The global increase of the excess weight within the population has been demanding governmental actions aimed at preventing health impacts generated by obesity. Over recent years, many Latin American countries have established a number of regulations aimed at reducing weight in the population using interventions that could effectively prevent childhood obesity, including the taxation of sugar-sweetened beverages (SSBs), increasing physical activity in open spaces, and, especially, front-of-package labeling. Some strategies are part of the Action Plan for Prevention of Child and Adolescence Obesity signed by all countries in Latin America, which currently have among the highest prevalence of childhood obesity in the world. Among them are the implementation of fiscal policies on energy-dense and nutrient-poor foods and taxes on SSBs; improvements in nutrition labeling, highlighting the front-of-package (FOP) labeling to promote the choice of healthier products at the time of purchase; and promotion of an active lifestyle, such as encouraging the use of bicycle paths or physical activity programs at school. The real impact of these prevention strategies implemented in Latin America on the prevalence of obesity is still unknown.

SumárioA síndrome metabólica (SM) tem gerado enormes controvérsias, a iniciar-se pela terminologia. O próprio autor que sugeriu o termo, Gerald Reaven, recomenda que não o utilizemos, porque, como a síndrome é um apanhado de alterações metabólicas e três dessas alterações podem defini-la, fica sempre difícil saber-se a que conjunto de alterações estamos nos referindo quando conotamos o termo SM. Em crianças, a complicação é ainda maior, já que se fazem diferentes adaptações aos critérios propostos para adultos. De qualquer forma, independentemente da terminologia, os riscos cardiovasculares são bem estabelecidos e fica cada vez mais claro que as crianças, já em tenra idade, podem começar a ter alterações metabólicas preditivas de problemas mais sérios futuramente. Assim, o papel do endocrinologista pediátrico e do pediatra geral é de investigar essas crianças, especialmente se portadoras de sobrepeso ou obesidade, para detectar precocemente e intervir em condições que podem ser prevenidas na vida adulta. Essa é uma nova visão de uma abordagem pediátrica preventiva de problemas que, usualmente, só são diagnosticados em vida adulta. Nesta revisão, abordamos os aspectos de definição, epidemiologia, fisiopatologia e de complicações da SM em crianças e adolescentes.Arq Bras Endocrinol Metab. 2011;55(8):576-82 Descritores Síndrome metabólica; dislipidemia; resistência à insulina; hipertensão arterial sistêmica; esteatose hepática; índice de massa corpóreo SummArYMetabolic syndrome (MS) has been a condition involved in considerable controversy, starting with the terminology. Gerald Reaven himself, the author who proposed the term MS, advised against the use of this terminology because the definition implies in at least three metabolic alterations, and it is never clear to which group of alterations we are referring to when we say that a patient has MS. In children, the problem is even more complicated, since there are many different adaptations to the criteria used in adults. On the other hand, independent of the terminology, cardiovascular risks are well-established and it is very clear that even children may present metabolic disturbances which predict future metabolic problems. The role of the pediatric endocrinologist or the general pediatrician is to investigate, especially in overweight/ obese children, conditions that if treated early, may prevent future complications that today, unfortunately, are being diagnosed only in adult life. In this review, we discuss problems on the definition, epidemiology, pathophysiology, and complications of MS in children and adolescents. Arq Bras Endocrinol Metab. 2011;55(8):576-82

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