Objetivou-se identificar a prevalência de sintomas de anorexia nervosa e de insatisfação com a imagem corporal em adolescentes (sexo feminino) de Florianópolis, Santa Catarina, Brasil. A amostra foi proporcional, estratificada conforme rede escolar (pública/privada) e região sócio-geográfica, posteriormente distribuída no ensino fundamental e médio. Foram analisadas 1.148 adolescentes sorteadas aleatoriamente nos estratos. A presença de sintomas de anorexia nervosa (EAT+) foi identificada pelo Teste de Atitudes Alimentares e a avaliação da imagem corporal pelo Questionário de Imagem Corporal. As prevalências de EAT+ e insatisfação com a imagem corporal foram 15,6% e 18,8%. O EAT+ apresentou-se associado à faixa de 10-13 anos (OR = 1,542; p = 0,046); sobrepeso e obesidade (OR = 2,075; p < 0,001); insatisfação com a imagem corporal (OR = 14,392; p < 0,0001) e rede pública (OR = 1,423; p = 0,041). A regressão logística múltipla apontou a insatisfação com a imagem corporal como a variável independente de maior risco para a manifestação dos sintomas (OR = 16,7; p < 0,001). Pode-se concluir que as adolescentes em Florianópolis apresentam índices de EAT+ semelhantes àqueles observados em outras regiões brasileiras.
Background/Aims: Protein-energy malnutrition remains a major public health problem in many countries. Scanty information is available about the effects of malnutrition during childhood on blood pressure (BP). Methods: In a cross-sectional study we assessed the BP of 172 children older than 2 years living in shantytowns in São Paulo city. Ninety-one children were malnourished (height-for-age or weight-for-age Z-score below –1 of the NCHS references); 20 had recovered from malnutrition after an average time of 6.4 years, and 61 were non-malnourished controls. Results: A greater percentage of children in the malnourished and recovered groups had increased systolic or diastolic BP (>95th percentile of the Update of the 2nd Task Force references) after adjusting for age, sex and height, compared to the controls (29, 20 and 2%, respectively, p < 0.001). Mean diastolic BP, adjusted for age, sex, race, weight, height and birth weight, was significantly increased in malnourished and recovered children compared to controls (65.2 ± 0.6, 66.5 ± 1.5, and 61.8 ± 0.8 mm Hg, respectively, p < 0.01). Conclusions: BP is increased in malnourished children and in those who recovered from malnutrition after an average period of 6 years. Malnutrition occurring during childhood may represent a risk factor for increased BP later in life.
It is estimated that over 51 million people in Brazil live in slums, areas where a high prevalence of malnutrition is also found. In general, the population of 'slum dwellers' is growing at a faster rate than urban populations. This condition is associated with poor sanitation, unhealthy food habits, low birthweight, and stunting. Stunting is of particular concern as longitudinal and cross-sectional studies of stunted adolescents have shown a high susceptibility to gain central fat, lower fat oxidation, and lower resting and postprandial energy expenditure. In addition, higher blood pressure, higher plasma uric acid and impaired flow-mediated vascular dilation were all associated with a higher level of hypertension in low birthweight and stunted children. In particular, stunted boys and girls also showed lower insulin production by pancreatic beta cells. All these factors are linked with a higher risk of chronic diseases later in life. Among stunted adults, alterations in plasma lipids, glucose and insulin have also been reported. However, adequate nutritional recovery with linear catch-up growth, after treatment in nutritional rehabilitation centers, can moderate the alterations in body composition, bone density and insulin production.
Among the causes of obesity, environmental factors have also been studied, in addition to genetic, social, psychological, and hormonal factors. The distribution of food outlets, facilitating or hindering food acquisition, can promote body weight control by encouraging healthier food habits. The objective of this study was to investigate associations between environmental availability and utilization of food outlets and overweight/obesity in 7 to 14-year-old schoolchildren in Florianópolis, in the South of Brazil. A logistic regression analysis identified a positive association between overweight/obesity in 2195 schoolchildren and the presence of restaurants in the vicinity of their homes (buffer = 400 meters). Being a member of a family that utilizes public markets/greengrocers was also positively associated with overweight/obesity in the sample investigated. Identifying the distribution of these establishments in the vicinity of the homes of schoolchildren in middle-income countries is an important element in understanding the role played by the food environment in weight gain in a variety of different settings.
Factors associated with obesity differ between men and women. The prevalence of obesity was higher in women and it was associated with low income and elderly.
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