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BackgroundChildren who have unhealthy lifestyles are predisposed to develop hypertension, dyslipidemia and other complications. The epidemic of obesity is also affecting children with congenital heart disease. The aim of this study is to estimate the prevalence of obesity and describe associated risk factors, including family history in children with congenital heart disease.MethodsA cross-sectional study with 316 children and adolescents with congenital heart disease seen in an outpatient clinic of a reference hospital. Collected sociodemographic data included family history of chronic disease, dietary habits, laboratory tests (total cholesterol, HDL and LDL/cholesterol, triglycerides, fasting glucose, CRP, hematocrit and hemoglobin), and anthropometric assessment. Anthropometric data of the caregivers was self-reported.ResultsThe prevalence of excess weight was 26.9%. Altered levels of total cholesterol were observed in 46.9%, of HDL in 32.7%, LDL in 23.6% and of triglycerides levels in 20.0%. A higher frequency of family history of obesity (42.6%; p = 0.001), dyslipidemia (48.1%; p = <0.001), diabetes (47.4%; p = 0.002), hypertension (39.2%; p = 0.006) and ischemic disease (43.7%; p = 0.023), as well as significantly higher values of triglycerides (p = 0.017), glycemia (p = 0.004) and C-reactive protein (p = 0.002) were observed among patients with excess weight.ConclusionThe presence of modifiable risk factors and the variables associated to excess weight in this population was similar to that described in the literature for children without congenital disease. As these children already present the risks associated to heart disease, it is particularly important to promote a healthy lifestyle in this group.

Objective: To estimate the prevalence of overweight, obesity and nutritional habits in schoolchildren aged 10-18 years. Methods: Contemporary, cross-sectional, population-based study, with a stratified probabilistic sample of secondary schools in Porto Alegre comprising a total of 511 schoolchildren. Data on family risk factors, anthropometrics and eating habits were collected. Results: The prevalence of excess weight was 27?6 % among the schoolchildren, with 17?8 % being overweight (BMI $ 85th and ,95th percentile) and 9?8 % obese (BMI $ 95th percentile). Overweight was more prevalent in females (19?9 %) and obesity in males (11?8 %). Children who ate fewer meals per day tend to be more obese (mean: 3?51 (SD 1?14) v. 4?22 (SD 1?01) meals/d for students with normal weight). The mean weekly intake of unhealthy foods was 3?25 times for soft drinks, 2?91 for fried foods and 4?01 for sweets. The intake of skimmed milk (38?9 %) and diet soft drinks (20?9 %) was greater among obese children. Conclusion: Overweight and obesity are increasing even in developing countries such as Brazil. Although many families are already taking measures towards healthier health habits, preventive actions must be considered a priority, with an emphasis on education, in order to avoid the need to treat obesity and its significant burden in the near future. Keywords Schoolchildren Overweight Obesity Risk factors Eating habitsAccording to data from the WHO, about one-third of deaths worldwide are due to circulatory diseases such as coronary artery disease and cerebrovascular disease (1) . Approximately 80 % of deaths from CVD occur in developing countries and it is estimated that by 2010 these diseases will be the main cause of death in those countries (2) . Atherosclerotic disease is the result of a combination of genetic, socio-economic and environmental factors. Pathological alterations due to atherosclerosis may be identified long before the onset of clinical signs of the disease. By the end of adolescence, about 61 % of individuals present some type of atherosclerotic lesion in the coronary arteries. After the age of 40 years, such lesions are present in almost 95 % of the population.Lifestyles causing atherosclerosis may begin in early childhood and the prevalence of risk factors such as overweight and obesity, hypertension, dyslipidaemia, sedentarism and diabetes mellitus in this age group has been rising. If these conditions persist, it is likely that diseases that were formerly seen only in much older adults will become a cause of morbidity in young adults and adolescents as well. It is therefore necessary to institute early preventive management at all levels of health care.Considering the evidence that the prevalence of overweight and obesity has been increasing in developing countries, including Brazil (3) , the purpose of the current study was to investigate the presence of these risk factors in a population-based sample of schoolchildren aged 10 to 18 years in Porto Alegre, southern Brazil. In addition, we sought to ex...

Objective To verify the relationship between the adductor pollicis muscle thickness test and the subjective global assessment and to correlate it with other anthropometric methods.Methods This observational cross-sectional study was conducted in the intensive care unit of a cardiology hospital in the state of Rio Grande do Sul, Brazil. The hospitalized patients underwent subjective global assessment and adductor pollicis muscle thickness tests on both hands, along with measurement of the right calf circumference. Laboratory parameters, length of stay, vital signs and electronic medical record data and tests were all collected.Results The study population included 83 patients, of whom 62% were men. The average age was 68.6 ± 12.5 years. The most common reason for hospitalization was acute myocardial infarction (34.9%), and the most common pathology was systolic blood pressure (63.9%), followed by diabetes mellitus (28.9%). According to subjective global assessment classifications, 62.7% of patients presented no nutritional risk, 20.5% were moderately malnourished and 16.9% were severely malnourished. Women had a higher nutritional risk, according to both the subjective global assessment and the adductor pollicis muscle thickness test, the cutoff for which was < 6.5mm (54.8%; p = 0.001). The pathology presenting the greatest nutritional risk was congestive heart failure (p = 0.001). Evaluation of the receiver operating characteristic (ROC) curve between adductor pollicis muscle thickness and subjective global assessment showed the accuracy of the former, with an area of 0.822.Conclusion Adductor pollicis muscle thickness proved to be a good method for evaluating nutritional risk.

BackgroundThe prevalence of hypertension among children and adolescents is estimated to range between 1% and 13%. Excess weight and central obesity are related to blood pressure levels in adults, and may be important in the early pathogenesis of SH when present in childhood. ObjectivesTo study the association between anthropometric variables and blood pressure levels in schoolchildren from the 5th and 8th grades, and to identify which parameter was more strongly correlated with blood pressure levels. MethodsContemporary cross-sectional study with probabilistic population-based cluster sampling of schoolchildren enrolled from the 5th to the 8th grades in public elementary schools of Porto Alegre. Data on familial risk factors and anthropometry were collected. Statistical analysis included correlations and cluster-adjusted confidence intervals. ResultsThe mean age of participants was 12.57 (± 1.64) years, and 55.2% of them were females. Abnormal blood pressure levels were found in 11.3% of the sample and borderline values, in 16.2%. Among the anthropometric variables analyzed, hip circumference was the one with the strongest correlation with increased blood pressure (r = 0.462, p < 0.001), followed by waist circumference (r = 0.404, p < 0.001) and abdominal skinfold (r = 0.291, p < 0.001). ConclusionWe observed an association of waist circumference and skinfolds with increased blood pressure levels in the schoolchildren of the sample. Therefore, it is of the utmost importance that early measurements of blood pressure, and waist and hip circumferences become a routine in health services in order to prevent this condition.

BackgroundThe aim of the current study was to test the effectiveness of a physical activity and exercise-based program in a clinical context to reduce cardiovascular risk factors in children and adolescents.MethodsA randomized clinical trial was conducted in a pediatric preventive outpatient clinic. Intervention was 14 weeks of exercise for the intervention group or general health advice for the control group. The primary and the secondary outcomes were reduction of cardiovascular risk factors and the feasibility and the effectiveness of clinical advice plan to practice physical exercises at home.ResultsA total of 134 children were screened; 26 met eligibility criteria. Of these, 10 were allocated in the exercise intervention group and nine were included in the control group until the end of the intervention. Those patients who discontinued the intervention had the lowest scores of z-BMI (P = 0.033) and subscapular skin fold (P = 0.048). After 14 weeks of intervention, no statistical differences were found between the groups. High-density lipoprotein cholesterol (HDL-C) was higher in the exercise group, with a mild tendency to be significant (P = 0.066). Patients who adhere to treatment had diastolic blood pressure decreased from baseline to the end of the follow-up period in the control group (P = 0.013). Regardless of this result, the other comparisons within the group were not statistically different between T0 and T14.ConclusionA low-cost physical activity advice intervention presented many barriers for implementation in routine clinical care, limiting its feasibility and evaluation of effectiveness to reduce cardiovascular risk factors.

O efeito do índice de massa corporal sobre as complicações no pós-operatório de cirurgia de revascularização do miocárdio em idososThe effect of the body mass index on postoperative complications of coronary artery bypass grafting in elderly Abstract Objectives: To evaluate the effect of BMI (body mass index) in the postoperative period of elderly patients undergoing CABG.Methods: Cross-sectional retrospective study, carried out in academic hospital, with all patients (n=290), aged or above 60 years, undergone CABG, from August 2006 to July 2007. The patients were divided into tertiles of BMI (<22, 22-27,> 27kg /m²). The variables included in the study were collected from medical records of patients and analyzed by logistic regression in association with the categories of BMI.Results: In the group with malnutrition were found larger percentage of impaired lung, kidney, hospital stay and immediate surgical mortality; but without statistical significance. Among female patients, the group malnutrition and eutrophy, 61.5% had hospital stay for a period longer than seven postoperative days compared to 42.5% male patients (p=0.003). In the group with malnutrition was found association between the CPB time and renal dysfunction with p<0.001 and, in eutrophic group with p=0.04. Obesity obtained protective association for lung dysfunction (RR=0.99), readmissions (RR=0.45) and mortality (RR = 0.77), and risk factor for renal dysfunction (RR=1.12). Conclusions 525REIS, C ET AL -The effect of the body mass index on postoperative complications of coronary artery bypass grafting in elderly Bras Cir Cardiovasc 2008; 23(4): 524-529 Rev