Objective: To analyze associations between health-related physical fitness and the anthropometric and demographic indicators of children at three elementary schools in Botucatu, SP, Brazil. Methods:The sample for this cross-sectional study was 988 elementary school students, recruited from the second to ninth grades (an age range of 7 to 15 years). The children underwent anthropometric assessment (weight, height, waist circumference and tricipital and subscapular skin folds) and were tested for health-related physical fitness (flexibility: sit and reach test; abdominal strength/stamina: 1-minute abdominal test; and aerobic stamina: 9-minute running/walking test). Data were analyzed using descriptive statistics plus Student's t test, the chi-square test or Fisher's exact test and logistic regression with a significance level of 5%. Results:The physical fitness levels observed were significantly influenced by age (all levels), sex (abdominal strength/stamina), obesity (all levels), body adiposity (flexibility, abdominal strength/stamina) and abdominal adiposity (abdominal strength/stamina and aerobic stamina). Females were more prone to be unfit in abdominal strength/stamina. Both obesity and excessive abdominal adiposity predisposed children to be unfit in abdominal strength/stamina and aerobic stamina. Excess body adiposity increased the likelihood of poor trunk flexibility. Conclusions:Unhealthy physical fitness levels were related to female sex, obesity and excessive abdominal adiposity. Implementing programs designed to effect lifestyle changes to achieve physical fitness and healthy nutrition in these schools would meet the objectives of promoting healthy body weight and increased physical fitness among these schoolchildren.J Pediatr (Rio J). 2010;86(6):497-502: Child, adolescent, nutritional status, healthcare in schools. ResumoObjetivo: Analisar a associação da aptidão física relacionada à saúde com os indicadores demográficos e antropométricos de crianças de três escolas do município de Botucatu (SP). Métodos:A amostra deste estudo transversal foi de 988 escolares do ensino fundamental, do 2º ao 9º ano (faixa etária de 7 a 15 anos). As avaliações realizadas foram antropométricas (peso, estatura, circunferên-cia abdominal e dobras cutâneas tricipital e subescapular) e de aptidão física relacionada à saúde (flexibilidade: teste de sentar e alcançar; força/resistência abdominal: teste abdominal em 1 minuto; e resistência aeróbia: teste de correr/andar por 9 minutos). Para a análise dos dados, utilizou-se estatística descritiva, teste t de Student, qui-quadrado ou exato de Fisher e regressão logística com nível de significância de 5%. Resultados:As aptidões físicas estudadas foram significativamente influenciadas por idade (todas), sexo (força/resistência abdominal), obesidade (todas), adiposidade corpórea (flexibilidade, força/resistên-cia abdominal) e adiposidade abdominal (força/resistência abdominal e resistência aeróbia). O sexo feminino mostrou-se mais propenso à inaptidão de força/resistência a...

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ÍNDICE DE ALIMENTAÇÃO SAUDÁVEL ADAPTADO | 545Rev. Nutr., Campinas, 21(5):545-552, set./out., 2008 Revista de Nutrição ORIGINAL | ORIGINAL 1 Artigo elaborado a partir da dissertação de J.F. MOTA, intitulada "Determinantes antropométricos, dietéticos, bioquímicos e físicos (aptidões aeróbia e muscular) da resistência insulínica". Programa

5Professor titular da FMB-Unesp e coordenador do CeMENutri. Botucatu, SP, Brasil RESUMOObjetivo: Revisar estudos que abordam as práticas alimentares atuais e o padrão de atividade física como contribuintes do excesso de peso na infância.Fontes de dados: Ovid Journals, Highwire e SciELO, com seleção de artigos originais e de revisão nos últimos dez anos (1997 a 2007), na língua portuguesa e inglesa.Síntese de dados: O acompanhamento do estado nutricional de crianças permite diagnosticar seu estado de saúde atual, bem como predizer parcialmente seu prognóstico na vida adulta. A prevalência de obesidade infantil, no Brasil, apresenta aumento progressivo em todas as classes sociais e sua freqüência varia entre cinco a 18%, dependendo da região estudada. A associação da transição epidemiológica, demográfica e comportamental e a alteração do hábito alimentar são apontadas como fatores causais do aumento progressivo da obesidade infantil. Práticas alimentares caracterizadas por elevado teor de lipídios, sacarose e sódio e por reduzido consumo de cereais integrais, frutas e hortaliças associadas à inatividade física decorrente do uso de computadores, jogos eletrônicos e televisores influenciam parte considerável de crianças. Este estilo de vida reflete os hábitos familiares e pode ser influenciado pelo ambiente escolar no qual a criança está inserida.Conclusões: Os dados sugerem influência considerável dos fatores ambientais, principalmente hábitos alimentares e inatividade física, no crescente aumento da prevalência de excesso de peso na população pediátrica.Palavras-chaves: obesidade; transição nutricional; consumo alimentar; atividade física. ABSTRACT Objective:To review the literature in order to show how current feeding and physical activity practices may contribute to childhood overweight.Data source: Ovid Journals, Highwire and SciELO, selecting original and review articles from 1997 to 2007, published in English and Portuguese.Data synthesis: The periodic assessment of children nutritional status is important to diagnose their current health status and to predict their adult life prognosis. In Brazil, the prevalence of childhood obesity is progressively increasing in all social classes and its frequency varies from five to 18%, according to the region assessed. The association between the health, demographic and behavioral transition and the change in feeding practices can explain the increasing prevalence of childhood overweight. The current food consumption with high fat, sugar and sodium intake and low intake of whole cereals, fruits and vegetables associated to physical inactivity due to the excessive use of computers, electronic games and television may play a role in childhood obesity. This life style can be explained by changing family

Background:The metabolic syndrome (MS) has been assessed since childhood mainly because of the nutritional and epidemiological transition that has occurred worldwide. Our objectives were to explore the MS and its components according to anthropometric and demographic factors and to assess the relationship among MS components and dietary characteristics in overweight and obese schoolchildren.Methods: This was a cross-sectional study which included 147 schoolchildren (aged 6-10 years) from three elementary schools, with body mass index (BMI) higher than the 85th percentile. Sexual maturation stages, anthropometric measures (weight, height, skinfold thickness and waist circumference), biochemical data (glucose, HDL-C and triacylglycerol), blood pressure and dietary intake were assessed. The metabolic syndrome was diagnosed if three or more of the following components were presented: waist circumference ≥90th age and sex-specific cut-off, blood pressure ≥90th age, sex and height-specific cut-off, glucose ≥100 mg/dL, HDL-C ≥ 40 mg/dL and triacylglycerols ≥ 110 mg/dL. The dietary intake was assessed by three non-consecutive 24-h recalls. The T test, Kruskal-Wallis and multiple linear regression analysis were applied to assess MS components and dietary intake. Results:The MS percentage was 10.2 % and it was higher in obese children and ones with high body fat percentage. The waist circumference was the main altered component of MS and 62 % of overweight schoolchildren showed at least one altered component of MS. The components of metabolic syndrome associated with dietary intake were triacylglycerol (positive association with saturated and monounsaturated fat, whole-milk products and processed foods and negative associated with legumes and polyunsaturated fat), glycemia (positive association with processed foods and negative with cereals), HDL-C (positive association with vegetables and greens) and waist circumference was negative associated with protein. Conclusions:The frequency of MS was higher in obese than overweight schoolchildren and the frequency of at least one MS component was high in more than half of our subjects. The waist circumference was the most frequent among all other components. The triacylglycerol and glycemia were the most frequent MS components associated with dietary intake. Unprocessed food was considered a protective dietary factor for MS metabolic components and processed food with high percentage of sugar and saturated fat was a risk factor for MS metabolic components.

Objective: To describe the solutions adopted in the multiple steps of the use of multivariate techniques to obtain a dietary pattern (DP) concerning: the objective of the studies, the selection of the method for measuring food intake, the criteria for grouping the foods, the number of food groups used, the number of DP obtained, and the nomenclature criteria. Methods: The articles were selected from MEDLINE and Lilacs scientific databases using the following keywords: "dietary patterns" versus "factor analysis"; "principal components analysis"; "cluster analysis" and "reduced regression rank." The initial search resulted in 1,752 articles. After inclusion and exclusion criteria, 189 publications were selected. Results: The following aspects were relevant among the studies: the prevalence of the principal component analysis (PCA); the prevalence of the use of 4 to 5 DPs in the studies of association with health outcomes; the use of 30 or more food groups from the food frequency questionnaire (FFQ); the prevalence of studies that associated DPs with health outcomes and socioeconomic factors; and the heterogeneity of criteria used throughout the analytical stages of the multivariate techniques. Conclusion: The heterogeneity between the publications concentrates on the criteria for food grouping, the nomenclature, and the number of dietary patterns calculated, which varied depending on the number of food groups present in these analyses. To understand, apply, and explore in full, the multivariate techniques has become necessary in order to improve the reliability of the results and, consequently, to improve the relationships with health outcomes and socioeconomic factors.

BackgroundThe high blood lipid levels and obesity are one of the main risk factors for cardiovascular diseases, and the atherosclerotic process begins in childhood. Some environmental factors are supposed to be involved in this relationship, such as dietary factors. This study aimed to investigate the relationship between dietary intake and blood lipids levels in overweight and obese schoolchildren.MethodsThis is a cross-sectional study with 147 overweight and obese schoolchildren in Botucatu city, Brazil. The anthropometric measurements (body weight, height, body mass index, waist circumference and skinfolds), pubertal staging evaluation and biochemical tests were taken in all children. Three 24h-recall were applied in order to estimate the dietary intake and its relationship with blood lipid levels. The Student t test and multiple linear regression analysis were used for statistical analysis. Statistical significance was assessed at the level of 0.05. The data were processed in SAS software (version 9.1.3; SAS Institute).ResultsAt this study, 63% of children were obese (body mass index higher than 95th percentile) and 80% showed high body fat percentage. The percentage of children with abnormal total cholesterol and triglycerides was 12% and 10%, respectively, and 28% presented at least one abnormal lipid levels. The average values of anthropometric measurements were higher in children with elevated lipid levels. Total cholesterol levels were positively related to full-fat dairy products and triglycerides levels to saturated fat percentage.ConclusionsSaturated fat was positively associated with elevated lipid levels in overweight and obese schoolchildren. These results reinforce the importance of healthy dietary habits since childhood in order to reduce the risks of cardiovascular diseases in adulthood.

Objective: To assess the prevalence of elevated blood pressure in schoolchildren and adolescents and the association of blood pressure with anthropometric measures.Methods: This cross-sectional study, conducted in three schools in Botucatu, Brazil, collected blood pressure (BP) measurements taken at three different time points and anthropometric data: weight, height, body mass index (BMI), arm circumference, waist circumference, triceps and subscapular skinfolds. Blood pressure was measured using the auscultation method, and children were classified into two groups: pre-hypertension or hypertension for values between the 90th and 95th percentiles or above the 95th percentile. Data were compared according to sex using the Student's t test. The Pearson correlation coefficient was used to evaluate the association between blood pressure and anthropometric data. To evaluate blood pressure, the Z score according to BMI percentile categories, one-factor analysis of variance (ANOVA) and the Tukey post hoc test were used.Results: This study evaluated 903 children and adolescents (51.7% boys) whose mean age was 9.3±2.5 years. The prevalence of pre-hypertension and hypertension was 9.1% and 2.9%. There was a positive correlation between both systolic and diastolic blood pressure and anthropometric variables, especially for weight (r=0.53 and r=0.45, p<0.05) and waist circumference (r=0. 50 and r=0.38, p<0.05).Conclusions: The prevalence of elevated blood pressure in this study was similar to what has been reported in international and national studies. A positive correlation with abnormal anthropometric measures was found. These results suggest that overweight affects blood pressure already in childhood.Key-words: hypertension; pre-hypertension; child; adolescent; obesity. RESUMOObjetivo: Verificar a prevalência de pressão arterial elevada em crianças e adolescentes e sua associação com indicadores antropométricos.Métodos: Estudo transversal de estudantes de três instituições de ensino em Botucatu (SP). As variáveis ava- Resultados: Foram avaliadas 903 crianças (51,7% meninos), com idade de 9,3±2,5 anos para ambos os sexos. A prevalência de PH foi de 9,1% e de HAS foi de 2,9%. Houve correlação positiva significativa entre os níveis de PAS e PAD elevados e as variáveis antropométricas, com valores maiores para peso (r=0,53 e r=0,45, p<0,05, respectivamente) e CA (r=0,50 e r=0,38, p<0,05, respectivamente).Conclusões: A prevalência de níveis pressóricos elevados nesta casuística foi compatível com outros estudos brasileiros e internacionais, correlacionando-se positivamente com indicadores antropométricos elevados, o que sinaliza a influência do excesso de peso na PA já na infância.Palavras-chave: hipertensão; pré-hipertensão; criança; adolescente; obesidade. RESUMENObjetivo: Verificar la prevalencia de presión arterial elevada en niños y adolescentes y su asociación con indicadores antropométricos.Métodos: Estudio transversal incluyendo a estudiantes de tres instituciones de enseñanza de Botucatu (São Paulo, Brasil)....