Exceto onde especificado diferentemente, a matéria publicada neste periódico é licenciada sob forma de uma licença Creative Commons -Atribuição 4. RESUMOObjetivo: descrever as ações de promoção da saúde (PS) no ambiente escolar e as dificuldades que permeiam estas ações. Método: trata-se de uma revisão bibliográ-fica de caráter descritivo em publicações disponíveis na literatura científica sobre o tema, sem restrição de data. Utilizou-se pesquisa em sistemas de busca na internet, como o a Biblioteca Virtual em Saúde, com fontes indexadas nas bases de dados SciELO, LILACS, PubMed. Adotaram--se os descritores: Escolas Promotoras de Saúde, Saúde escolar, PS, em português e Health Promoting Schools, School health, Health promotion em inglês. Os artigos foram selecionados pelos títulos e resumos, após, lidos na íntegra e incluídos os com informações sobre o tema. Foram elaboradas categorias temáticas para a discussão dos dados encontrados, articulando-os com referenciais teóricos. Resultados: a PS busca fortalecer a ideia de autonomia dos sujeitos e dos grupos sociais, como um processo social e político, não limitado a abraçar ações direcionadas a fortalecer as habilidades e capacidades dos indivíduos. O ambiente escolar passou a ser reconhecido como apropriado para ações de PS, através de várias iniciativas de Escolas Promotoras da Saúde e do Programa Saúde na Escola, para ampliar os fatores protetores da saúde do escolar. No entanto, têm se destacado ações curativas e assistenciais e, as de PS têm sido confundidas com as de prevenção, influenciadas pelo antigo conceito. As ações apresentam como fragilidade a dificuldade na compreensão do conceito de PS pelos profissionais. Considerações finais: a efetividade da PS é um desafio metodológico e político que possibilita gerar conhecimento de programas adaptados à realidade de cada contexto, com vistas à aplicação de metodologia adequada. Para que as ações se concretizem de forma eficiente e permanente, é necessário o comprometimento de todos os envolvidos, propondo o empoderamento da comunidade escolar em atitudes do cotidiano. Palavras-chave: Saúde na Escola; Promoção da
RESUMOJustificativa e Objetivos: Atualmente, a obesidade é considerada um importante problema de saúde pública, pois sua prevalência configura-se em níveis alarmantes. Os custos atribuídos aos gastos com a obesidade são muito elevados e, a longo prazo, podem tornar-se empecilhos à sustentabilidade do tratamento dos indivíduos, tanto no âmbito público, quanto no privado. O objetivo foi refletir sobre a importância das Políticas Públicas voltadas ao enfrentamento da epidemia da obesidade e seus custos à saúde pública. Conteúdo: o tratamento das doenças relacionadas ao sobrepeso e a obesidade acarretam um número substancial nas despesas, sendo que no Brasil este dispêndio chega a ser de 5% dos gastos destinados a saúde. Para enfrentar a epidemia da obesidade, as políticas públicas devem proporcionar ambientes estimuladores, que apoiem e mantenham padrões saudáveis de alimentação e atividade física, enfatizando que tais atitudes devem ir além de informar e educar a população. Diversas são as ações propostas pelo governo brasileiro para organizar políticas voltadas para a área de nutrição e atividade física que visam à prevenção e o tratamento da obesidade. No entanto, essas intervenções acabam atendendo situações imediatas e específicas, permanecendo o desafio para sejam consolidadas de forma universal. Conclusão: faz-se necessário um olhar mais ampliado na busca de políticas públicas realmente eficazes, pensadas em longo prazo e que possam envolver toda a população. Levar em consideração a conscientização sobre a prática de hábitos saudáveis, uma vez que intervenções pensadas na perspectiva da promoção da saúde terão impacto positivo nos recursos financeiros da saúde pública. DESCRITORES: Políticas públicas. Obesidade. Promoção da saúde. ABSTRACT Background and objectives:Currently, obesity is considered a major public health problem because its prevalence set up at an alarming rate. The costs allocated to spending on obesity are very high and in the long run, can become obstacles to the sustainability of treatment of individuals, whether in the public, as in private. The objective was to reflect on the importance of public policies aimed at combating the epidemic of obesity and its costs to
ObjectiveThere is no consensus on the best diagnostic criteria for metabolic syndrome (MetS) in the child and adolescent population. Thus, the present study aimed to establish cutoff points for a continuous metabolic risk score (cMetS) in adolescents from southern Brazil.MethodsThis was a cross‐sectional study conducted between 2014 and 2015. The sample consisted of 1739 schoolchildren (985 girls), aged 10‐17 years. cMetS was calculated by sum of the Z‐score of the following parameters: waist circumference, systolic blood pressure, glucose, high‐density lipoprotein cholesterol, triglycerides, and cardiorespiratory fitness. Three diagnostic criteria of MetS were used to create cut points for cMetS.ResultsThe best cutoff point for cMetS was set at 3.40 for boys (sensitivity: 100.0%, specificity: 92.9%, AUC: 0.978) and 3.61 for girls (sensitivity: 100, 0%, specificity: 93.1%, AUC: 0.991). For these cutoff points, metabolic risk was found in 8.9% of adolescents (9.4% for boys and 8.5% for girls). A linear relationship was found between the mean values of cMetS and the number of components of MetS (mean cMetS −1.09 for no component present and 6.66 for 3 or more components).ConclusionsThe use of cMetS is valid for adolescents and can detect a greater proportion of students with metabolic risk, compared to the current criteria for diagnosis of MetS.
Este artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho seja corretamente citado. ASSOCIAÇÃO ENTRE A OBESIDADE INFANTIL E A CAPACIDADE Hildegard Hedwig Pohl Universidade de Santa Cruz do Sul -UNISC -Santa Cruz do Sul (RS) -Brasil Miria Suzana Burgos Universidade de Santa Cruz do Sul -UNISC -Santa Cruz do Sul (RS) -Brasil RESUMOObjetivo: Verificar as evidências científicas a respeito da associação entre obesidade infantil e aptidão cardiorrespiratória. Métodos: Realizouse uma revisão de literatura advinda da busca de artigos, publicados nos últimos cinco anos, nas bases de dados SciELO e Portal de Periódicos da CAPES. Os descritores utilizados foram aptidão física, sobrepeso/obesidade e crianças/adolescentes/escolares. Incluíram-se no estudo artigos completos publicados em periódicos, nos idiomas inglês, português e espanhol, com ano de publicação no período de 2010 a 2015, e que tinham como objetivo a predição da aptidão cardiorrespiratória com testes de exercício na obesidade infantil. Resultados: Ao todo foram 97 artigos pesquisados, mas, após análise e submissão aos critérios de inclusão e exclusão, restaram cinco artigos, sendo dois em língua portuguesa, dois em espanhol e um em inglês. Dos cinco artigos analisados, quatro estudos relataram que a capacidade cardiorrespiratória foi afetada pelos índices de adiposidade corporal. Conclusão: Foi evidenciada associação inversa entre o índice de massa corporal e o condicionamento cardiorrespiratório, em que os escolares com excesso de peso apresentaram menores índices de aptidão cardiorrespiratória.Descritores: Obesidade; Aptidão física; Crianças; Adolescentes. ABSTRACT Objective: To investigate the scientific evidence regarding the association between childhood obesity and cardiorespiratory fitness. Methods: A review was conducted on the literature arising from the search of articles published in the last five years in the databases SciELO and CAPES Journal Portal (Portal de Periódicos da CAPES
Purpose: To verify the reciprocal longitudinal relationships between cardiorespiratory fitness (CRF), percentage body fat (%body fat), and metabolic syndrome in Brazilian primary school students. Method: This longitudinal study involved 420 children and adolescents followed for 3 years (2011–2014). The continuous Metabolic Syndrome (cMetSyn) score was calculated by summing adjusted z scores of glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, and waist circumference. The CRF was assessed using running/walking tests, and %body fat was assessed through sex-specific 2-site skinfold thickness. Cross-lagged panel models were used to analyze longitudinal reciprocal relationships between CRF and %body fat with cMetSyn. Results: Results indicated that 2011 %body fat significantly predicted both 2014 CRF scores and 2014 cMetSyn scores (P < .001); however, 2011 CRF only predicted 2014 %body fat (P < .001) but not 2014 cMetSyn (P = .103). Furthermore, 2011 cMetSyn predicted 2014 %body fat (P = .002). The model explained 36%, 48%, and 37% of the variance in 2014 CRF, %body fat, and cMetSyn, respectively. Conclusion: The results suggest a reciprocal inverse relationship between %body fat and metabolic syndrome risk and that %body fat may play a more important role in the risk of developing metabolic syndrome compared with CRF.
Background: There is a lack of clarity as to which obesity parameters may be more important in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk factors (CMRF). Aim: To verify the mediating role of different obesity parameters on the association between CRF and CMRF in normal weight and overweight/obese children and adolescents. Methods: This cross-sectional study comprised 999 children and adolescents (534 boys) aged 7-14 years from the south of Brazil. Body mass index (BMI), waist circumference (WC), waist-toheight ratio (WHtR) and percentage of body fat were assessed. Participants were classified as normal weight, overweight and obese according to BMI. CRF was evaluated by the 6-minute run/walk test. . A continuous CMRF score was calculated by summing the Z-scores of the following variables: systolic and diastolic blood pressure, glucose, total cholesterol, highdensity lipoprotein cholesterol and triglycerides. Data analysis was performed using partial correlation and linear regression models. Results: BMI, WC, WHtR and percentage of body fat mediated the relationship between CRF and CMRF in overweight/obese boys and girls but not those of normal weight. Additionally, the percentage of the influence of each obesity parameter was 20% for BMI and WC, 16% for percentage of body fat and 18% for WHtR in girls. For boys, the mediation effect was 25% for BMI, 26% for WC, 28% for percentage of body fat and 25% for WHtR. Conclusion: Adiposity plays a central role in CMRF; therefore, maintaining an adequate weight status should be an important objective of health-promoting programmes in early age.
Objective: To verify the effect of a multicomponent intervention with overweight/obese adolescents on physical fitness, body composition, and insulin biomarkers.Methods: A quasi-experimental study with 37 adolescents, aged 10 to 17 years, of both sexes, overweight and obese, allocated in two groups (Intervention—IG Group, n = 17; Control—GC Group, n = 20). The IGs were submitted to a multicomponent intervention for 6 months (three weekly sessions) consisting of physical exercises (sports, functional circuit, recreational, and water activities) and nutritional and psychological guidance. Participants were assessed before and after intervention on body composition [body mass index (BMI), body fat, waist circumference, and waist-to-hip ratio (WHR)], physical fitness [cardiorespiratory fitness (CRF) and abdominal strength], and biomarkers of insulin (glucose, insulin, evaluation of the homeostasis model of insulin, and resistin resistance). The prevalence of responders in both groups was obtained according to the theoretical model applied in previous studies similar to this one to determine the cutoff points for response to intervention. Poisson regression was used to verify the difference in the prevalence ratio (PR) of the interviewees between the groups.Results: The responders' prevalence between groups CG and IG showed significant differences for body fat (CG = 30.0%; IG = 70.6%; PR = 1.396; p < 0.001), WHR (CG = 30.0%; IG = 76.5%; PR = 1.730; p < 0.001), and CRF (CG = 15.0%; IG = 52.5%; PR = 1.580; p < 0.001).Conclusions: A 6-month multicomponent intervention program improved certain body composition parameters and the CRF of overweight and obese adolescents but did not improve insulin biomarkers.Clinical Trial Registration: Clinical Trials under Protocol ID: 54985316.0.0000.5343.
Introduction Hyperuricemia is related to health issues among children and adolescents, once the uric acid concentration is associated with metabolic syndrome, hypertension, insulin resistance, obesity, and dyslipidemia. However, few studies are addressing uric acid levels and food uptake in this age group. Aim To verify the association between food consumption and uric acid in children and adolescents. Methods This is a cross-sectional study developed with 2335 children and adolescents of both genders aged 6-17 years old. Blood collection was performed after 12 h of fasting. Uric acid values were classified according to tertiles, in which the highest tertile was considered as hyperuricemia. Food consumption was evaluated by weekly consumption frequency questionnaire. Pearson correlation and logistic binary regressions were used for statistical analysis. Models were adjusted for age, systolic blood pressure, body mass index (BMI), and skin color/ethnicity. Results It was found an association between red meat consumption and hyperuricemia only in boys in the crude model (OR = 1.56; 95% CI 1.12; 2.18). Also, there was an association between pasta (OR = 1.52; 95% CI 1.11; 2.10) with hyperuricemia in boys, when adjusted age, systolic blood pressure, BMI, and skin color/ethnicity. Conclusion The knowledge of food patterns which are predisposing factors for the increase in serum uric acid levels is important for the implementation of strategies and public health policies for health promotion among children and adolescents.
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