Many school-based interventions for obesity prevention have been proposed with positive changes in behaviour, but with unsatisfactory results on weight change. The objective was to verify the effectiveness of a combined school- and home-based obesity prevention programme on excessive weight gain in adolescents. Teachers delivered the school-based primary prevention programme to fifth- and sixth-graders (nine schools, forty-eight control classes, forty-nine intervention classes), which included encouraging healthy eating habits and physical activity. A subgroup of overweight or obese adolescents also received a home-based secondary prevention programme delivered by community health professionals. Schools were randomised to intervention or control group. Intent-to-treat analysis used mixed models for repeated continuous measures and considered the cluster effect. The main outcomes were changes in BMI and percentage body fat (%body fat) after one school-year of intervention and follow-up. Against our hypothesis, BMI increased more in the intervention group than in the control group (Δ = 0·3 kg/m2; P = 0·05) with a greater decrease in %body fat among boys (Δ = –0·6 %; P = 0·03) in the control group. The intervention group increased physical activity by 12·5 min per week compared with the control group. Female adolescents in the intervention group ate healthier items more frequently than in the control group. The subgroup that received both the school and home interventions had an increase in %body fat than in the control group (Δ = 0·89 %; P = 0·01). In the present study, a behavioural change led to a small increase in physical activity and healthy eating habits but also to an overall increase in food intake.
OBJETIVO: Verificar a freqüência de hipertensão arterial, sedentarismo e consumo alimentar inadequado em adolescentes com excesso de massa corporal. MÉTODOS: Estudo transversal com 56 adolescentes, sendo 21 meninos e 35 meninas, entre 10 e 19 anos. As variáveis foram: sexo, idade, peso, estatura, índice de massa corporal, classificação nutricional, hipertensão arterial, atividade física e consumo alimentar de risco cardiovascular. Avaliou-se o consumo alimentar com questionário que estabelece consumo de risco cardiovascular entre adolescentes por categorias de consumo, segundo pontuações por quantidades e freqüência consumida. Do questionário originaram-se as variáveis categorias de consumo e pontuações. Aplicou-se correlação de Spearman entre índice de massa corporal, idade e pontuação de consumo. Por teste "t" de Student compararam-se entre os sexos as médias de índice de massa corporal, idade, massa corporal, estatura e pontuação de consumo, e por qui-quadrado as freqüências por presença e ausência de hipertensão arterial, prática de atividade física e categorias de consumo. Com teste Kruskal-Wallis, analisou-se a variância da pontuação de consumo entre grupos. RESULTADOS: Não houve diferenças estatísticas entre os sexos para atividade física (p=0,68), hipertensão arterial (p=0,94), excesso de massa corporal (p=0,31) e categorias de consumo (p=0,53). O índice de massa corporal não se correlacionou com a idade (r=0,20 e p=0,14) e a pontuação de consumo (r=-0,06 e p=0,60). Não houve diferença estatística (p=0,19) na pontuação do consumo por grupos. CONCLUSÃO: Os adolescentes não apresentaram distinções por sexo quanto à prevalência de hipertensão arterial, sedentarismo e consumo alimentar de risco cardiovascular, embora as meninas apresentassem maior freqüência desses fatores quando agrupados.
Objective: To compare Brazilian and international criteria for assessing the nutritional status of schoolchildren.Methods: This was a cross-sectional study that enrolled 160 schoolchildren from a public school in the city of Rio de Janeiro, 91 boys and 69 girls, aged 7 to 9 full years. Body mass index (BMI) for sex and age was used to diagnose underweight, healthy weight and overweight, according to Cole et al., Conde & Monteiro and the World Health Organization (WHO) criteria. Student's t test, the chi-square test, the Kendall concordance test and the chi-square testfor tendencies were used to analyze the data; graphs were plotted demonstrating BMI by age, according to the nutritional diagnosis at each set of criteria.Results: Mean BMI did not differ by sex (t = 0.2845, p = 0.7789). According to the first two sets of criteria, none of the children were underweight, whereas, according to the WHO criteria, one of the boys was underweight. The Kendall test did not demonstrate any significant difference between the three sets of criteria (coefficient of concordance for boys was W < 0.0004 and for girls it was W < 0.0008, with p = 1.00). There was a greater proportion of assessments that did not agree among the boys, at 15.13%, while for the girls this figure was 13.04%. A significant tendency was observed for the difference between the criteria to increase with age among the boys (chi-square for tendencies = 6.552, p = 0.0105), which was evident on the graph and was independent of nutritional status. Conclusions:The criteria used here converged on the same result, without discrepancies between them or advantages for either. Nevertheless, among the boys there was a significant tendency for the diagnoses to differentiate and BMI to increase with age, which is a warning to take care when choosing among criteria.J Pediatr (Rio J). 2008;84(6):550-555: Nutritional assessment, nutritional status, diagnostic methods, body mass index, children.
ResumoObjetivo: Comparar critério nacional e internacional para avaliação do estado nutricional de escolares.Métodos: Estudo transversal incluindo 160 crianças, 91 meninos e 69 meninas, de 7 a 9 anos completos, alunos de escola pública da cidade do Rio de Janeiro. Utilizou-se o índice de massa corporal (IMC) por gênero e idade para diagnosticar baixo peso, peso adequado e excesso de peso, empregando-se critérios propostos por Cole et al., Conde & Monteiro e pela Organização Mundial da Saúde (OMS).Foram aplicados teste t de Student, qui-quadrado, concordância de Kendall, qui-quadrado de tendência e gráficos demonstrando a evolução do IMC, segundo diagnóstico nutricional obtido com cada critério.Resultados: As médias de IMC não diferiram entre sexos (t = 0,2845 e p = 0,7789). Segundo critérios propostos por autores, não houve baixo peso, enquanto que para os critérios da OMS, ocorreu um caso de baixo peso entre meninos. O teste de Kendall não demonstrou diferença significativa entre os três critérios (coeficiente de concordância: meninos = W < 0,0004, meninas = W < 0,0008 e p = 1,00). As discordâncias na avaliação predominaram entre meninos, atingindo 15,13%, sendo 13,04% para meninas. Observou-se significativa tendência crescente de diferenciação dos critérios com a idade dos meninos (qui-quadrado de tendência = 6,552 e p = 0,0105), evidenciada no gráfico e independente do estado nutricional. Conclusões:Os critérios utilizados convergem para o mesmo resultado, não havendo discrepâncias ou vantagens entre eles.Entretanto, para meninos, houve significativa tendência de diferenciação nos diagnósticos e evolução do IMC por idade, alertando para cuidado na opção dos diferentes critérios.J Pediatr (Rio J). 2008;84(6):550-555: Avaliação nutricional, estado nutricional, métodos de diagnóstico, índice de massa corporal, crianças. AbstractObjective: To compare Brazilian and international criteria for assessing the nutritional status of schoolchildren.Methods: This was a cross-sectional study that enrolled 160 schoolchildren from a public school in the city of Rio de Janeiro, 91 boys and 69 girls, aged 7 to 9 full years. Body mass index (BMI) for According to the first two sets of criteria, none of the children were underweight, whereas, according to the WHO criteria, one of the boys was underweight. The Kendall test did not demonstrate any significant difference between the three sets of criteria (coefficient of concordance for boys was W < 0.0004 and for girls it was W < 0.0008, with p = 1.00). There was a greater proportion of assessments that did not agree among the boys, at 15.13%, while for the girls this figure was 13.04%. A significant tendency was observed for the difference between the criteria to increase with age among the boys (chi-square for tendencies = 6.552, p = 0.0105), which was evident on the graph and was independent of nutritional status. Conclusions:The criteria used here converged on the same result, without discrepancies between them or advantages for either. Nevertheless, among the boys there wa...
Objective: To assess the performance of central obesity indicators by correlation and agreement considering the body mass index in the nutritional assessment of adolescents according to sex and age. Methods: Cross-sectional census study with 635 adolescents, aged 10-19 years (342 males and 293 females), studying in a public school in Rio de Janeiro, Brazil. Study variables were body mass index (BMI), waist and abdominal circumference, waist-to-hip ratio, waist-to-height ratio, nutritional status, sex and age. Univariate and multivariate analyses adjusted by stratification were developed. Results: Waist and abdominal circumferences and BMI were positively and significantly correlated to sex, age group and nutritional status (p < 0.05). For the waist-to-hip ratio, co-relation variation was also influenced by age (p < 0.05). Waist and abdominal circumferences depended on BMI values in all groups (R 2 = 0.66-0.80, positive β), which did not occur in waistto-hip ratio and waist-to-height ratio. Only the waist circumference showed moderate agreement with BMI (Kappa: 0.41-0.57) in all groups, while for the remaining indicators this agreement ranged from poor to moderate. Conclusions: Among the central obesity indicators analyzed, waist and abdominal circumferences showed the best performances, but waist circumference was the most adequate to be used in addition to BMI in the nutritional assessment of adolescents. Correlação e concordância entre indicadores de obesidade central e índice de massa corporal em adolescentes Chiara, V.L. et al. c C. abdominal: ≤14 and ≤13: t=1.81;p(bilateral)=0.07 ns ; ≥15 and ≥14: t=3.86; p(bilateral)<0.01 sig dRazão cintura/quadril: ≤14 e ≤13: U=6097,00; p<0,01 sig ; ≥15 e ≥14: U=2197,00; p<0,01 sig d waist-to-hip ratio: ≤14 and ≤13: U=6097.00; p<0.01 sig ; ≥15 and ≥14: U=2197.00; p<0.01 sig e Razão cintura/altura: ≤14 e ≤13: U=9141,50; p<0,01 sig ; ≥15 e ≥14: U=10978,00; p<0,01 sig e waist-to-height ratio: ≤14 and ≤13: U=9141.50; p<0.01 sig ; ≥15 and ≥14: U=10978.00; p<0.01 sig 2009; 12(3): 368-77 Correlação e concordância entre indicadores de obesidade central e índice de massa corporal em adolescentes Chiara, V.L. et al. Rev Bras Epidemiol 2009; 12(3): 368-77Correlação e concordância entre indicadores de obesidade central e índice de massa corporal em adolescentes Chiara, V.L. et al.
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