RESUMEN

Abstract Life habits during childhood are decisive for future health conditions. The aim of this study was to evaluate screen time and anthropometry of children enrolled in municipal schools in the interior of the State of São Paulo. A cross-sectional study was carried out with students from 9 to 10 years of age from a city in the State of São Paulo, Brazil. A socioeconomic questionnaire validated by the Brazilian Association of Research Companies was used, containing also the determination of screen time (TV, video game, computer and cell phone), recommended by the Pediatrics Society. Anthropometry data was collected according to the Lohmam Anthropometric Standardization Reference Manual and compared to the z-score level with the WHO 2007. For the statistical analysis, Kruskal-Wallis, Chi-square or Fisher's Exact tests were used.The confidence level was at 95%. Out of the 703 schoolchildren assessed, 97.44% had adequate height, 59.17% eutrophy BMI and 30.44% overweight. There was a correlation between BMI and non-stratified social class (p=0.038) and BMI and neck circumference (NC) (p<0.001).The z-score of the BMI showed that children with weight loss stayed longer watching TV (p=0.0486). The gender comparison showed that girls of higher social class stayed longer at the computer (p=0.0351) and using the cell phone (p<0.0001),and boys playing videogame (p=0.0005). Overweight and weight loss shown in the positive correlation between BMI and NC, although on opposite sides, were associated with screen time and especially with TV in children of higher social class.

Resumo Hábitos de vida apresentados durante a infância, serão decisivos para a situação de saúde no futuro. Objetivou-se avaliar tempo de tela e antropometria de crianças matriculadas em escolas municipais do interior de São Paulo. Estudo transversal com escolares de 9 a 10 anos de idade de uma cidade do estado de São Paulo-Brasil. Utilizou-se um questionário sócio-econômico validado pela Associação Brasileira de Empresas de Pesquisa, contendo também a determinação do tempo de tela (TV, vídeo game, computador e celular), recomendado pela Sociedade de Pediatria. A antropometria foi coletada de acordo com o Anthropometric Standardization Reference Manual de Lohmam e comparada à nível de escore-z, com a WHO 2007. Para a análise estatística utilizou-se os testes de Kruskal-Wallis, Qui-quadrado ou Exato de Fisher. O nível de confiança foi de 95%. Dos 703 escolares avaliados, 97,44% apresentaram estatura adequada, 59,17% IMC de eutrofia e 30,44% de sobrepeso. Houve correlação entre o IMC e a classe social não estratificada (p=0,038) e o IMC e circunferência do pescoço (CP) (p<0,001). O escore-z do IMC mostrou que as crianças com magreza ficaram mais tempo na TV (p=0,0486). A comparação de gêneros mostrou que as meninas de classe social mais alta ficaram mais tempo no computador (p=0,0351) e no celular (p< 0,0001), e os meninos no videogame (p=0,0005). O sobrepeso e a magreza mostrados na correlação positiva entre IMC e CP, embora estejam em lados opostos, foram associados ao tempo de tela e principalmente à TV, nas crianças de maior classe social.

Asunto(s)

RESUMEN

Nutritional assessment is essential to diagnose and correct nutritional status, thus reducing hospital costs and mortality due to malnutrition. A new technique to evaluate the muscular compartment is the assessment of the adductor pollicis muscle thickness. It is a simpler alternative compared to the anthropometric parameters presently used. The objective of this research was to verify the association of the adductor policis muscle thickness with the anthropometric and subjective parameters of hospitalized patients, and subsequently, identify a cutoff point to be used as indicator of nutritional status. One hundred twelve patients hospitalized in the Medical and Surgical Clinic of a University Hospital in the countryside of the State of Sao Paulo were evaluated. The patients were submitted to nutritional assessment using the following parameters: subjective global assessment, classic anthropometry, and measurement of the adductor pollicis muscle thickness. The sample consisted mostly of patients with cardiovascular diseases (30.4%). The nutritional status of patients was characterized according to body mass index on prevalence of overweight and obesity (53.6%) and subjective global assessment of patients classified as nourished (72.3%). The mean thickness of the adductor pollicis muscle was 12.4±5.1mm. The adductor policis muscle thickness was weakly associated with anthropometric and subjective measures and failed to identify the cutoff point as an indicator of nutritional status, since the majority of the patients assessed presented overweight and obesity.

La evaluación nutricional es fundamental para diagnosticar y corregir el estado nutricional, reduciendo así los costos hospitalarios y la mortalidad, derivados de la desnutrición. Una nueva técnica para evaluar el compartimiento muscular consiste en evaluar la espesura del músculo aductor del pulgar (EMAP), que resulta una alternativa tan o más simple que los parámetros antropométricos utilizados actualmente. El objetivo de este estudio fue investigar la asociación de la espesura del músculo aductor del pulgar con parámetros antropométricos y subjetivos de pacientes hospitalizados, y la posterior identificación de un punto de corte a ser usado como indicador del estado nutricional. Se evaluaron 112 pacientes hospitalizados en la Clínica Médica y Clínica Quirúrgica de un Hospital Universitario del interior paulista. Los pacientes fueron sometidos a evaluación nutricional, utilizándose la medida de espesura del músculo aductor del pulgar, la evaluación subjetiva global y la antropometría clásica. La muestra estaba compuesta en su mayoría por pacientes con enfermedades cardiovasculares (30,4%). El estado nutricional de los pacientes se caracterizó, de acuerdo con el índice de masa corporal, por la prevalencia de sobrepeso y obesidad (53,6%) y, de acuerdo con la evaluación subjetiva global, por pacientes clasificados como bien nutridos (72,3%). El promedio de espesura del músculo aductor del pulgar para la muestra total fue de 12,4±5,1mm. El EMAP presentó asociación débil con los indicadores antropométricos y subjetivos, aunque no fue posible determinar un punto de corte del EMAP para su uso como indicador de estado nutricional, como consecuencia de la gran proporción de sobrepeso y obesidad en la población estudiada.

A avaliação nutricional é fundamental para se diagnosticar e corrigir o quadro nutricional, reduzindo-se assim os custos hospitalares e a mortalidade decorrentes da desnutrição. Uma nova técnica para avaliar o compartimento muscular é a avaliação da espessura do músculo adutor do polegar que surge como uma alternativa tão ou mais simples frente aos parâmetros antropométricos já utilizados. O objetivo do trabalho foi verificar a associação da espessura do músculo adutor do polegar com parâmetros antropométricos e subjetivos de pacientes hospitalizados e, posteriormente, identificar um ponto de corte a ser utilizado como indicador do estado nutricional. Foram avaliados 112 pacientes internados nas enfermarias de Clínica Médica e Clínica Cirúrgica de um Hospital Universitário do interior paulista. Os pacientes foram submetidos à avaliação nutricional, sendo utilizada a medida da espessura do músculo adutor do polegar, a avaliação subjetiva global e a antropometria clássica. A amostra foi constituída, na sua maioria, por pacientes com doenças cardiovasculares (30,4%). O estado nutricional dos pacientes caracterizou-se, segundo o índice de massa corporal, por prevalência de sobrepeso e obesidade (53,6%) e, segundo a avaliação subjetiva global, de pacientes classificados como bem nutridos (72,3%). A média da espessura do músculo adutor do polegar para o total da amostra foi de 12,4±5,1mm. A EMAP apresentou fraca associação com os indicadores antropométricos e subjetivos, não sendo possível determinar um ponto de corte do EMAP para a classificação do estado nutricional, tendo em vista a grande proporção de sobrepeso e obesidade na população estudada.

Asunto(s)

RESUMEN

CONTEXT: Malnutrition is frequently observed in inpatients with malignant diseases and may contribute to longer hospital stays. OBJECTIVE: To compare the nutritional status, lymphocyte count, hemoglobin values and length of hospital stay of patients with and without malignant diseases. METHODS: This comparative study assessed indicators of nutritional status, namely body mass index, recent weight loss, lymphocyte count, hemoglobin and length of hospital stay, of 928 surgical patients with and without malignant diseases (50.2% females and 49.8% males). The chi-square test was used to compare proportions and the Mann-Whitney test was used to compare continuous measurements between two groups. The significance level was set at 5%. RESULTS: Patients with malignant diseases had longer hospital stays (P<0.0001), furthermore, a higher percentage of patients with malignant diseases had body mass index <18.5 (P<0.0001) and experienced recent weight changes (P<0.0002). Lymphocyte count also differed statistically between the groups (P = 0.0131), which lower levels were identified among patients with malignant diseases. CONCLUSION: The lymphocyte count, hemoglobin values and weight loss are important findings of nutritional depletion in patients with malignant diseases.

Asunto(s)

RESUMEN

CONTEXT: Malnutrition is frequently observed in inpatients with malignant diseases and may contribute to longer hospital stays. OBJECTIVE: To compare the nutritional status, lymphocyte count, hemoglobin values and length of hospital stay of patients with and without malignant diseases. METHODS: This comparative study assessed indicators of nutritional status, namely body mass index, recent weight loss, lymphocyte count, hemoglobin and length of hospital stay, of 928 surgical patients with and without malignant diseases (50.2 percent females and 49.8 percent males). The chi-square test was used to compare proportions and the Mann-Whitney test was used to compare continuous measurements between two groups. The significance level was set at 5 percent. RESULTS: Patients with malignant diseases had longer hospital stays (P<0.0001), furthermore, a higher percentage of patients with malignant diseases had body mass index <18.5 (P<0.0001) and experienced recent weight changes (P<0.0002). Lymphocyte count also differed statistically between the groups (P = 0.0131), which lower levels were identified among patients with malignant diseases. CONCLUSION: The lymphocyte count, hemoglobin values and weight loss are important findings of nutritional depletion in patients with malignant diseases.

CONTEXTO: A desnutrição em pacientes com doenças malignas é frequentemente observada durante a hospitalização e pode acarretar num aumento do período de internação. OBJETIVO: Comparar o estado nutricional, valores de linfócitos e hemoglobina e o tempo de internação em pacientes com e sem doenças malignas. MÉTODOS: Estudo comparativo com 928 pacientes cirúrgicos com e sem doenças malignas (50,2 por cento do sexo feminino e 49,8 por cento do sexo masculino), sendo analisados os indicadores do estado nutricional como índice de massa corporal, perda de peso recente, contagem de linfócitos, hemoglobina e o tempo de internação. Foi aplicado o teste qui ao quadrado para comparação de proporções e para a comparação de medidas contínuas entre dois grupos e foi aplicado também o teste de Mann-Whitney, com nível de significância de 5 por cento. RESULTADOS: Os pacientes com doenças malignas ficaram internados por mais tempo (P<0.0001), sendo constatado ainda neste grupo, maior percentual de pacientes com índice de massa corporal <18.5 (P<0.0001) e alteração de peso (P = 0.0002). Na contagem de linfócitos, constatou-se diferença estatística entre os grupos (P = 0,0131), sendo os menores valores encontrados entre os pacientes com doenças malignas (P = 0.01). CONCLUSÃO: A contagem de linfócitos, os valores de hemoglobina e a perda ponderal são achados importantes de depleção nutricional em pacientes com doenças malignas.

Asunto(s)

RESUMEN

OBJECTIVE: The objective of this study was to identify the associations between the nutritional status of elderly patients and length of hospital stay and presence of dental and gastrointestinal changes. CASUISTIC AND METHOD: This cross-sectional study analyzed anthropometric and food intake indicators, dental and gastrointestinal changes and length of hospital stay of 441 elderly patients of both genders. The Pearson's correlation coefficient was used to verify the correlation between the nutritional status of the elderly patients and length of hospital stay and presence of dental and gastrointestinal changes. The significance level was set at P < 0.05. RESULTS: Dietary and anthropometric variables as well as length of hospital stay were similar for patients with and without dental changes. Patients with gastrointestinal changes consumed less energy (P < 0.05) than patients without gastrointestinal changes. Length of hospital stay was inversely correlated with body mass index (r = -0.15; P < 0.05); arm circumference was inversely correlated with presence of dental changes (r = -0.12; P < 0.05) and mid-arm muscle circumference was inversely correlated with gastrointestinal changes (r = -0.12; P < 0.05). CONCLUSION: Dental and gastrointestinal changes are important indicators of nutritional depletion and dietary intake of inpatients.

Asunto(s)

RESUMEN

Objetivos: Investigar o reflexo da transição nutricional sobre o estado nutricional e a composição corporal de pacientes hospitalizados. Métodos: Avaliaram-se 819 pacientes hospitalizados (435 homens e 384 mulheres) sob aspectos clínicos, antropométricos e dietéticos. As variáveis antropométricas estudadas foram: peso atual (PA), altura (A), circunferência da cintura (CC), circunferência do quadril (CQ), circunferência braquial (CB), prega cutânea triciptal (PCT), e prega cutânea subescapular (PCSE). A partir destas medidas foram calculados: o índice de massa corporal (IMC), a relação entre a cintura e o quadril (RCQ), a relação entre a cintura e a altura (RCA), a circunferência muscular do braço (CMB), a área muscular do braço (AMB) e a área adiposa do braço (AAB). Para o diagnóstico da adiposidade central utilizou-se a relação entre a circunferência da cintura e a do quadril. Resultados: A idade média da população foi de 53,7±16,0 anos, com permanência hospitalar de 8 dias, sendo maior entre os idosos sendo maior entre os idosos (p<0,01).Parte dos pacientes (47,8%) apresentou sobrepeso/obesidade, 48,6% valores alterados de circunferência dacintura e 76,4% adiposidade central. As doenças cardiovasculares representaram 45,4%do total de internações, sendo 60,4% entre os idosos. Conclusão: Esse estudo mostrou elevada prevalência de obesidade e adiposidade central entre os pacientes hospitalizados independente do gênero, da idade, e do motivo de internação, tornando evidente o reflexo datransição nutricional na população estudada.

Objectives: To investigate the effects of nutritional transition on the nutritional status and body composition of inpatients. Methods: We assessed 819 inpatients (435 men and 384women) regarding clinical, anthropometric and dietary aspects. The anthropometric variables studied were: current weight (CW), height (H), waist circumference (WC), hip circumference (HC), arm circumference (AC), triceps skinfold (TSF) and subscapular skinfold thickness (SST). From these measures were determined: the body mass index (BMI), the waist and hip ratio (WHR), the waist and height ratio (RCA), the arm muscle circumference (AMC), the arm muscle area (AMA) and arm fat area (AFA). For the diagnosis of central adiposity, we used the relationship between waist and hip circumferences. Results: The mean age was 53.7 ± 16.0 years, with hospital stay of 8 days, being higher among the elderly (p <0.01). Most patients (47.8%) were overweight or obese, 48.6% presented altered values of waist circumference and 76.4% had central adiposity. Cardiovascular disease accounted for 45.4% of total admissions, and 60.4% among the elderly. Conclusion: This study showed high prevalence of obesity and central adiposity among inpatients regardless of gender, age, and the reason for admission, evidencing the effects of nutritional transition in the studied population.

Asunto(s)

RESUMEN

CONTEXT AND OBJECTIVE: Increasing obesity is starting to occur among Brazilians. The aim of this study was to investigate the weight and length of children under two years of age in relation to sociodemographic variables and according to whether they were breastfed. DESIGN AND SETTING: Cross-sectional randomized study conducted in 2004-2005, based on the declaration of live births (SINASC) in Campinas, Brazil. METHODS: 2,857 mothers of newborns were interviewed and answered a questionnaire seeking socioeconomic and breastfeeding information. The newborns' weights and lengths were measured at the end of the interviews and the body mass index was calculated. Percentiles (< 15 and > 85) and Z-scores (< -1 and > +1) were used for classification based on the new growth charts recommended by WHO (2006). The log-rank test, multiple linear regression and binomial test (Z) were used. The statistical significance level used was 5%. RESULTS: The predominant social level was class C. The median for exclusive breastfeeding was 90 days; 61.25% of the children were between P15 and P85 for body mass index and 61.12% for length, respectively. Children whose mothers studied for nine to eleven years and children whose mothers were unemployed presented lower weight. Children whose mothers worked in health-related professions presented lower length when correlated with breastfeeding. CONCLUSION: The breastfeeding, maternal schooling and maternal occupation levels had an influence on nutrition status and indicated that obesity is occurring in early childhood among the infants living in the municipality.

Asunto(s)

RESUMEN

OBJETIVO: Verificar a prevalência do aleitamento materno entre lactentes, correlacionada com variáveis sócio-demográficas, em Campinas (SP). MÉTODOS: Entre os anos de 2004 e 2005, entrevistadores visitaram 2 857 domicílios de crianças menores de dois anos e aplicaram às mães um questionário estruturado, composto por perguntas sobre nível socioeconômico, amamentação e alimentação complementar. O estudo foi transversal, de base populacional, randomizado, realizado com base nos dados da Declaração de Nascidos Vivos e da prevalência do aleitamento. A duração mediana do aleitamento foi determinada pela análise de sobrevida de Kaplan Méier, e o ajuste do tempo, pela análise multivariada de Cox. A significância estatística adotada foi de 5 por cento. RESULTADOS: A mediana do aleitamento materno exclusivo foi de 90 dias (Intervalo de Confiança - IC95 por cento: 87,6-92,4) e a do aleitamento materno geral foi de 120 dias (IC95 por cento: 117,7-122,3). Com um mês de vida, 66,2 por cento das crianças estavam sendo amamentadas exclusivamente com leite do peito, índice que diminuiu para 2,3 por cento aos seis meses. A introdução mediana para chá (IC95 por cento: 113,2-126,8) e para leite em pó (IC95 por cento: 112,7-127,3) foi de 120 dias. A cor da pele da criança, a escolaridade, a profissão e o estado civil maternos foram fatores associados à duração e ao tipo de amamentação. CONCLUSÃO: Fatores sócio-demográficos podem interferir na duração mediana do aleitamento materno que, embora esteja melhor do que em outros locais do Brasil, está abaixo do padrão recomendado internacionalmente, sugerindo a necessidade de maiores investimentos em relação a este fato, no município.

OBJECTIVE: The aim of this study was to verify the proportion of breastfed infants and correlate it with sociodemographic data in Campinas (SP), Brazil. METHODS: Between 2004 and 2005, interviewers visited 2,857 homes of children under two years of age and interviewed their mothers with a structured questionnaire containing questions regarding their socioeconomic level, breastfeeding practices and complementary foods. This randomized, cross-sectional, population-based study was based on data of "Children Born Alive" and on the prevalence of breastfeeding. The median breastfeeding duration was determined by Kaplan Meier's survival analysis and the time was adjusted by Cox's multivariate analysis. The significance level was set at 5 percent. RESULTS: Median exclusive breastfeeding was 90 days (CI 95 percent: 87.6 - 92.4); and median general breastfeeding was 120 days (CI 95 percent: 117.7 - 122.3). At 1 month of age, 66.2 percent of the children were exclusively breastfed; this percentage decreased to 2.3 percent at 6 months of age. Tea and powdered milk were introduced at a median age of 120 days (CI 95 percent: 113.2 - 126.8 and CI 95 percent: 112.7 - 127.3 respectively). The child's skin color and the mother's education level, profession and marital status were associated with breastfeeding duration and practices. CONCLUSION: Sociodemographic factors can interfere in median breastfeeding duration. Although the median breastfeeding duration in Campinas is better than elsewhere in Brazil, it is below the internationally recommended median, the city needs to invest more in this area.

Asunto(s)

RESUMEN

OBJETIVO: Estabelecer o momento da introdução de alimentos complementares na dieta dos lactentes no Município de Campinas, Estado de São Paulo, Brasil. MÉTODOS: Estudo transversal com 2 857 crianças menores de 2 anos sorteadas no banco de nascidos vivos (SINASC) da secretaria de saúde do município entre 2004 e 2005. As mães responderam a um questionário contendo 87 questões fechadas que coletou informações sociais, sobre aleitamento materno e sobre a época de introdução de outros alimentos. RESULTADOS: A caracterização das mães revelou que 13,5 por cento eram adolescentes, 73,1 por cento completaram o ensino fundamental ou médio, 45,9 por cento desempenhavam funções de nível técnico, 6,7 por cento tinham profissões de nível superior e 2,7 por cento eram profissionais da saúde. O nível socioeconômico médio da população foi da classe C; porém, todas as classes sociais estiveram representadas. A mediana do aleitamento materno exclusivo foi de 90 dias (IC95 por cento: 87,6 a 92,4). Para introdução de água (IC95 por cento: 118,6 a 121,4) e de chá (IC95 por cento: 113,2 a 126,8), a mediana foi de 120 dias; da papa salgada (IC95 por cento: 178,6 a 181,4) e leite em pó (IC95 por cento: 169,0 a 191,0), de 180 dias. Antes dos 4 meses, 39,1 por cento haviam ingerido leite em pó e 2,1 por cento refrigerantes, dados que subiram para 63,2 e 69,1 por cento, respectivamente, com 1 ano. As mulheres que trabalhavam em profissões de nível técnico, as que estavam desempregadas e as que não tinham companheiro ofereceram leite materno por menos tempo. CONCLUSÕES: A mediana do aleitamento materno exclusivo está distante do preconizado devido à oferta de líquidos. A introdução alimentar revelou-se precoce, principalmente para guloseimas.

OBJECTIVE: To establish the timing for introducing supplementary foods in the diet of infants from the city of Campinas, state of São Paulo, Brazil. METHODS: This cross-sectional study included 2 857 children younger than 2 years of age randomly selected from the city department of health live birth database between 2004 and 2005. The mothers answered a questionnaire that included 87 closed questions designed to collect information concerning socioeconomic status, breastfeeding, and timing of introduction of supplementary foods. RESULTS: Assessment of the mothers revealed that 13.5 percent were adolescents, 73.1 percent had completed elementary or high school education, 45.9 percent had technical level jobs, 6,7 percent had jobs requiring a university degree, and 2.7 percent were health professionals. On average, participants belonged to socioeconomic class C (ranging from A, highest, to E, lowest), but all socioeconomic classes were represented. The median duration of exclusive breastfeeding was 90 days (95 percentCI: 87.6-92.4). Water (95 percentCI: 118.6-121.4) and tea (95CI percent: 113.2-126.8) were introduced at a median of 120 days. Semi-solid foods (95 percentCI: 178.6-181,4) and powdered milk (95 percentCI: 169.0-191.0) were introduced at a median of 180 days. Powdered milk and soft drinks had been ingested by 39.1 percent and 2.1 percent, respectively, at 4 months, and by 63.2 and 69.1 percent, respectively, at 1 year of age. Shorter breastfeeding duration was observed for women with technical level jobs, those who were unemployed, and those without a partner. CONCLUSIONS: The median duration of exclusive breastfeeding was far from that recommended due to the offer of supplementary fluids. Supplementary foods were introduced precociously, especially sweets.

Asunto(s)

RESUMEN

CONTEXT AND OBJECTIVE: Increasing obesity is starting to occur among Brazilians. The aim of this study was to investigate the weight and length of children under two years of age in relation to sociodemographic variables and according to whether they were breastfed. DESIGN AND SETTING: Cross-sectional randomized study conducted in 2004-2005, based on the declaration of live births (SINASC) in Campinas, Brazil. METHODS: 2,857 mothers of newborns were interviewed and answered a questionnaire seeking socioeconomic and breastfeeding information. The newborns' weights and lengths were measured at the end of the interviews and the body mass index was calculated. Percentiles (< 15 and > 85) and Z-scores (< -1 and > +1) were used for classification based on the new growth charts recommended by WHO (2006). The log-rank test, multiple linear regression and binomial test (Z) were used. The statistical significance level used was 5 percent. RESULTS: The predominant social level was class C. The median for exclusive breastfeeding was 90 days; 61.25 percent of the children were between P15 and P85 for body mass index and 61.12 percent for length, respectively. Children whose mothers studied for nine to eleven years and children whose mothers were unemployed presented lower weight. Children whose mothers worked in health-related professions presented lower length when correlated with breastfeeding. CONCLUSION: The breastfeeding, maternal schooling and maternal occupation levels had an influence on nutrition status and indicated that obesity is occurring in early childhood among the infants living in the municipality.

CONTEXTO E OBJETIVO: O aumento da obesidade começa a acontecer entre os brasileiros. O objetivo do estudo foi verificar o peso e a altura associados a variáveis sócio-demográficas de crianças menores de dois anos, de acordo com o aleitamento materno. TIPO DE ESTUDO E LOCAL: Estudo transversal, aleatório, realizado entre 2004 e 2005, com base na Declaração de Nascidos Vivos (SINASC) de Campinas, São Paulo. MÉTODOS: Mães de 2.857 crianças foram entrevistadas respondendo a um questionário com informações sócio-demográficas e de amamentação. Ao final, foram aferidos peso e comprimento dos lactentes e calculado o Índice de Massa Corporal. Os pontos de percentis (< 15 e > 85) e de escore-Z (< -1 e > +1) foram utilizados para classificação, com base nos novos gráficos de crescimento recomendados pela Organização Mundial de Saúde 2006. Foi utilizado o teste de log-rank, a análise de regressão linear e o teste binomial (Z). O nível de significância estatística adotado foi de 5 por cento. RESULTADOS: O nível social predominante foi classe C. A mediana do aleitamento materno exclusivo foi de 90 dias. 61,25 por cento das crianças estavam entre os percentis P15-P85 para índice de massa corporal e 61,12 por cento para comprimento, respectivamente. Nas crianças cuja mãe estudou entre 9 e 11 anos o peso foi menor, bem como para os filhos de mães desempregadas. Filhos de mães com profissões na área da saúde apresentaram menor comprimento, quando correlacionados ao aleitamento. CONCLUSÃO: Os níveis encontrados para aleitamento, escolaridade e profissão maternas exerceram influência sobre o estado de nutrição, indicando que a obesidade está acontecendo precocemente na infância nos lactentes do município.

Asunto(s)

RESUMEN

Gota é uma desordem metabólica associada a alterações no metabolismo do ácido úrico e hiperuricemia. A incidência de hiperuricemia e de gota tem aumentado no mundo todo e está frequentemente associada aos fatores de risco da síndrome metabólica. A terapia nutricional consiste no consumo de alimentos pobres em purina, proteína de origem animal e frutos do mar; aumento no consumo de frutas, hortaliças, leite e derivados; adequada hidratação, e restrição de bebidas alcóolicas. A presença de hiperuricemia deve permitir a oportunidade de modificar ou corrigir suas causas, por meio de uma intervenção nutricional individualizada, e deve servir como incentivo para a implementação de estratégias modificadoras de estilo de vida, incluindo a prevenção da obesidade, intolerância à glicose, hipercolesterolemia e hipertensão arterial.

La gota es un trastorno metabólico asociado con cambios en el metabolismo del ácido úrico e hiperuricemia. La incidencia de la hiperuricemia y la gota se ha incrementado en todo el mundo y se asocia frecuentemente a los factores de riesgo del síndrome metabólico. El tratamiento nutricional es el uso de alimentos bajos en purinas, proteínas de origen animal y productos del mar, el mayor consumo de frutas, verduras, productos lácteos, una hidratación adecuada, y el alcohol restricción. La presencia de hiperuricemia debe permitir la oportunidad de cambiar o corregir sus causas, a través de una intervención nutricional individualizado, y deben servir como incentivo para la implementación de estrategias para modificar el estilo de vida, incluida la prevención de la obesidad, intolerancia a la glucosa, la hipercolesterolemia y la hipertensión.

Gout is a metabolic disorder associated with changes in uric acid metabolism and hyperuricemia. The incidence of hyperuricemia and gout has increased worldwide and is frequently associated risk factors of metabolic syndrome. Nutritional therapy is the use of low-purine foods, animal protein and seafood, increased consumption of fruits, vegetables, dairy products, adequate hydration, and restricting alcohol. The presence of hyperuricemia should allow the opportunity to change or correct their causes, through an individualized nutrition intervention, and should serve as incentive for the implementation of strategies for modifying lifestyle, including the prevention of obesity, glucose intolerance, hypercholesterolemia and hypertension.

Asunto(s)

RESUMEN

OBJECTIVE: To establish the timing for introducing supplementary foods in the diet of infants from the city of Campinas, state of São Paulo, Brazil. METHODS: This cross-sectional study included 2 857 children younger than 2 years of age randomly selected from the city department of health live birth database between 2004 and 2005. The mothers answered a questionnaire that included 87 closed questions designed to collect information concerning socioeconomic status, breastfeeding, and timing of introduction of supplementary foods. RESULTS: Assessment of the mothers revealed that 13.5% were adolescents, 73.1% had completed elementary or high school education, 45.9% had technical level jobs, 6,7% had jobs requiring a university degree, and 2.7% were health professionals. On average, participants belonged to socioeconomic class C (ranging from A, highest, to E, lowest), but all socioeconomic classes were represented. The median duration of exclusive breastfeeding was 90 days (95%CI: 87.6-92.4). Water (95%CI: 118.6-121.4) and tea (95 CI%: 113.2-126.8) were introduced at a median of 120 days. Semi-solid foods (95%CI: 178.6-181,4) and powdered milk (95%CI: 169.0-191.0) were introduced at a median of 180 days. Powdered milk and soft drinks had been ingested by 39.1% and 2.1%, respectively, at 4 months, and by 63.2 and 69.1%, respectively, at 1 year of age. Shorter breastfeeding duration was observed for women with technical level jobs, those who were unemployed, and those without a partner. CONCLUSIONS: The median duration of exclusive breastfeeding was far from that recommended due to the offer of supplementary fluids. Supplementary foods were introduced precociously, especially sweets.

Asunto(s)

Asunto(s)

RESUMEN

Alteração nos padrões alimentares associados ao aumento do sedentarismo têm sido relacionadas com a epidemia da obesidade, doença que envolve interação complexa entre fatores genéticos e metabólicos entre outros. O excesso de peso está associado ao risco de doença aterosclerótica, diabetes mellitus tipo 2 e certos tipos de cânceres, além de provocar efeitos adversos no metabolismo, como aumento da pressão arterial, dislipidemias e resistência à insulina. No tratamento da obesidade é importante considerar todos os fatores causais, sendo indicada atuação multidisciplinar. É recomendada mudança no estilo de vida, mas, em alguns casos, são necessários medicamentos ou mesmo intervenção cirúrgica. Dentre as intervenções nutricionais, as dietas com restrição de carboidratos têm se tornado cada vez mais populares. Este trabalho buscou apresentar os principais resultados de estudos dos últimos dez anos referentes a dietas restritas em carboidratos como parte do tratamento da obesidade. Os estudos mostram-se bastante heterogêneos, dificultando a comparação entre eles. A perda de peso parece estar mais relacionada à restrição energética, responsável por balanço energético negativo do que com o conteúdo de carboidrato das dietas. Embora alguns autores relatem melhora do perfil lipídico, da glicemia e da insulinemia, relacionada às dietas restritas em carboidratos, ainda estamos distantes de um consenso. Conclui-se, portanto, que ainda não há evidências suficientes para recomendações de tais dietas.

Asunto(s)

RESUMEN

CONTEXT: There are few longitudinal studies that analyze the growth and nutritional status parameters of children born prematurely. OBJECTIVE: To evaluate the growth and dietary intake of preterm newborns in the first year of gestation-corrected age. DESIGN: Prospective clinical study. SETTING: Tertiary care hospital. PATIENTS: 19 children (7 male) who were born prematurely, with birth weight between 1000 g and 2000 g, which was adequate for the gestational age. PROCEDURES: At 3, 6, 9 and 12 months of gestation-corrected age, children were evaluated in relation to weight, height and cephalic perimeter, using the National Center for Health Statistics as the standard reference, and the Rozalez-Lopez and Frisancho standards for brachial perimeter and triceps and subscapular skinfolds. The calculated dietary intake was compared to the Recommended Dietary Allowances. MAIN MEASUREMENTS: The Z score was calculated for the weight/age, height/age and weight/height relationships, and the percentiles of the perimeters and skinfolds were considered. Dietary intake records were made using the 24-hour Dietary Recall and the Food Frequency Intake Questionnaire methods. The Virtual Nutri software was used to calculate energy and protein intake. RESULTS: The weight/age, height/age and weight/height relationships and the brachial perimeter and triceps skinfold were statistically greater in the first semester in relation to the second. The cephalic perimeter remained above the 50th percentile for the ages studied and there was no difference in the subscapular skinfold between the first and second semesters, remaining below the 50th percentile. The calorie and protein intake, although statistically lower in the first than in the second semester, always remained above the recommended. CONCLUSIONS: The pace of growth is greater in the first semester than in the second, not reaching the standard expected for full-term newborns, with the exception of the cephalic perimeter, which remains adequate. Calorie/protein intake shows an inverse relationship with growth speed, remaining above the recommended for full-term newborns, although with difficulty in depositing subcutaneous fat, in spite of the high caloric intake.

Asunto(s)

RESUMEN

CONTEXT: There are few longitudinal studies that analyze the growth and nutritional status parameters of children born prematurely. OBJECTIVE: To evaluate the growth and dietary intake of preterm newborns in the first year of gestation-corrected age. DESIGN: Prospective clinical study. SETTING: Tertiary care hospital. PATIENTS: 19 children (7 male) who were born prematurely, with birth weight between 1000g and 2000g, which was adequate for the gestational age. PROCEDURES: At 3, 6, 9 and 12 months of gestation-corrected age, children were evaluated in relation to weight, height and cephalic perimeter, using the National Center for Health Statistics as the standard reference, and the Rozalez-Lopez and Frisancho standards for brachial perimeter and triceps and subscapular skinfolds. The calculated dietary intake was compared to the Recommended Dietary Allowances. MAIN MEASUREMENTS: The Z score was calculated for the weight/age, height/age and weight/height relationships, and the percentiles of the perimeters and skinfolds were considered. Dietary intake records were made using the 24-hour Dietary Recall and the Food Frequency Intake Questionnaire methods. The Virtual Nutri software was used to calculate energy and protein intake. RESULTS: The weight/age, height/age and weight/height relationships and the brachial perimeter and triceps skinfold were statistically greater in the first semester in relation to the second. The cephalic perimeter remained above the 50th percentile for the ages studied and there was no difference in the subscapular skinfold between the first and second semesters, remaining below the 50th percentile. The calorie and protein intake, although statistically lower in the first than in the second semester, always remained above the recommended. CONCLUSIONS: The pace of growth is greater in the first semester than in the second, not reaching the standard expected for full-term newborns, with the exception of the cephalic perimeter, which remains adequate. Calorie/protein intake shows an inverse relationship with growth speed, remaining above the recommended for full-term newborns, although with difficulty in depositing subcutaneous fat, in spite of the high caloric intake

Asunto(s)