Que padrões usar para medir obesidade em crianças?

Abstract

Childhood obesity is of increasing public health concern because of the rapidly increasing prevalence in many countries worldwide. 1 Obesity contributes to early heart disease, the metabolic syndrome including hyperlipidemia and diabetes, hypertension and stroke. 2 Policies and programs for improving the nutrition and health of children can only really be developed on an evidence base if there is some information on how many children are overweight and how much their health risk is increased by being at a specified level of overweight or frank obesity. Among adults this is relatively easy because of the well- There are several issues to face when deciding on what cutoffs give a safe level of body weight for stature in childhood. The first is age. In a comparison of six international data sets, median BMI is around 13 at birth and increases to 17 by age 1, decreasing to 15.5 by age 6, and then increasing to 21 at age 20. 6 The second is ethnic diversity. There are differences in the distribution of body fat between subjects of different descent though how much this is due to dietary differences rather than genetic predisposition is still disputed. The third is puberty. There are clear differences in body shape between boys and girls and the age at which puberty occurs changes the shape of any agespecific BMI curve.A key question remains to be addressed at nationaland international levels what standards should be used for diagnosing overweight among children? In May 2000, an important paper was published by Cole and colleagues describing weight and height at different ages in both boys and girls using population data from USA, Singapore, Netherlands, Hong Kong, UK and Brazil. 6,7 The datasets used were large and rigorous, each survey containing over 10,000 subjects with ages ranging from 6-18 years. Percentile curves for BMI of these children were constructed using the LMS method. 7 This summarizes the data in terms of three smooth age-specific curves called L (lambda), M (mu) and S (sigma). The M and S curves correspond to the median and coefficients of variation of the BMI at each 2-year age band. The L curve allows for the substantial age-dependent skewness in the distribution of BMI. The mean values for the LMS calculation can then be provided in a table or a figure. The rationale for using this particular statistical approach is given in the paper by Cole et al. Not surprisingly there were differences in the curves using the median BMI by age for boys and girls between the six data sets. However, the basic shape of the curves was very similar.Data were also expressed as the centile for overweight (using the adult BMI index of 25) and a centile for obesity (using the adult BMI of 30). These centile curves were much closer together than the median curves.Using a BMI of 25 as cutoff at 18 years, the percentage above the cutoff (overweight) ranged from 4.7% in Brazilian boys up to 18.1% among USA boys. The equivalent figures for girls were 15.2% and 16.5% respectively. Using the centile score for a BMI of 30 (obe...

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“…Desta forma, entende-se que o investimento na prevenção da obesidade infantil nas primeiras etapas de vida, através da detecção de fatores de risco é capaz de evitar consequências a curto e longo prazos, como a incidência de coronariopatias e dislipidemias na vida adulta (9) . A promoção da saúde e a prevenção de agravos são os principais componentes de políticas de vida saudável para crianças, que podem ser fomentados pelo enfermeiro da ESF (10)(11) .…”

Acerca do regime fundacional da U. Porto

“…os riscos de curto a longo prazo da obesidade pediátrica incluem as dimensões físicas e psicológicas que podem induzir alterações psicossociais imediatas (isolamento social, 105-RPcd 13 (2) segundo tomkins (50) , há evidências, em estudos longitudinais, de que a obesidade infantil está associada a um maior risco de problemas vasculares e metabólicos na vida adulta.…”

Criança e jovem em risco: extensão desta noção ao contexto da Educação Física

“…(50) , há evidências, em estudos longitudinais, de que a obesidade infantil está associada a um maior risco de problemas vasculares e metabólicos na vida adulta.…”