RESUMO: Este estudo teve como objetivo verificar se existe associação entre pressão arterial (PA) alterada em adolescentes com fatores de risco às doenças cardiovasculares de seus pais. Estudo transversal com 859 adolescentes, sendo 479 (55,8%) do sexo feminino, entre dez a 17 anos, estudantes de escolas da rede pública e privada, do município de Santa Cruz do Sul-RS. Considerou-se alteração na PA sistólica e diastólica os casos limítrofes e hipertensão. Foram utilizados os valores de razão de prevalência (RP), por meio da regressão de Poisson. Constatou-se elevado percentual de adolescentes com alteração na PA (19,4%), sendo esta superior entre os adolescentes, cujas mães apresentam hipertensão (RP: 1,09) e histórico de infarto (RP: 1,25). Entre os pais, somente colesterol elevado associou-se com a alteração da PA, nos adolescentes (RP: 1,08). Conclui-se que é elevada a prevalência de PA alterada em escolares, estando esta associada com fatores de risco às doenças cardiovasculares dos pais. PALAVRAS-CHAVES: Adolescente; Fatores de risco; Pressão arterial; Relação pais-filho. ALTERED ARTERIAL BLOOD PRESSURE IN ADOLESCENTS: ASSOCIATION WITH RISK FACTORS TO THEIR PARENTS´CARDIOVASCULARPARENTS´CARDIOVASCULAR DISEASES ABSTRACT: Current analysis verified whether there was any association between altered arterial blood pressure (BP) in adolescents and risk factors for their parents´cardiovascularparents´cardiovascular diseases. Current transversal analysis involved 859 adolescents, 479 (55.8%) females, aged 10-17 years, in government-run and private schools in Santa Cruz do Sul RS Brazil. Borderline and hypertension cases were considered alterations in systolic and diastolic AP. Prevalence ratio (PR) rates were employed by Poisson regression. Results showed high percentage of adolescents with changes in BP (19.4%), which was higher among adolescents with hypertensive mothers (PR: 1.09) and stroke history (PR: 1.25). Only high cholesterol among parents was associated with AP alterations in adolescents (PR: 1.08). High AP in school children is associated with risk factors for parents´cardiovascularparents´cardiovascular diseases. KEY WORDS: Adolescents; Risk factors; Arterial blood pressure; Parents-children relationship. INTRODUÇÃO Casos de pressão arterial (PA) elevada, em crianças e adolescentes, vêm aumentando nos últimos anos, cujo histórico Saúde e Pesquisa, Maringá (PR)

ResumoObjetivo: Verificar a frequência de excesso de peso em crianças de favelas na cidade do Recife, PE, e sua associação com inatividade física. Métodos:Foi realizado estudo transversal em duas favelas do Recife (Fragoso e Caranguejo), com população total de 9.315 habitantes, sendo 973 crianças na faixa etária compreendida entre 7 e 10 anos, das quais 733 foram incluídas no estudo. Foram consideradas com sobrepeso e obesidade aquelas crianças com índice de massa corporal acima dos percentis 85 e 95, respectivamente, de acordo com as curvas e as tabelas de percentis do Centro de Controle e Prevenção de Doenças (Centers for Disease Control and Prevention). O nível de atividade física foi avaliado através do questionário de atividade física para crianças, aplicado às crianças na presença das mães. Foram consideradas fisicamente ativas as crianças com escore ≥ 3 e sedentárias aquelas com escores < 3. Resultados:De 733 crianças estudadas, detectou-se excesso de peso em 92 (12,6%) delas. Não houve associação entre excesso de peso e sexo, renda familiar, escolaridade materna, número de irmãos ou horas diárias de assistência à televisão. Entretanto, observou-se maior número de crianças com inatividade física entre aquelas com sobrepeso e obesidade, 66/92 (71,6%) versus 363/ 641 (56,7%) (p = 0,008). Conclusões:A frequência de excesso de peso entre escolares residentes em favelas na cidade do Recife é elevada e está associada à inatividade física.J Pediatr (Rio J). 2009;85(1):67-71: Criança, excesso de peso, obesidade, atividade motora. AbstractObjective: To assess the prevalence of overweight and obesity and its association with physical activity levels in children living in favelas in the city of Recife, state of Pernambuco, Brazil. Methods:A cross-sectional study was performed with 973 children ranging from 7 to 10 years old, all from two favelas in Recife, Fragoso and Caranguejo (total population of 9,315); of the 973 children assessed, 733 were included in the study. Overweight was defined as body mass index (BMI) equal to or above the 85th percentile, and obesity as BMI equal to or above the 95th percentile, using Centers for Disease Control and Prevention growth charts. Physical activity level was assessed by the Physical Activity Questionnaire for Older Children (PAQ-C). Children with scores ≥ 3 were considered active, while those with scores < 3 were considered inactive.Results: Of the 733 children studied, overweight and obesity were observed in 92 (12.6%). There was no statistical association between physical inactivity and sex, income, maternal schooling, number of siblings and hours of television. However, more children with physical inactivity were observed among overweight or obese children, 66/92 (71.6%) vs. 363/641 (56.7%) (p = 0.008). Conclusions:The prevalence of overweight and obesity is high, and is associated with physical inactivity in children living in favelas in the city of Recife, Brazil.J Pediatr (Rio J). 2009;85(1):67-71: Child, overweight, obesity, motor activity.

OBJETIVO: Determinar a frequência e os principais fatores associados a sobrepeso e obesidade em crianças moradoras de uma favela do Nordeste do Brasil. MÉTODOS: Estudo transversal com amostra de 86 crianças (40 eutróficas e 46 sobrepeso/obesas), com idade entre cinco e nove anos, selecionadas em um universo de 508 crianças nesta faixa etária, avaliadas e cadastradas na Unidade de Saúde da Família (USF). Para definição de sobrepeso/obesidade, foram utilizados os pontos de corte estabelecidos por Cole et al. Pesquisaram-se variáveis biológicas, socioeconômicas, hábitos alimentares, tempo em frente à televisão e sedentarismo. Para a análise dos dados foram empregados os testes de associação, sendo significante p<0,05. RESULTADOS: A frequência de sobrepeso/obesidade entre as 508 crianças foi 13%. Ingestão calórica excessiva, consumo de refresco artificial açucarado e sedentarismo foram os fatores associados ao sobrepeso e à obesidade. CONCLUSÕES: A frequência de sobrepeso/obesidade foi relevante no grupo estudado e os fatores que estiveram associados ao sobrepeso/obesidade foram ingestão calórica excessiva, consumo de refresco artificial açucarado e sedentarismo, que constituem pontos a serem trabalhados na população como forma de intervenção e prevenção de agravamentos no futuro.

Conclusão: o início precoce de alimentação, tanto enteral como parenteral e a avaliação nutricional são imprescindíveis para garantir o crescimento e desenvolvimento neuropsicomotor adequados e evitar seqüelas futuras nos recém-nascidos de muito baixo peso ao nascer. Palavras-chave:Nutrição; muito baixo peso; prematuro; avaliação nutricional. INTRODUÇÃOOs recém-nascidos de muito baixo peso ao nascer (RNMBP) são aqueles que apresentam peso ao nascer < 1.500g. 1 Quanto à gestação, são prematuros (PT) aqueles com nascimento menor que 37 semanas. 1 A definição mais aceita de pequenos para a idade gestacional é a que considera Pequeno para a Idade Gestacional (PIG) como os nascidos vivos que apresentam valor inferior ao percentil 10 de peso ao nascer segundo idade gestacional. 2 O peso ao nascer é o melhor preditor do padrão de saúde imediato e futuro do recém-nascido (RN), sendo que naqueles RN com peso ao nascer menor do que 1.500g e idade gestacional inferior a 32 semanas, existem relações diretas de fatores de risco de instalação da hemorragia peri-intraventricular, à sobrevida e ao crescimento e desenvolvimento, sendo o muito baixo peso considerado relevante na taxa de mortalidade infantil. 3 O nascimento antes do final do 3° trimestre predispõe o RN ao risco nutricional, em ra-

BackgroundExcess of weight is a serious public health concern in almost all countries, afflicting people of different ages and socioeconomic backgrounds. Studies have indicated the need for developing treatment strategies that intervene directly in the obesogenic environment. This study aims to evaluate the effectiveness of a multi-component and environmental school-based intervention, lasting 16 months, on the recovery of the nutritional status of low-income children and adolescents with overweight/ obesity.Methods/study designThe study was conducted by the Center for Recovery and Nutritional Education (CREN) in São Paulo, Brazil. Two schools located in poor neighborhoods were selected for the intervention, between March 2016 and June 2017. The participants were all students aged 8 to 12 years from the two participating schools. At the beginning of the intervention, anthropometric measurements were carried out to assess the nutritional status of the students. For convenience, students from one of the schools were considered as the control group, while those from the other school formed the experimental group. The intervention in the experimental group (n = 438) consists of the following weekly activities at school: psychological counseling in groups, theoretical/practical nutrition workshops, and supervised physical education classes. In addition, theoretical and practical educational activities are held regularly for parents, teachers, and cooks. Students with excess of weight (≥1 body mass index [BMI] –for-age Z score, n = 138) received clinical and nutritional care periodically at the outpatient care at CREN. Students enrolled in the control group (n = 353) participated in psychological counseling groups and theoretical/practical nutrition workshops for 6 months held in the school environment to provide motivation to entire classrooms. In the following 10 months, students with excess of weight from the control group (n = 125) were invited to attend the routine outpatient care at CREN.DiscussionThis study is the first to assess the effectiveness of a multi-component and environmental school-based intervention for the recovery of low-income, overweight/obese children and adolescents. If positive, the results demonstrate the feasibility for the recovery of excess of weight in populations of similar conditions and age.Trial registrationBrazilian Registry of Clinical Trials - ReBEC Primary Id Number RBR-9t2jr8. Registration Date: Nov. 30, 2016. Retrospectively registered. Protocol version: 3.

Background After quitting smoking, quitters frequently increase their weight and change their dietary intake. Still, most studies on the topic are over 20 years old and focused on few dietary markers. We analysed the changes in weight and dietary intake after quitting smoking using a large panel of dietary markers. Methods Prospective study including 5064 participants, 169 of whom (3.3%) quitted during a median follow-up of 5 years. Dietary intake was assessed using a food frequency questionnaire. Participants were excluded if they lacked dietary data or reported extreme total energy intakes (TEI) < 850 or > 4000 kcal/day. Results Data from 128 participants (43.8% women, aged 56.0 ± 10.0 years) were used. After quitting smoking, mean weight increased 2.1 ± 0.7 kg; the majority (58%) of the participants gained over 1 kg, and only 7.1% were on a diet to reduce their weight. Total protein intake increased from (median [interquartile range]) 14.4 [12.9–16.4] to 15.1 [13.4–17.9] % of total energy intake (TEI), p = 0.008, while animal protein intake increased from 9.7 [8.0–12.1] to 10.8 [8.5–13.5] %TEI, p = 0.011. Fish intake increased from 27 [17–45] to 37 [19–55] g/day, p = 0.016 and dairy intake decreased from 177 [94–288] to 150 [77–243] g/day, p = 0.009. No other changes were found. Among the 68 (53%) participants who reported time since quitting, quitting for <=1 year led to a decreased consumption of fruits, while the opposite was found for participants who quit for longer than one year. No associations were found between weight or dietary changes and time since quitting. Conclusions People who quit smoking tend to gain weight, do not significantly change their dietary intake, and seem to make little effort to prevent weight gain. Systematic dietary support should be provided to all smokers wishing to quit.

Objective: To assess the prevalence of overweight and obesity and its association with physical activity levels in children living in favelas in the city of Recife, state of Pernambuco, Brazil. Methods:A cross-sectional study was performed with 973 children ranging from 7 to 10 years old, all from two favelas in Recife, Fragoso and Caranguejo (total population of 9,315); of the 973 children assessed, 733 were included in the study. Overweight was defined as body mass index (BMI) equal to or above the 85th percentile, and obesity as BMI equal to or above the 95th percentile, using Centers for Disease Control and Prevention growth charts. Physical activity level was assessed by the Physical Activity Questionnaire for Older Children (PAQ-C). Children with scores ≥ 3 were considered active, while those with scores < 3 were considered inactive. Results:Of the 733 children studied, overweight and obesity were observed in 92 (12.6%). There was no statistical association between physical inactivity and sex, income, maternal schooling, number of siblings and hours of television.However, more children with physical inactivity were observed among overweight or obese children, 66/92 (71.6%) vs. 363/641 (56.7%) (p = 0.008). Conclusions:The prevalence of overweight and obesity is high, and is associated with physical inactivity in children living in favelas in the city of Recife, Brazil.J Pediatr (Rio J). 2009;85(1):67-71: Child, overweight, obesity, motor activity.

Background: The association between vitamin D and weight gain remains controversial due to important limitations in the studies. We investigated the relationship between vitamin D levels and 5 and 10 years of weight and waist circumference change in a population-based prospective cohort study. Methods: Prospective study including participants aged between 35 and 75 years living in the city of Lausanne, Switzerland. Weight and waist change at 5- and 10-year follow-up were assessed according to baseline vitamin D status (normal, insufficiency and deficiency). Results: A total of 3638 participants (47.9 % women, mean age 51.6 ± 10.4 years) were included for the 5-year follow-up. No association was found between vitamin D categories and weight change, multivariate-adjusted average ± standard error: 1.6 ± 0.3, 1.5 ± 0.2 and 1.2 ± 0.1 kg for normal, insufficiency and deficiency, respectively, p = 0.159. For waist change, the corresponding values were 3.3 ± 0.4, 3.3 ± 0.2 and 3.4 ± 0.2 cm, p = 0.792. For the 10-year follow-up, data from 2999 participants (45.8% women, mean age 50.8 ± 10.3 years) were used. No association was found for weight 2.3 ± 0.4, 2.3 ± 0.2 and 2.0 ± 0.2 kg, p = 0.588, or for waist 3.7 ± 0.4, 3.6 ± 0.3 and 4.2 ± 0.2 cm for normal, insufficiency and deficiency, respectively, p = 0.259. Conclusion: No association between vitamin D status and weight or waist gain at 5- and 10-year follow-up was found.