that segmented FFM and FFM Index were associated with higher iron content in the IG. In the CG, interaction analyses showed that increased visceral fat area was associated with higher insulin resistance index.ConclusionAn early intervention protocol from NICU to a home-based program performed by the mothers of VLBW preterm children of low-income families presents a small effect on FFM.