Background: Adolescents with excess body fat and eutrophic had the same metabolic changes expected in obese individuals.

OBJECTIVE: To verify the correlation between body fat location measurements with the body mass index (BMI), body fat percentage (BF%) and height, according to the nutritional status in female adolescents. METHODS: A controlled cross-sectional study was carried out with 113 adolescents (G1: 38 with normal weight, but with high body fat level, G2: 40 with normal weight and G3: 35 overweight) from public schools in Viçosa-MG, Brazil. The following measures were assessed: weight, height, waist circumference (WC), umbilical circumference (UC), hip circumference (HC), thigh circumference, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-thigh ratio (WTR), conicity index (CI), sagittal abdominal diameter (SAD), coronal diameter (CD), central (CS) and peripheral skinfolds (PS). The BF% was assessed by tetrapolar electric bioimpedance. RESULTS: The increase in central fat, represented by WC, UC, WHtR, SAD, CD and CS, and the increase in peripheral fat indicated by HC and thigh circumference were proportional to the increase in BMI and BF%. WC and especially the UC showed the strongest correlations with adiposity. Weak correlation between WHR, WTR, CI and CS/PS with adiposity were observed. The height showed correlation with almost all the fat location measures, being fair or weak with waist measurements. CONCLUSIONS: The results indicate colinearity between body mass and total adiposity with central and peripheral adipose tissue. We recommend the use of UC for assessing nutritional status of adolescents, as it showed the highest capacity to predict adiposity in each group, and also showed fair or weak correlation with height.

OBJETIVO: Avaliar se a medida da circunferência da cintura e a relação cintura/estatura (RCE) são preditoras de fatores de risco cardiovasculares em adolescentes do sexo feminino. MÉTODOS: Avaliaram-se 113 adolescentes de 14 a 19 anos quanto à antropometria (peso, estatura e circunferência da cintura), parâmetros bioquímicos e clínicos (colesterol total, LDL-C, HDL-C, triglicerídeos, glicemia de jejum, insulina, homeostasis model assessment to assess insulin resistance - HOMA-IR, leptina, homocisteína e pressão arterial). Considerou-se como ponto de corte de obesidade abdominal valores de cintura e RCE>percentil 90. RESULTADOS: As adolescentes com obesidade abdominal apresentaram valores significantemente maiores de triglicerídeos (exceto para a RCE), insulina, HOMA-IR, leptina, pressão arterial sistólica e diastólica; o HDL-C foi mais baixo no grupo com cintura >percentil 90, porém sem significância estatística (p=0,052). CONCLUSÕES: O presente estudo demonstrou que a cintura e a RCE são medidas úteis para identificar adolescentes do sexo feminino com maior risco cardiovascular; contudo, a circunferência da cintura, isoladamente, apresentou melhor desempenho.

Waist circumference as an indicator of body fat and metabolic disorders in adolescents: a comparison of four criteria 665Rev Assoc Med Bras 2010; 56(6): 665-9 IntroductIonObesity is defined as excessive body fat and not only overweight. 1 This disorder is increasingly prevalent and in developed countries it is the most frequent pediatric disease. 2 In Brazil, from 1974 to 1997, overweight increased from 4.1% to 13.9% in children and adolescents 3 and it is estimated that 50%-77% of this age group will also have this condition in adulthood. 2 Additionally, excessive weight in childhood and adolescence contributes to a higher incidence of morbidity and mortality from cardiovascular causes in adulthood. 4 In adolescence, excess of body fat may be associated with several important metabolic disorders, such as dyslipidemia, hypertension, and hyperinsulinemia, which characterize the metabolic syndrome. 5 This association between obesity and metabolic syndrome is even stronger if there is abdominal or central adiposity. 6 This is alarming given that abdominal obesity has been increasing more than overall obesity (assessed by body mass index) among adolescents. 7,8 Recently, there has been an increase in the waist circumference of children and adolescents in the United Kingdom 7 and Spain. 8 In British children, increased waist was higher than BMI in the last 10-20 years, especially in girls. 7 In Zaragoza, Spain, waist circumference values showed an increasing trend in adolescents aged 13 to 14 years, from 1995 to 2000-2002, and

The results suggest that the body fat distribution in adolescents is relevant in the development of cardiovascular risk factors. Simple measurements such as waist circumference and the waist/stature ratio were the best predictors of a risk of disease and they should therefore be associated with the body mass index in clinical practice in order to identify those adolescents at higher risk.

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Índice glicêmico: uma abordagem crítica acerca de sua utilização na prevenção e no tratamento de fatores de risco cardiovasculares Glycemic index: a critical analysis of its use as a tool to prevent and treat cardiovascular risk factors R E S U M OAs doenças cardiovasculares são consideradas um grande problema de saúde pública, uma vez que são a principal causa de morte no Brasil e no mundo. Essas doenças possuem etiologia multifatorial. Além da susceptibilidade genética, outros fatores, tais como idade e presença de hipertensão arterial, dislipidemias, obesidade, diabetes mellitus, inatividade física e alguns hábitos alimentares inadequados, são considerados importantes fatores de risco para o desenvolvimento de doenças cardiovasculares. O elevado consumo de carboidratos tem sido associado ao aumento da obesidade, às dislipidemias, à intolerância à glicose/diabetes mellitus e à resistência insulínica, estando, dessa forma, entre os fatores de risco das doenças cardiovasculares. Entretanto, existem controvérsias acerca da influência da qualidade do carboidrato ingerido no desenvolvimento de tais doenças, independentemente da quantidade ingerida. O índice glicêmico é um indicador da qualidade do carboidrato ingerido. Sua utilidade em condições de vida livre tem sido questionada, devido à interferência de vários fatores, os quais são difíceis de serem controlados sob tais condições. Este trabalho objetivou analisar criticamente os estudos que avaliaram o efeito do índice glicêmico dos alimentos na manifestação de doenças cardiovasculares e seus fatores de risco. Termos de indexação:Índice glicêmico. Doenças cardiovasculares. Aterosclerose. Dislipidemias. Carboidratos. A B S T R A C T

The objective of this study was to evaluate the peripheral expression of inflammatory markers in adolescents with different nutritional status and its correlation with parameters of the metabolic syndrome. Seventy-two female postpubescent adolescents were divided into 3 groups: eutrophic (Co), eutrophic with a high body fat percentage (HBF), and overweight (OW). Data related to the parameters of the metabolic syndrome and the peripheral expression of tumour necrosis factor (TNF)-α, interleukin (IL)-6, and IL-10 were evaluated. Higher values of glycemia and insulin resistance were found in the HBF group than in the Co group. No differences related to the peripheral expression of the cytokines were found among the groups. In the HBF group, a positive correlation was observed between TNF-α and IL-6, IL-10 and the proinflammatory cytokines, and IL-6 and glycemia. In the OW group, a positive correlation was found between IL-6 and triglycerides. Adolescents with normal weight but body fat excess present a metabolic profile and body composition similar to those of overweight adolescents. This suggests that these adolescents have a risk of developing cardiovascular diseases similar to that of overweight adolescents. The positive correlation between IL-10 and TNF-α and IL-6 suggests an attempt to inhibit the production of these cytokines by IL-10.