RESUMO

PURPOSE: The use of a nonadjustable silicone band around the gastric pouch of Roux-en-Y gastric bypass (RYGB) to reduce the recurrence of obesity is still being debated in the literature. The primary objective of this study was to evaluate banded and non-banded RYGB regarding % total weight loss (%TWL) and complications up to 10 years postoperatively and regarding the removal rate of the silicone band. MATERIAL AND METHODS: A retrospective study of the medical records of all patients submitted to banded and non-banded RYGB between 2000 and 2020 was conducted. Clinical data (age, gender, weight, body mass index-BMI, comorbidities, %TWL, and the prevalence of vomiting) and laboratory data (hemoglobin, serum iron, albumin, and vitamin B12) were obtained preoperatively and at 6 months, 1, 2, 3, 5, 7, and 10 years for both groups and at 12, 15, and 20 years after banded RYGB. RESULTS: In total, 858 patients underwent RYGB: 409 underwent banded RYGB and 449 underwent non-banded RYGB. In the preoperative period, banded RYGB patients were heavier and had higher rates of hypertension and dyslipidemia. The %TWL was higher in the banded RYGB group up to 7 years. The prevalence of vomiting is much higher in this group, which also had lower laboratory test values. Of the banded RYGB patients, 9.53% had to have the silicone ring removed after presenting complications. CONCLUSION: Banded RYGB promotes significantly higher rates of TWL at the expense of a higher frequency of food intolerance and vomiting.

Assuntos

RESUMO

(1) Background: An elevated wrist circumference may indicate excess weight and cardiometabolic risk. The present study aims to identify wrist circumference cutoff points (WrC) to determine excess weight levels and predict cardiometabolic risk in adults. (2) Methods: A cross-sectional study was conducted with adults aged 20 to 59 years old, attending the outpatient clinic at University Hospital/Federal University of Sergipe HU/UFS-EBSERH. Demographic, anthropometric, biochemical, and blood pressure (BP) data were collected. Cardiometabolic risk was assessed, according to the global risk score (ERG) and Framingham score criteria. The descriptive analysis included calculating medians and frequencies of anthropometric, demographic, biochemical, and blood pressure variables. The gender and age of adult groups were compared using the Mann-Whitney test. Spearman's correlation coefficient and multiple regression analysis were used to assess the association between wrist circumference (WrC) and the variables mentioned above. The predictive validity of WrC in identifying excess weight levels and cardiometabolic risk was analyzed using the ROC curve. The sample consisted of 1487 adults aged 20 to 59 years, 55.7% of whom were female; (3) Results: WrC correlated positively with other adiposity indicators such as waist circumference and Body Mass Index. WrC was the anthropometric indicator most significantly associated with cardiometabolic risk factors. WrC cutoff points identified by the study for determining excess weight were categorized by gender and age group. For males aged 20 to 40 years and >40 years, respectively, the cutoff points for overweight were 17.1 cm and 17.3 cm, and for obesity, 17.9 cm and 17.5 cm. For females aged 20 to 40 years and >40 years, respectively, the cutoff points for overweight were 15.6 cm and 15.4 cm, and for obesity, 16.1 cm and 16 cm (4). Conclusions: Wrist circumference showed a significant correlation with other adiposity indicators and can be used to identify adults with excess weight and predict cardiometabolic risk.

Assuntos

RESUMO

BACKGROUND: Evidence from Latin America suggests that children embedded in South-to-North migrant networks (i.e. relatives who live abroad, typically in the United States) are at increased risk of excess weight. It is unclear if the same findings apply to children embedded in Latin American intraregional migration or South-to-South migration networks. OBJECTIVE: To compare excess weight among Colombian children embedded in South-to-South migration networks (n = 334) to children with non-migrant parents (n = 4272) using Colombia's 2015 National Survey of the Nutritional Situation. METHODS: Prevalence ratios (PRs) for excess weight (BMI z-score ≥1) by parent migration history were estimated using weighted multivariable logistic regression adjusting for demographics, child behaviours, community and household indicators, including household food insecurity. RESULTS: Most migrant parents returned to Colombia from Venezuela (84%) and reported higher household food insecurity rates than non-migrant parents (59% versus 32%). Models excluding household food insecurity showed that excess weight among children with migrant parents was 51% lower (PR = 0.49; 95% CI 0.25, 0.98) than among children with non-migrant parents. After adjustment for household food insecurity, no statistically significant differences were found. CONCLUSION: Colombian children with return migrant parents from Venezuela experienced less excess weight than children with non-migrant parents, but higher rates of food insecurity in migrant households might partially explain this difference. This study calls attention to two serious public health concerns for Colombian children-those who have excess weight and those who lack sufficient food, particularly among migrant returnees (a situation that may have worsened since the COVID-19 pandemic).

Assuntos

RESUMO

PURPOSE: Previous literature has demonstrated the mediating role of adiposity in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk as well as the potential role of CRF in attenuating the adverse consequences associated with excess weight. This study aimed to evaluate the mediating role of CRF and adiposity in the possible association with cardiometabolic risk. METHOD: Observational 3-year longitudinal study that included 420 children and adolescents (10.50 [2.05] y of age at baseline; 56.2% girls). Body mass index (BMI) was calculated, and CRF was evaluated using field assessments. A clustered cardiometabolic risk score (cMetS) was calculated from glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, and triglycerides z scores. Analyses evaluated the mediating role of BMI in the association between CRF and cMetS as well as whether CRF mediated the association between BMI and cMetS. RESULTS: BMI at baseline was directly associated with the cMetS at follow-up (0.102; 95% confidence interval, 0.020 to 0.181), independently of CRF, whereas CRF was only indirectly associated with cMetS at follow-up through BMI (-0.036; 95% confidence interval, -0.070 to -0.009), meaning that the association between CRF and cMetS was explained via the mediation role of BMI. CONCLUSIONS: BMI presented direct association with cMetS, whereas CRF exhibited indirect association with cMetS mediated via BMI.

Assuntos

RESUMO

Background/Objective: Guidelines on obesity management reinforce regular exercise to reduce body fat. Exercise modalities, including high-intensity interval training (HIIT), appear to produce a similar effect to continuous aerobic training (CAT) on body fat. However, they have not addressed the chronic effect of HIIT vs. CAT on body fat assessed by dual energy X-ray absorptiometry (DEXA). Thus, we compared the effectiveness of CAT vs. HIIT protocols on body fat (absolute or relative) (%BF) and abdominal visceral fat reduction, assessed by DEXA, in adults with overweight and obesity. Methods: We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) including both female or male adults with excess body weight. We performed searches in the databases MEDLINE (PubMed), EMBASE, Scopus, LILACS, Web of Science and Cochrane. Results: In our analysis (11 RCTs), we found no greater benefit on %BF of HIIT vs. CAT (MD -0.55%, 95% CI -1.42 to 0.31; p = 0.209). As for abdominal visceral fat, no training modality was superior (SMD: -0.05, 95% CI -0.29 to 0.19; p = 0.997). Regarding secondary outcomes (body weight, BMI, VO2 max, glycemic and lipid profiles), HIIT shows greater benefit than CAT in increasing VO2 max and fasting blood glucose and reducing total cholesterol. Conclusion: HIIT is not superior to CAT in reducing %BF or abdominal visceral fat in individuals characterized by excess weight. However, HIIT showed beneficial effects on cardiorespiratory fitness, total cholesterol and fasting blood glucose when compared to CAT.

RESUMO

In Colombia, although it can be said that, on average children living in urban areas have better quality of life than their rural peers, it is also true that within cities, there are high levels of socioeconomic inequality. Our objective is to identify the contribution of the factors that explain the gap in stunting and excess weight between poor and non-poor children under 5 years of age in urban areas of Colombia. We use data from the 2015 National Nutritional Status Survey, and two nonlinear decomposition techniques based on the classical decomposition method developed by Blinder-Oaxaca. With a sample of 6877 observations, the results show that the intraurban gap of stunting between poor and non-poor children in urban areas is 4.8 percentage points. Its main determinants are the mother's educational level (46.5%), affiliation to the health system by the mother (19.4%), and assisted delivery in a medical institution (16.6%). For excess weight, the gap is - 2.1 percentage points, and its main determinants are the mother's educational level (39.2%) and birth attended by a physician (21.8%). This study suggests the coexistence of a double burden of malnutrition (DBM) in children under 5 years of age living in urban areas of Colombia. Stunting is associated with low-income levels while excess weight is associated with higher income levels. The identification of the main determinants of DBM and its relative importance, constitutes a contribution for public policy makers aimed at reducing socioeconomic gaps.

Assuntos

RESUMO

Background and objectives: children's food-related lifestyle brought changes in their weight status and eating patterns. We aimed to investigate the association between food consumption pattern and excess weight in preschoolers aged six. Methods: a cross-sectional analysis of a prospective birth cohort, in 2004, in Feira de Santana-BA. Food consumption frequency was verified, characterized by patterns and established through a food frequency questionnaire, validated in a previous study, in pattern 1: milk, vegetables, cereals, legumes, fruits and fish; pattern 2: snacks, soda/artificial juice, oils, sweets and coffee/tea; pattern 3: sausages, fast food, ketchup/mayonnaise and egg; pattern 4: red meat and chicken. Excess weight was defined according to the World Health Organization criteria. The main association was assessed using Pearson's chi-square test and Poisson regression. Results: a total of 618 children were investigated. Excess weight occurred in 28.6%, and pattern 3 frequency was 68%. In the bivariate analysis, only pattern 3 was associated with children's excess weight (PR: 1.23; 95%CI: 1.01-1.63). In the multivariate analysis, the prevalence of excess weight children who consumed pattern 3 was 50% (adjustedPR: 1.50; 95%CI: 1.01­1.93). Conclusion: moderate/high consumption of sausages, fast food, ketchup/mayonnaise and eggs was associated with excess weight among children in the sample.(AU)

Justificativa e objetivos: o estilo de vida das crianças relacionado à alimentação trouxe mudanças no estado de peso e no padrão alimentar. Objetivou-se averiguar a associação entre o padrão de consumo alimentar e o excesso de peso em pré-escolares aos seis anos de idade. Métodos: análise transversal, de uma coorte prospectiva de nascimento, em 2004, em Feira de Santana-BA. Verificou-se a frequência do consumo alimentar, caracterizado por padrões e estabelecido por meio do questionário de frequência alimentar, validado em um estudo prévio, em padrão 1: leite, verduras, cereais, leguminosas, frutas e pescados; padrão 2: salgadinhos, refrigerantes/sucos artificiais, óleos, doces e cafés/chás; padrão 3: embutidos, fast food, ketchup/maionese e ovo; padrão 4: carnes vermelhas e frango. O excesso de peso foi definido segundo os critérios da Organização Mundial da Saúde. A associação principal foi avaliada mediante Teste Qui-Quadrado de Pearson e regressão de Poisson. Resultados: investigaram-se 618 crianças. O excesso de peso ocorreu em 28,6%, e a frequência do padrão 3 foi de 68%. Na análise bivariada, somente o padrão 3 se associou com o excesso de peso da criança (RP: 1,23; IC95%: 1,01-1,63). Na análise multivariada, a prevalência de crianças que consumiam o padrão 3 com excesso de peso foi de 50% (RPajustado: 1,50; IC95%: 1,01­1,93). Conclusão: o consumo moderado/alto de embutidos, fast food, ketchup/maionese e ovo se associou com o excesso de peso entre as crianças.(AU)

Justificación y objetivos: el estilo de vida de los niños relacionado con la alimentación trajo cambios en su estado de peso y patrones de alimentación. El objetivo fue investigar la asociación entre el patrón de consumo de alimentos y el sobrepeso en preescolares de seis años. Métodos: análisis transversal de una cohorte prospectiva de nacimiento, en 2004, en Feira de Santana-BA. Se verificó la frecuencia de consumo de alimentos, caracterizada por patrones y establecida a través del cuestionario de frecuencia de alimentos, validado en un estudio previo, en el patrón 1: leche, verduras, cereales, legumbres, frutas y pescado; patrón 2: bocadillos, refrescos/jugos artificiales, aceites, dulces y café/té; patrón 3: salchichas, fast food, salsa de tomate/mayonesa y huevo; patrón 4: carnes rojas y pollo. El exceso de peso se definió según los criterios de la Organización Mundial de la Salud, la asociación principal se evaluó mediante la prueba de chi-cuadrado de Pearson y regresión de Poisson. Resultados: 618 niños fueron investigados. El exceso de peso se presentó en el 28,6% y la frecuencia del patrón 3 fue del 68%. En el análisis bivariado, solo el patrón 3 se asoció con el exceso de peso del niño (RP: 1,23; IC95%: 1,01-1,63). En el análisis multivariado, la prevalencia de niños con sobrepeso que consumieron el patrón 3 fue del 50% (RPajustado: 1,50; IC95%: 1,01­1,93). Conclusión: el consumo moderado/alto de salchichas, fast food, ketchup/mayonesa y huevos se asoció con sobrepeso entre los niños de la muestra.(AU)

Assuntos

RESUMO

Metabolic disorders are a public health problem worldwide. The vitamin D status in patients with metabolic diseases is not a routine procedure. The aim of this study was to determine the prevalence of vitamin D deficiency and examine the correlation between vitamin D status and cardiometabolic parameters in Latin American population with metabolic disorders. Methods: This observational study with a cross-sectional design included 151 patients with metabolic disorders (type 2 diabetes, hypothyroidism, type 2 diabetes with hypothyroidism, and excess weight). A fasting blood sample was collected and analyzed to determine the levels of 25-hydroxyvitamin D, calcium, glucose, hemoglobin A1c, thyroid-stimulating hormone, and free thyroxine. Anthropometric and blood pressure measurements were also performed. Results: According to vitamin D values established by the Institute of Medicine, subjects with metabolic disorders group showed: 23% risk to bone health (9.42 ±3.O4ng/mL), 45% risk of insufficiency/deficiency (17.05 ±2.12ng/mL), and 32% had sufficient levels (26.34±6.74ng/mL), whereas healthy subjects group showed significantly higher values than metabolic diseases group (37.25± 7.72). In addition, vitamin D levels were inversely correlated with elevated body mass index (29.13±5.15kg/m2), systolic blood pressure (126.50± 15.60 mm Hg), fast blood glucose (106.29±33.80 mg/dL), and hemoglobin A1c (6.40% ± 1.38%) values. Conclusion: Subjects with metabolic disorders and with adequate nutritional intake of vitamin D-rich foods and frequent exposure to sunlight have low serum vitamin D concentrations compared to the general population and vitamin D status should be assessed in these patients.

RESUMO

PURPOSE: Immune checkpoint inhibitors are one of the most effective treatments available in advanced non-small cell lung cancer. However, at present, there are no clinical or analytical biomarkers that define which patients benefit with certainty from these treatments. In our study, we evaluated whether excess weight could be a good predictive biomarker of benefit from these drugs. METHODS: We studied a population of 79 patients, divided into a study group with 39 patients diagnosed with non-small cell lung cancer treated with immunotherapy and 40 patients in a control group, diagnosed with different advanced cancers, treated with non-immunotherapy treatment. We analyzed according to the presence of excess weight or not, the treatment's outcome in the study group and in the control group (objective response, and progression-free and overall survival). RESULTS: In our study, we detected a better response rate to immunotherapy in patients with excess weight (62.50 vs 26.08%, OR 4.72, p = 0.02), and a better median progression-free survival (14.19 vs 5.03 months, HR 0.50, p = 0.058) and median overall survival (33.84 months vs 20.76 months, HR 0.43, p = 0.01) in the study group. These findings were specific to the immunotherapy group since in the control group, with patients who did not receive immune checkpoint inhibitors, these findings were not found. CONCLUSION: Our study suggests that patients with excess weight who receive anti-PD-1 immune checkpoint inhibitors diagnosed with non-small cell lung cancer have a better outcome. This effect is specific to patients receiving immunotherapy.

Assuntos

RESUMO

INTRODUCTION/BACKGROUND: This work aims to analyse the prevalence of excess weight in Brazil to demonstrate the nutritional transition that is occurring. The data mobilized in the research are from the Food and Nutritional Surveillance System (FNSS). MATERIALS AND METHODS: This study employed a quantitative approach from the FNSS online secondary data survey through reports of nutritional status in different phases of life (child, adolescent, adult, elderly and pregnant), in different macroregions of the country (South, Southeast, Midwest, Northeast and North) and with a 12-year historical series (2008 to 2019). RESULTS: In the adult life stage, there was a time trend of increasing excess weight in all regions of this historical series. The southern region of Brazil and the adult life stage had the highest national percentage of excess weight (69,1%) in 2019 and had the lowest percentage of eutrophy (29.3%) in the region in 2019. In the elderly life phase, in the South, Southeast and Midwest regions, excess weight was higher than the other outcomes in the time series, with the highest annual prevalence in the South region (58,6%) in 2019. In the adolescent life stage, there was a time trend of increasing excess weight in all regions, and excess weight had the highest prevalence in 2019 in the South (35,8%). The lowest prevalence rates of excess weight were in the following age groups: children aged 0 to < 2 years old and children aged 2 to < 5 years old. Additionally, it was in Group 5 to < 10 years old that the most critical prevalence of excess weight (35,07%) was found in 2018. However, malnutrition (low weight) persists, especially in the elderly and children. In the pregnancy life stage, there was a temporal trend of increase in excess weight in all regions, with higher percentages in 2019 in the South (53.5%) and Southeast (50.8%). CONCLUSION: Excess weight has shown increasing time trends in the adolescent, adult, elderly and pregnant life stages in all regions of Brazil, suggesting that public FNS policymakers should be more assertive in the planning and management of programs and actions to reduce the percentages of diseases.

Assuntos

RESUMO

BACKGROUND: Whereas parental feeding styles (PFS) influence children's diet, less is known about this relationship in adolescents. METHODS: A cross-sectional study in 686 Costa Rican adolescents (13-18 years) evaluated 4 validated PFS scores: healthy eating verbal encouragement; scolding; directly controlling diet; instrumental/emotional. Diet was evaluated through 3-day food records, deriving a Traditional Costa Rica Adolescents Diet Score (TCRAD). Excess weight (EW) measured by BMI was dichotomized following standards. Regression-based mediation analysis estimated the overall and sex-stratified odds ratios of EW for natural direct (NDE), natural indirect (NIE), and total effects (TE) of the pathway PFS→TCRAD→EW. RESULTS: A one-unit increase in the direct control PFS score was associated with higher EW odds overall [(TE: 1.55; 95% CI: 1.04-2.31; p-value = 0.033), (NDE: 1.52; 95% CI: 1.02-2.27; p-value = 0.039)], and in boys [(TE: 2.13; 95% CI: 1.04-4.38; p-value = 0.039), (NDE: 2.10; 95% CI: 1.03-4.31; p-value = 0.042)]. Non-significant mediation by TCRAD was observed for the healthy eating verbal encouragement PFS overall (p-value = 0.06). Associations for the instrumental/emotional and scolding PFS were not significant. CONCLUSIONS: Direct diet control from parents may contribute to adolescents' excess weight, particularly among boys. Parents encouraging healthy eating might support adolescents' healthy weight through a healthy diet. Longitudinal research should clarify the association between PFS and diet-related outcomes among diverse adolescents.

Assuntos

RESUMO

This study aimed to evaluate the association between the years of work of food handlers in the foodservice and excess weight among Brazilian low-income food handlers. A total of 559 food handlers from all Brazilian regions were characterized using a questionnaire. Weight and height were measured to estimate the Body Mass Index and classify the individuals. The association between food handlers' years of work in the foodservice, anthropometric status, and other variables (gender, age group, educational level, participation in a government program and per capita income at home and energetic consumption) were performed using Pearson's chi-square test (p < 0.05). Multinomial logistic regression analyses were performed (p < 0.05) as well as sensitivity tests using the outcome continuously and transformed, excluding underweight individuals, in a multivariate linear regression model. Most of the sample was female (63.1%), aged between 21 and 40 years old (63.5%), and 53.3% had studied up to complete elementary school. Almost 41% of the food handlers had less than half the minimum wage per capita income. Of the evaluated individuals, 59.9% presented excess weight. There was an association with family per capita income (Odds Ratio - OR: 1.73; Confidence interval - CI95%: 1.09-2.75); handlers whose per capita income was ≤0.5 minimum wage had a 73% higher chance of obesity than those with higher income. Working in foodservive ≥3 years increased the chance of being overweight by 96% compared to those who work for <3 years (OR: 1.96; CI95%: 1.11-3.49). No significant association was found between the years of work of food handlers in the foodservice and obesity. Since work-related factors may contribute to the high prevalence of excess weight, including working in a food handling environment, the government and employers should consider workplace interventions. These would guide the food handlers in avoiding high rates of excess weight and their consequences on public health. Excess weight is an important driver of costs in the workplace associated with absenteeism, job change, and diseases. More studies are necessary to clarify the relationship between the factors related to work and the anthropometric status of food handlers since excess weight is multifactorial.

Assuntos

RESUMO

Excess weight requires multidisciplinary treatment, including psychology in face-to-face and e-health interventions. The need to analyse interventions' content validity has become evident. The objective is to assess content validity of a psychological e-health program of self-control and motivation for adults with excess weight. Six health professionals (a nutritionist, a personal trainer, physician and three psychologists) evaluated the content validity of the program. The results showed that the item-level content validity index (I-CVI) was 1 (the maximum value) for 11 of the 22 activities that comprise the program. This index fluctuated between 0.83 and 0.85 for the other activities, and the scale-level content validity index was greater than 0.90 for the four modules. In terms of relevance, effectiveness and appropriateness, 90%, 65% and 60% of the activities, respectively, obtained the maximum possible I-CVI, while the index was acceptable for the remainder of the activities. This is the first study about content validity of a psychological program for adults with excess weight in Mexico and it supported that the content program was suitable, and it may be used as a part of multidisciplinary treatments. This study also highlights the importance of involving an expert review in the development of intervention programs. This intervention program may be useful in the context of a multidisciplinary intervention; however, it is important to conduct studies to evaluate its efficacy.

Assuntos

RESUMO

Obesity is considered one of the main contemporary public health problems. We aim to assess changes in body weight and nutritional status in adulthood and the associated sociodemographic variables. We use data from the 2013 National Health Survey (n = 21,743). Changes in weight and body mass index (BMI) were calculated based on mean difference between measurements at age 20 and data collected at the interview, stratified by sex. The association was analyzed using linear regression. Mean weight gain was greater among women than men. The largest gain was verified among the younger adults for both sexes. Age was found to be associated with weight and BMI change in men and women where, for every additional year of age, there was an increase in weight and BMI of 0.10 kg and 0.04 kg/m2 in men and of 0.22 kg and 0.09 kg/m2 in women, respectively. For education, a direct association was found for men and an inverse for women. Association with area of residence was significant among males only, where rural men gained less than their urban counterparts. Weight gain was progressive, being more marked in the younger group, and was associated with education differently according to sex.

Assuntos

RESUMO

PURPOSE: To identify preoperative factors that influence the outcomes of gastric bypass surgery, in terms of excess weight loss at 24 months. METHODS: This retrospective study included two groups of patients who underwent laparoscopic gastric bypass surgery. Group A (poor outcomes) had ≤ 50%EWL or BMI ≥ 30 kg/m2; group B (excellent outcomes) had ≥ 80%EWL at 24 months. A comparative analysis of demography, anthropometry, comorbidities, and metabolic status was performed. A linear regression model was used to evaluate %EWL association; the number of preoperative and postoperative consultations were also compared. RESULTS: A total of 202 patients completed follow-up; 71 (35.1%) and 78 (38%) had poor and excellent outcomes (%EWL 44.1 ± 9.4% vs. 92 ± 10.9%), respectively. Mean age was 40.4 ± 8.9 years. Patients with poor outcomes had higher weight and BMI, lesser preoperative %EWL, higher dyslipidemia and diabetes rates with longer periods of evolution, and increased HbA1c% levels. In the linear regression analysis, preoperative %EWL and initial and preoperative BMI were statistically significant determinants of %EWL at 24 months Diabetes remission was 46.2% (group A) vs. 66.6% (group B). Group A had higher non-attendance rates after surgery. CONCLUSION: The factors independently associated with greater %EWL at 24 months between groups were higher preoperative %EWL, and lower initial and preoperative BMI.

Assuntos

RESUMO

BACKGROUND: The national health and nutrition survey allows to know the state of health of the Mexican population, it provides data for the analysis of different factors and / or indicators of health, diseases and nutritional conditions, such as chronic degenerative diseases and depressive symptoms, which, in turn, if both occur simultaneously, they will have a negative impact on health. This article studies the four factors involved in the overall health of the population in Mexico: excess weight, diabetes, high blood pressure, and depressive symptoms, which are used to conduct a multidimensional characterization and analysis. METHODS: Two methodological resources are applied, a descriptive statistical characterization and the construction of a multidimensional health index with the use of fuzzy sets, through the National Health and Nutrition Survey (ENSANUT 2018-19 - for its acronym in Spanish) in Mexico. RESULTS: The results reveal a growing percentage of individuals who experience detriments to their health, that is, the factors being studied have had a negative impact and tend to follow international projections. The construction of a multidimensional index enables the interaction between the factors being studied, thus allowing for an adequate modeling for the identification of health in Mexico. CONCLUSION: This study aims to elucidate the current state of health throughout the population in Mexico by using the most current data provided by the autonomous public body of statistics and geography to build a multidimensional panorama using four elementary public health indicators (diabetes, obesity, high blood pressure, and depressive symptoms).

Assuntos

RESUMO

Physical exercise is effective in modulating circulating inflammatory markers of obesity. However, little is known about the effects of interventions with physical exercise programs accompanied by nutritional and/or psychological guidance, configuring themselves as multicomponent programs. Thus, the aim of this review is to systematically evaluate the evidence related to the effects of mul-ticomponent weight-loss interventions in modulating circulating inflammatory markers in children and adolescents. Therefore, the following databases will be searched to identify all relevant articles: PubMed, SciELO, Lilacs, Web of Science, EMBASE, Scopus, SPORT Discus. Randomized con-trolled trials and quasi-experimental studies of children and adolescents (6 to 18 years old) will be included. Eligible interventions will target weight-related behaviors (including diet, physical activity, behavior modification and/or combinations thereof ). Two independent reviewers will select studies using Rayyan QCRI software and extract the data to a standard form. The main outcomes of the review will be the circulating values of leptin, interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF- α) in a quantitative way. To assess the methodological quality (or risk of bias) of individual studies, Effective Public Health Practice Project assessment tool will be used. The meta-analysis will be performed using the Review Manager software

O exercício físico é eficaz na modulação dos marcadores inflamatórios circulantes da obesidade. Porém, pou-co se sabe sobre os efeitos de intervenções com programas de exercícios físicos acompanhados de orientações nutricionais e/ou psicológicas, configurando-se como programas multicomponentes. Assim, o objetivo des-te protocolo é propor uma revisão sistematicamente das evidências relacionadas aos efeitos de intervenções multicomponentes para perda de peso na modulação de marcadores inflamatórios circulantes em crianças e adolescentes. Para tanto, as seguintes bases de dados serão pesquisadas para identificar todos os artigos relevantes: PubMed, SciELO, Lilacs, Web of Science, EMBASE, Scopus, SPORT Discus. Serão incluídos ensaios clínicos randomizados e estudos quase experimentais com crianças e adolescentes (6 a 18 anos). As intervenções elegíveis terão como foco a melhora dos comportamentos relacionados ao peso (incluindo dieta, atividade física, modificação de comportamento e/ou combinações dos mesmos). Dois revisores independentes selecionarão estudos usando o software Rayyan QCRI e extrairão os dados em um formulário padrão. O principal resultado da revisão serão os valores circulantes de leptina, interleucina 6 (IL-6) e fator de necrose tumoral alfa (TNF-α) de forma quantitativa. Para avaliar a qualidade metodológica (ou risco de viés) de estudos individuais será utilizada a ferramenta de avaliação Effective Public Health Practice Project. A meta-análise será realizada no software Review Manager

Assuntos

RESUMO

Background: Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) may reduce appetite and caloric intake and may be able to play a role as an adjunct treatment for obesity. Stimulation of this brain area is also used for the treatment of depression, which shares a common pathophysiology with obesity. As a result, the effect of tDCS on mental health and its impact on the quality of life of subjects with excess weight needs to be addressed.Objective: To assess the effect of daily tDCS of the right DLPFC on mood, daytime sleepiness, anxiety and quality of life in subjects with excess weight on a hypocaloric diet.Methods: We randomly assigned 28 subjects to receive 20 sessions of active or sham tDCS over the right DLPFC for 20 consecutive weekdays. The severity of depressive and anxiety symptoms was assessed by the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory-State (STAI-S). Sleepiness was measured by a daytime sleepiness questionnaire (DSQ), and quality of life was measured by the 36-Item Short Form Health Survey (SF-36).Results: There were no significant changes in BDI, STAI-S and DSQ scores between groups, even after adjustments for the use of antidepressant medications and changes in body weight. There were also no significant changes in different subscales of the SF-36 quality of life questionnaire between groups.Conclusion: Repetitive tDCS on the right DLPFC is not associated with impairment in mental health or quality of life in overweight and obese subjects.

Assuntos

RESUMO

ABSTRACT BACKGROUND: Individuals who are overweight or obese often underestimate their size, and they are less likely to consider their weight status to be a health problem and consequently to make lifestyle changes. OBJECTIVES: To estimate the proportion of satisfaction with weight among adolescents classified as overweight/obese, according to sociodemographic factors, morbidities and health-related behaviors. DESIGN AND SETTING: Cross-sectional population-based study conducted among adolescents aged 10 to 19 years in the city of Campinas (SP), Brazil. METHODS: The sample (n = 217) included participants with self-reported weight and height who were classified as overweight or obese, based on body mass index (BMI) according to age-specific cutoff points recommended by the World Health Organization. Participants whose answer to the question: "Would you like to gain or lose weight?" was "no" (i.e. no change) were deemed to be satisfied with their body weight. Odds ratios and 95% confidence intervals (95% CI) were calculated using logistic regression. RESULTS: The proportions of the respondents who were satisfied with their weight were 75.8% (95% CI: 65.3-83.9) among the overweight adolescents and 24.2% (95% CI: 16.1-34.7) among the obese adolescents (P < 0.01). Satisfaction was lower among individuals aged 15 to 19 years (versus 10 to 14 years), those born outside of Campinas (versus in Campinas), those with ≥ 8 household appliances (versus < 8), and those reporting ≥ two health complaints (versus none). CONCLUSIONS: More than half of the overweight adolescents and almost a quarter of the obese adolescents were satisfied with their weight. These results support the need for strategies for healthy weight management among Brazilian adolescents.

Assuntos

RESUMO

OBJECTIVE: The aim of this study was to investigate the association between percent contribution of ultra-processed foods to total dietary energy intake and measurements of body composition obtained using high-validity methods. METHODS: This was a cross-sectional study with 1525 adolescents 18 to 19 y of age from the second follow-up of the 1997/98 São Luís birth cohort, Brazil. To evaluate nutritional status and body composition, the body mass index (BMI)-for-age was used, along with waist circumference, total and android body fat percentage, muscle mass, and the lean mass index (LMI). Food consumption was evaluated by a food frequency questionnaire. Food items were grouped according to the level of processing as per the NOVA classification. Through semi-structured questionnaires, sociodemographic and lifestyle data were abstracted. Adjusted linear regression models were used to evaluate the associations between consumption of ultra-processed foods and body composition measurements. RESULTS: Total average energy consumption was 2919.7 kcal, with 58% (1634.9 kcal) derived from natural or minimally processed foods and 37% (1136.5 kcal) from ultra-processed products. In the adjusted analyses, BMI, muscle mass, and LMI were inversely associated with consumption of ultra-processed foods. A 1% increase in the percent contribution of ultra-processed items to total dietary energy intake was associated with a 0.04 kg decrease in muscle mass (ß = -0.04; 95% confidence interval [CI], -0.06 to -0.02; P < 0.001) and a 0.01 kg/m2 decrease in lean body mass (ß = -0.01; 95% CI, -0.02 to -0.01; P < 0.001). CONCLUSION: The contribution of ultra-processed foods to total dietary energy intake of Brazilian adolescents was associated with body composition, especially with decreasing lean body mass.

Assuntos