Frequency of obesity and related risk factors among school children and adolescents in a low-income community
a cross-sectional study
Keywords:
Obesity, Risk factors, Nutritional status, Cardiovascular diseases, LipidsAbstract
CONTEXT AND OBJECTIVE: The frequency of obesity at an early age may contribute to atherosclerosis and cardiovascular disease (CVD) in adults. This study measured the frequency of obesity and cardiovascular risk factors in children and adolescents aged 6 to 17 years. DESIGN AND SETTING: Cross-sectional study in a school located in a region of low income and socioeconomic status in Santa Rita do Sapucai, Minas Gerais, Brazil. METHODS: A total of 175 students were classified using body mass index (BMI) and their waist circumference, blood pressure, number of hours of sedentary behavior and school meals were evaluated. Serum concentrations of fasting blood glucose, total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C) were analyzed. RESULTS: 37.2% of the students had BMI above the 85th percentile and had significantly lower age, higher prevalence of hypertension, higher serum TC, LDL-C and TG, and greater waist circumference than those with BMI below the 85th percentile. Hypertension was observed in 2.9% of the students; 5.1% presented impaired glucose tolerance, 40% had two risk factors for atherosclerosis and 26.9% had three risk factors. A sedentary lifestyle was significantly less prevalent among subjects with BMI above the 85th percentile and was significantly correlated with serum TC and LDL-C. The school meals were hypoglycemic, hyperproteic and hyperlipidemic. CONCLUSION: One third of the children and adolescents had weights greater than or equal to the age-adjusted weight, and this was associated with greater waist circumference, hypertension and prevalence of dyslipidemia.
Downloads
References
Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med. 1999;340(2):115-26.
Oliveira CL, Fisberg M. Obesidade na infância e adolescência: uma verdadeira epidemia [Obesity in children and adolescent: a true epidemiology]. Arq Bras Endocrinol Metab. 2003;47(2):107-8.
Mendis S, Lindholm LH, Mancia G, et al. World Health Organization (WHO) and International Society of Hypertension (ISH) risk prediction charts: assessment of cardiovascular risk for prevention and control of cardiovascular disease in low and middle-income countries. J Hypertens. 2007;25(8):1578-82.
Baena CP, Chowdhury R, Schio NA, et al. Ischaemic heart disease deaths in Brazil: current trends, regional disparities and future projections. Heart. 2013;99(18):1359-64.
Ferraz ML, Nascimento DM, Rorato JP, et al. Correlation of lifetime progress of atherosclerosis and morphologic markers of severity in humans: new tools for a more sensitive evaluation. Clinics (Sao Paulo). 2012;67(9):1071-5.
Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics--2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;113(6):e85-151.
Romaldini CC, Issler H, Cardoso AL, Diament J, Forti N. Fatores de risco para aterosclerose em crianças e adolescentes com história familiar de doença arterial coronariana prematura [Risk factors for atherosclerosis in children and adolescents with family history of premature coronary artery disease]. J Pediatr (Rio J). 2004;80(2):135-40.
Williamson DF, Madans J, Anda RF, et al. Recreational physical activity and ten-year weight change in a US national cohort. Int J Obes Relat Metab Disord. 1993;17(5):279-86.
Lis S, Chen W, Srinivasan SR, et al. Childhood cardiovascular risk factors and carotid vascular changes in adulthood: the Bogalusa Hearth Study. JAMA. 2003;290(17):2271-6.
Coutinho W. Consenso Latino-Americano de Obesidade [Latin America consensus on obesity]. Arq Bras Endocrinol Metab. 1999;43(1):21-67.
Chinn S, Rona RJ. Prevalence and trends in overweight and obesity in three cross sectional studies of British Children, 1974-94. BMJ. 2001;322(7277):24-6.
Leão LSCS, Araújo LMB, Moraes LTLP, Assis AM. Prevalência de obesidade em escolares de Salvador, Bahia [Prevalence of obesity in school children from Salvador, Bahia]. Arq Bras Endocrinol Metab. 2003;47(2):151-7.
Holmbäck U, Fridman J, Gustafsson J, et al. Overweight more prevalent among children than among adolescents. Acta Paediatr. 2007;96(4):577-81.
Petersen S, Brulin C, Bergström E. Increasing prevalence of overweight in young schoolchildren in Umeå, Sweden, from 1986 to 2001. Acta Paediatr. 2003;92(7):848-53.
Dietz WH. Periods of risk on childhood for the development of adult obesity--what do we need to learn? J Nutr. 1997;127(9):1884S-1886S.
Brasil. Instituto Brasileiro de Geografia e Estatística. Sinopse do Censo demográfico 2010. População residente, total, urbana total e urbana na sede municipal, em números absolutos e relativos, com indicação da área total e densidade demográfica, segundo as Unidades da Federação e os municípios-2010. Available from: http://www.censo2010.ibge.gov.br/sinopse/index.php?uf=31. Accessed in 2014 (Nov 18).
Santos RD. III Diretrizes Brasileiras Sobre Dislipidemias e Diretriz de Prevenção da Aterosclerose do Departamento de Aterosclerose da Sociedade Brasileira de Cardiologia [III Brazilian Guidelines on Dyslipidemias and Guideline of Atherosclerosis Prevention from Atherosclerosis Department of Sociedade Brasileira de Cardiologia]. Arq Bras Cardiol. 2001;77(supl. 3):1-48.
Suñé FR, Dias-da-Costa JS, Olinto MTA, Pattussi MP. Prevalência e fatores associados para sobrepeso e obesidade em escolares de uma cidade no Sul do Brasil [Prevalence of overweight and obesity and associated factors among schoolchildren in a southern Brazilian city]. Cad Saude Publica. 2007;23(6):1361-71.
Bolzan A, Guimarey L, Frisancho AR. Study of growth in rural school children from Buenos Aires, Argentina using upper arm muscle area by height and other anthropometric dimensions of body composition. Ann Hum Biol. 1999;26(2):185-93.
de Onis M, Onyango AW, Borghi E, et al. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660-7.
Casey VA, Dwyer JT, Berkey CS, et al. The distribution of body fat from childhood to adulthood in a longitudinal study population. Ann Hum Biol. 1994;21(1):39-55.
Freedman DS, Serdula MK, Srinivasan SR, Berenson GS. Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr. 1999;69(2):308-17.
Falkner B, Daniels SR. Summary of the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Hypertension. 2004;44(4):387-8.
Brasil. Instituto Brasileiro de Geografia e Estatística. Pesquisa de orçamentos Familiares 2008-2009. Tabela de composição nutricional dos alimentos consumidos no Brasil. Rio de Janeiro: IBGE; 2011. Available from: http://www.ibge.gov.br/home/estatistica/populacao/condicaodevida/pof/2008_2009_composicao_nutricional/pofcomposicao.pdf. Accessed in 2014 (Nov 19).
American Diabetes Association, Bantle JB, Wylie-Rosett J, et al. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2008;31 Suppl 1:S61-78.
Sociedade Brasileira de Cardiologia; Sociedade Brasileira de Cardiologia; Sociedade Brasileira de Pediatria; et al. I Diretriz de Prevenção da Aterosclerose na Infância e na Adolescência. Arq Bras Cardiol. 2005;85(supl. 6):3-36.
Institute of Medicine (US) Subcommittee on Interpretation and Uses of Dietary Reference Intakes, Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. DRI Dietary Reference Intakes: Applications in Dietary Assessment. Washington: National Academies Press; 2000.
Coronelli CL, de Mourab EC. Hipercolesterolemia em escolares e seus fatores de risco [Hypercholesterolemia and its risk factors among schoolchildren]. Rev Saude Publica. 2003;37(1):24-31.
Barja S, Barrios X, Arnaiz P, et al. Niveles de lípidos sanguíneos em escolares chilenos de 10 a 14 años de edad [Blood lipids in Chilean children 10-14 years of age]. Nutr Hosp. 2013;28(3):719-25.
Bucher BS, Tschumi S, Simonetti GD. [Childhood’s determinants for high blood pressure in adulthood]. Ther Umsch. 2012;69(5):295-8.
Rover MRM, Kupek E, Delgado RCB, Souza LC. Perfil lipídico e sua relação com fatores de risco para a aterosclerose em crianças e adolescentes [Lipid profile and its relationship atherosclerosis risk factors in children and adolescents]. Rev Bras Anal Clín. 2010;42(3):191-5.
Costa JV, Silva ARV, Moura IH, et al. Análisis de los factores de riesgo para hipertensión arterial en adolescentes escolares [An analysis of risk factors for arterial hypertension in adolescent students]. Rev Latinoam Enferm. 2012;20(2):289-95.
Scherr C, Magalhães CK, Malheiros W. Análise do perfil lipídico em escolares [Lipid profile analysis in school children]. Arq Br Cardiol. 2007;89(2):73-8.
Moser DC, Milano GE, Brito LMS, Titski ACK, Leite N. Pressão arterial elevada, excesso de peso e obesidade abdominal em crianças e adolescentes [High blood pressure, overweigth and abdominal obesity in children and adolescentes]. Rev Educ Fis. 2011;22(4):591-600.
Silva JEF, Giorgetti KS, Colosio RC. Obesidade e sedentarismo como fatores de risco para doenças cardiovasculares em crianças e adolescentes de escolas públicas de Maringá, PR. Revista Saúde e Pesquisa. 2009;2(1):41-51. Available from: http://www.cesumar.br/pesquisa/periodicos/index.php/saudpesq/article/viewFile/868/721. Accessed in 2014 (Oct 16).
Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128 Suppl 5:S213-56.
Grillo LP, Crispim SP, Siebert AN, et al. Perfil lipídico e obesidade em escolares de baixa renda [Lipid profile and obesity in low income school children]. Rev Bras Epidemiol. 2005;8(1):75-81.
Halpern A, Mancini MC, Magalhães ME, et al. Metabolic syndrome, dyslipidemia, hypertension and type 2 diabetes in youth: from diagnosis to treatment. Diabetol Metab Syndr. 2010; 2:55.
Vásquez F, Díaz E, Lera L, et al. Impacto del ejercicio de fuerza muscular en la prevención secundaria de la obesidad infantil; intervención al interior del sistema escolar [Impact of strength training exercise on secondary prevention of childhood obesity; an intervention within the school system]. Nutr Hosp. 2013;28(2):347-56.