Associação entre realização de refeições com os pais ou responsáveis e obesidade em adolescentes brasileiros

Abstract

Resumo: O objetivo do trabalho foi analisar a associação da frequência de almoçar e jantar com os pais/responsáveis e obesidade em adolescentes brasileiros participantes do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA). Estudo seccional, de base escolar, com adolescentes de 12 a 17 anos. A obesidade foi classificada pelo índice de massa corporal baseado nos critérios da Organização Mundial da Saúde, segundo idade e sexo. A associação entre obesidade e almoço e jantar com os pais/responsáveis (nunca, às vezes, quase todos os dias e todos os dias) foi investigada pela razão de prevalência bruta e ajustada para estratos de sexo e faixa etária. Foram avaliados 71.740 adolescentes. Desses, almoçavam e jantavam com os pais/responsáveis todos os dias ou quase todos os dias, respectivamente, cerca de 48% e 60% das meninas e 56% e 65% dos meninos. Os meninos que almoçavam e jantavam com os pais/responsáveis quase todos os dias e todos os dias apresentaram menor prevalência de obesidade. Na estratificação por faixa etária, apenas os meninos mais novos que afirmaram almoçar com os pais/responsáveis às vezes (RP = 0,64; IC95%: 0,46-0,89), quase todos os dias (RP = 0,50; IC95%: 0,37-0,69) e todos os dias (RP = 0,65; IC95%: 0,49-0,85) e jantar com os pais/responsáveis todos os dias (RP = 0,61; IC95%: 0,43-0,87) apresentaram menor prevalência de obesidade. Os achados reforçam a importância da promoção de comportamentos alimentares saudáveis no ambiente familiar como parte das estratégias de prevenção da obesidade em adolescentes.

Eating contexts and their associations with socio-demographic factors in Brazilian adolescents (EVA-JF Study)

“…Regarding the relationship between the socio-demographic factors and the eating contexts clusters, we observed that 'inappropriate eating context at breakfast' and 'inappropriate eating context at dinner' were associated with female sex; the youngest (14-15-year-olds) were less likely to belong to the 'inappropriate eating context at breakfast' cluster and the 'inappropriate eating context at dinner' cluster was also associated to higher mother's schooling. Our findings were consistent with the aforementioned literature, in which it was proved that the female sex (4,13,24,25,(27)(28)(29)31,38,39) and the highest SEP (white race and ethnicity, more schooled mothers and/or higher income) (4,31,39,45) were connected to inappropriate eating contexts and a lower diet quality, despite there being divergent evidence (medium or low SEP associated with inappropriate eating contexts (habit of skipping breakfast and of having meals in front of screens) (25,27) and unhealthy dietary patterns (39) ; and high SEP associated with appropriate eating contexts (habit of having meals in the company of family) (24) and healthy dietary patterns (44,46) ). Regarding age ranges, what we found was also supposedly aligned with the literature: among the youngest, there was a higher frequency of meals in the company of family (24,31) ; and among the oldest, higher omission frequency (27,29) and lower nutritional quality (26) at breakfast.…”

“…Regarding the comparisons between sexes, we observed that boys had breakfast, lunch and dinner more d/week, usually in a place perceived by them as quiet and sitting at the table; girls would more frequently switch regular dinner food for a snack or fast food and snacked more frequently while studying or doing homework. Previous national and international studies corroborate our findings: in boys, a higher frequency of breakfast consumption (24,(27)(28)(29) , of healthy eating pattern markers (beans, fruits and vegetables) (4,38) and of meals in the company of family (13,24,31) were seen; and in girls, higher frequencies of unhealthy food consumption (fried snacks, hamburgers, hot dogs and other processed meats, sweets, chocolate and soda) (4,38,39) , of eating fast food (5) and eating while watching TV or studying (25,39) were seen. Authors suggest that such differences may be connected to the fact that girls present greater dissatisfaction with body image, which, in turn, results in disordinate, restrictive and worse quality feeding behaviours (13,15,24,27,29,40) .…”

“…Previous national and international studies corroborate our findings: in boys, a higher frequency of breakfast consumption (24,(27)(28)(29) , of healthy eating pattern markers (beans, fruits and vegetables) (4,38) and of meals in the company of family (13,24,31) were seen; and in girls, higher frequencies of unhealthy food consumption (fried snacks, hamburgers, hot dogs and other processed meats, sweets, chocolate and soda) (4,38,39) , of eating fast food (5) and eating while watching TV or studying (25,39) were seen. Authors suggest that such differences may be connected to the fact that girls present greater dissatisfaction with body image, which, in turn, results in disordinate, restrictive and worse quality feeding behaviours (13,15,24,27,29,40) . In regard to the comparisons between socio-economic status, we observed that the high and middle strata had lunch more days/week; the middle stratum snacked more frequently at times close to main meals and the low stratum, despite having dinner on more days, had a higher prevalence of having meals on the couch/bed or standing/walking, and in front of screens.…”

“…(iii) Silva et al (13) , when analysing the data from ERICA (n 71 740), found that 44•4 % and 34•7 % of boys, and 52•4 % and 39•9 % of girls, respectively, did not have lunch or dinner in the company of their parents/guardians; and (iv) Maia et al (4) , when analysing the data from PeNSE (n 10 926), found that 31•5 % of the adolescents did not have the habit of having meals in the company of their parents/guardians, and 48•8 % would generally eat in front of screens or while studying. We hypothesised that our findings were more alarming than other representative national studies because we included only students enrolled in public schools, besides the differences in the instrument used to evaluate eating contexts.…”

“…In adolescents, it has been shown that certain eating contexts (e.g. omitting breakfast; eating out; having meals in front of screens (TV, videogames or smartphone/tablet/ computer) or while studying; and having meals without company) were associated with a lower diet quality (4)(5)(6)(7)(8)(9)(10) and a greater BMI (5,9,(11)(12)(13) . However, there is still a lack of studies in this field, especially regarding young individuals, a very critical gap, considering that adolescence is a phase of learning and biopsychosocial (physical, psychological and social) change (14)(15)(16) .…”