BackgroundObesity is growing at an alarming rate in Latin America. Lifestyle behaviours such as physical activity and dietary intake have been largely associated with obesity in many countries; however studies that combine nutrition and physical activity assessment in representative samples of Latin American countries are lacking. The aim of this study is to present the design rationale of the Latin American Study of Nutrition and Health/Estudio Latinoamericano de Nutrición y Salud (ELANS) with a particular focus on its quality control procedures and recruitment processes.Methods/DesignThe ELANS is a multicenter cross-sectional nutrition and health surveillance study of a nationally representative sample of urban populations from eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Perú and Venezuela). A standard study protocol was designed to evaluate the nutritional intakes, physical activity levels, and anthropometric measurements of 9000 enrolled participants. The study was based on a complex, multistage sample design and the sample was stratified by gender, age (15 to 65 years old) and socioeconomic level. A small-scale pilot study was performed in each country to test the procedures and tools.DiscussionThis study will provide valuable information and a unique dataset regarding Latin America that will enable cross-country comparisons of nutritional statuses that focus on energy and macro- and micronutrient intakes, food patterns, and energy expenditure.Trial RegistrationClinical Trials NCT02226627
When compared to the French-Canadian sample of Demirjian, Brazilian males and females were 0.681 years and 0.616 years, respectively, more advanced in dental maturity. There was no significant correlation between dental maturity and body mass index.
RESUMOO objetivo deste estudo populacional foi verificar as prevalências de sobrepeso e obesidade em escolas públicas e particulares da cidade de Santos, SP. Foram avaliadas crianças de 7 a 10 anos de idade, num total de 10.822 crianças. Para a determinação de sobrepeso e obesidade foram utilizados, respectivamente, os percentis 85 e 95 do IMC por idade propostos pelos Centers for Disease Control and Prevention -CDC (2000). As prevalências totais de sobrepeso e obesidade foram de 15,7% (IC 95%= 15,0% a 16,4%) e 18,0% (17,3% a 18,7%), respectivamente. A prevalência de sobrepeso foi de 13,7% (12,6% a 14,8%) nos meninos e 14,8% (13,7% a 15,9%) nas meninas das escolas públicas. Nas escolas particulares, foi de 17,7% (15,7% a 19,7%) nos meninos e 22,2% (20,0% a 24,4%) nas meninas. A obesidade foi prevalente em 16,9% (15,7% a 18,1%) dos meninos e 14,3% (13,2% a 15,4%) das meninas das escolas públicas. Nas escolas particulares, 29,8% (27,4% a 32,2%) dos meninos e 20,3% (18,2% a 22,4%) das meninas foram diagnosticados como obesos. Concluímos que a prevalência de obesidade é superior à de estudos nacionais e latino-americanos. Escolas privadas apresentaram prevalên-cia de obesidade maior que escolas públicas (p= 0,001). The aim of this population-based study was to estimate the prevalence of overweight and obesity in public and private schools of Santos city, Brazil. We evaluated a total of 10,822 children aged 7 to 10 years old. Determination of overweight and obesity was obtained by the 85 th and 95 th percentiles of BMI for age, respectively, as proposed by CDC in 2000. The overall prevalence rates of overweight and obesity were 15.7% (CI 95%= 15.0% to 16.4%) and 18.0% (17.3% to 18.7%), respectively. The prevalence of overweight was 13.7% (12.6% a 14.8%) in boys and 14.8% (13.7% a 15.9%) in girls of public schools. In private schools, the rates were 17.7% (15.7% to 19.7%) in boys and 22.2% (20.0% to 24.4%) in girls. Obesity was found in 16.9% (15.7% to 18.1%) of the boys and 14.3% (13.2% to 15.4%) of the girls of public schools. In the private schools, 29.8% (27.4% to 32.2%) of the boys and 20.3% (18.2% to 22.4%) of the girls were obese. We concluded that the prevalence of obesity in public and private schools in the city of Santos is higher than other studies conducted in Brazil and in other countries of Latin America. Private schools showed higher prevalence rates of obesity than public schools (p= 0.001).
Overweight and obesity in youth is a worldwide public health problem. Overweight and obesity in childhood and adolescents have a substantial effect upon many systems, resulting in clinical conditions such as metabolic syndrome, early atherosclerosis, dyslipidemia, hypertension and type 2 diabetes (T2D). Obesity and the type of body fat distribution are still the core aspects of insulin resistance and seem to be the physiopathologic links common to metabolic syndrome, cardiovascular disease and T2D. The earlier the appearance of the clustering of risk factors and the higher the time of exposure, the greater will be the chance of developing coronary disease with a more severe endpoint. The age when the event may occur seems to be related to the presence and aggregation of risk factors throughout life.The treatment in this age-group is non pharmacological and aims at promoting changes in lifestyle. However, pharmacological treatments are indicated in special situations.The major goals in dietary treatments are not only limited to weight loss, but also to an improvement in the quality of life. Modification of risk factors associated to comorbidities, personal satisfaction of the child or adolescent and trying to establish healthy life habits from an early age are also important. There is a continuous debate on the best possible exercise to do, for children or adolescents, in order to lose weight. The prescription of physical activity to children and adolescents requires extensive integrated work among multidisciplinary teams, patients and their families, in order to reach therapeutic success.The most important conclusion drawn from this symposium was that if the growing prevalence of overweight and obesity continues at this pace, the result will be a population of children and adolescents with metabolic syndrome. This would lead to high mortality rates in young adults, changing the current increasing trend of worldwide longevity. Government actions and a better understanding of the causes of this problem must be implemented worldwide, by aiming at the prevention of obesity in children and adolescents.
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