Objective: To review therapeutic approaches to childhood obesity and also its diagnosis and prevention.Sources of data: Searches were performed of scientific papers held on the MEDLINE, Ovid, Highwire and Scielo databases. Keywords utilized were: childhood obesity and a variety of combinations of this term with treatment , prevention and consequence . The search returned papers including review articles, observational studies, clinical trials and consensus statements. Bibliographical references in these articles were also investigated if it was perceived that they were relevant. Data was collected from 1998 to 2003.Summary of the findings: While a number of different Brazilian prevalence studies were found, few gave details of the results of educational programs in our country.Conclusions: Childhood obesity must be prevented through prescriptive diets from birth throughout childhood. Educational programs that might be applicable to primary health care or schools should receive further study. There is consensus that childhood obesity is increasing at a significant rate and that it is responsible for a number of different complications both during childhood and adulthood. During childhood, obesity management can be even more difficult than with adults because it is dependent on both changing habits and availability of parents and is further complicated by the child s lack of understanding of the damage caused by obesity.

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Peripheral markers of iron status and food intake of iron do not seem to be modified in children with attention-deficit/hyperactivity disorder, but further studies assessing brain iron levels are needed to fully understand the role of iron in attention-deficit/hyperactivity disorder pathophysiology.

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Purpose: to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia. Methods: A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests. Results: Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP. Conclusion: The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.

BackgroundBoth poor aerobic fitness and obesity, separately, are associated with abnormal lipid profiles.ObjectiveTo identify possible relationships of dyslipidemia with cardiorespiratory fitness and obesity, evaluated together, in children and adolescents.MethodsThis cross-sectional study included 1,243 children and adolescents (563 males and 680 females) between 7 and 17 years of age from 19 schools. Obesity was assessed using body mass index (BMI) measurements, and cardiorespiratory fitness was determined via a 9-minute run/walk test. To analyze the lipid profile of each subject, the following markers were used: total cholesterol, cholesterol fractions (high-density lipoprotein and low-density lipoprotein) and triglycerides. Data were analyzed using SPSS v. 20.0, via prevalence ratio (PR), using the Poisson regression.ResultsDyslipidemia is more prevalent among unfit/overweight-obese children and adolescents compared with fit/underweight-normal weight boys (PR: 1.25; p = 0.007) and girls (PR: 1.30, p = 0.001).ConclusionsThe prevalence of dyslipidemia is directly related to both obesity and lower levels of cardiorespiratory fitness.

There is an association between the AA genotype of rs9939609 polymorphism and BMI among schoolchildren. The association between overweight/obesity in schoolchildren with a family history of obesity was found mainly among students with the AA genotype.