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Reducing ultra-processed foods (UPF) improves diet quality and may curb energy consumption. This study aimed to compare an intervention based on the reduction of UPF, according to the Dietary Guideline for the Brazilian Population (DGBP), with and without advice on energy intake. A parallel and randomised controlled trial was carried out with children with obesity from 7 to 12 years old. Both control (CG) and intervention groups (IG) participated monthly in 6 standardised educational activities based on the 10 steps of the DGBP. An individualised food plan was also provided to the IG. The rate of change for body mass index (BMI), waist circumference, body weight, and UPF consumption were investigated based on mixed-effect models. At the end of the study, the BMI declined in the IG (Δ = -0.27 kg/m2) compared to the CG (Δ = + 0.53 kg/m2) (p = .0002). Both groups showed a decline in grams of UPF until the fourth month and a gradual increase in the following months. Combining the qualitative approach of the DGBP with counselling on energy restriction through the diet plan proved to be effective in reducing childhood obesity. Clinical Trial Registration: This trial is registered at the Brazilian Registry of Clinical Trials (REBEC), under the RBR-3st5sn registry, available at http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn/. The datasets generated by the current study are not publicly available but are available from the corresponding author on reasonable request.

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BACKGROUND: In socially vulnerable populations, evidence is needed regarding the role of maternal nutritional status on child weight during the first 2 years of life. OBJECTIVES: We aimed to assess the association of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with offspring BMI-for-age z-scores (BAZs) during the first 2 years of life. METHODS: A population-based birth cohort study was conducted with 900 mother-child pairs. Pre-pregnancy weight and weight at delivery were collected from medical records, and anthropometric data were measured at birth and at 6-month, 1-year and 2-year follow-up visits. Linear regression and linear mixed-effect models assessed associations with pre-pregnancy BMI, GWG and BAZ during the first 2 years of life. RESULTS: Pre-pregnancy overweight and obesity and excessive GWG were positively associated with BAZ at birth and at 1- and 2-year follow-up visits. There were no significant additional BAZ changes per year based on the exposures up to age 2 years. CONCLUSIONS: Elevated maternal pre-pregnancy BMI and GWG were associated with a child's higher BAZ at birth, and these differences remained constant throughout the first 2 years of life in Amazonian children. These findings highlight the importance of promoting adequate maternal weight before pregnancy and during prenatal care also in socially vulnerable populations.

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CONTEXT: There is an increasing prevalence of overweight during early childhood in the most impoverished areas in Brazil, although there is a lack of evidence regarding its onset. OBJECTIVES: To investigate the incidence and risk factors associated with overweight among low-income children during their first year of life. METHODS: We analysed data from a prospective birth cohort study conducted in Brazil, which followed-up children at birth, 3rd, 6th and 12th months (n = 196). The overweight incidence (zBMI/A > 2SD) was analysed using the Kaplan-Meier survival estimator and its associated factors by the Coxs regression model. Missing data were addressed with multiple imputations and results on the final adjusted model were calculated by pooling the estimates generated for each imputed dataset. RESULTS: The overweight incidence was 17 events/100 children-year, and most cases occurred before the 6th month. The final model showed that children exclusively breastfed up to 30 days (vs. >30 days; HR 2.68; 95%CI 1.11-6.49) and whose mothers consumed ultra-processed foods more than 4 times/day (vs. ≤4 times/day; HR 3.02; 95%CI 1.28-7.13) presented a higher risk of developing overweight. CONCLUSION: The overweight incidence was high in this impoverished population. Shorter exclusive breastfeeding duration and an unhealthy household food environment provided a short-term risk increase.

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BACKGROUND: The association of gut microbiota with obesity and its cardio-metabolic complications in paediatric populations is still controversial. OBJECTIVE: We investigated the association of obesity and cardio-metabolic traits with gut microbiota on 167 and 163 children with normal weight and obesity from Mexico City and Oaxaca, Mexico. METHODS: Anthropometric and biochemical traits were measured. The microbial communities were determined by high-throughput sequencing of bacterial 16S rRNA gene v3-v4 region. RESULTS: The gut microbial community structure was associated with obesity and fasting plasma insulin (FPI) in Mexico City (PObesity = 0.012, PFPI = 0.0003) and Oaxaca (PObesity = 0.034, PFPI = 0.016), and with triglycerides (TG) in Oaxaca (P = .0002). The Firmicutes/Bacteroidetes ratio was positively associated with TG in Oaxaca (P = .003). Firmicutes and Bacteroidetes phyla were positively and negatively associated with obesity (Mexico City: PFirmicutes = 0.013, PBacteroidetes = 0.009) and TG (Oaxaca: PFirmicutes = 0.002, PBacteroidetes = 0.004). In Oaxaca, Verrucomicrobia was negatively associated with obesity (P = .004). In Mexico City, the bacterial genus Fusicatenibacter, Romboutsia, Ruminococcaceae, Ruminiclostridium, Blautia, Clostridium, Anaerostipes and Intestinibacter were associated with obesity and FPI, while in Oaxaca, Bacteroides, Alistipes and Clostridium were associated with TG. CONCLUSION: The gut microbial community structure in children is associated with obesity and FPI in Mexico City, and with obesity, FPI and TG in Oaxaca.

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Resumen Objetivo: La presente investigación tiene como objetivo principal, describir la relación entre el nivel de actividad física y el estado nutricional de los escolares de Tabasco, estado que pertenece a la región sureste de México. Material y métodos: Se utilizó un diseño descriptivo-correlacional con muestreo probabilístico irrestricto aleatorio, en una muestra de 2,084 escolares inscritos en seis escuelas de educación primaria de Tabasco. Los datos se recolectaron a través del "Four by One-day physical activity questionare", además de valoraciones antropométricas. Resultados: Los resultados mostraron que el 46.3% de los escolares se encuentran en sobrepeso y obesidad; y que las actividades físicas realizadas con mayor frecuencia por los escolares son de tipo muy ligero, lo que indica menor gasto energético. También se refleja que del 62% de infantes muy inactivos, las niñas representan el 34.7%, lo que indica que son más inactivas en comparación con los niños. Se encontró una relación negativa estadísticamente significativa (rs = -.105, p=.001) de la actividad física con el estado nutricional.

Abstract Objective: The main objective of this research is to describe relationship between physical activity and nutritional status level of schoolchildren in Tabasco, a southeastern state from Mexico. Materials and methods: It was used a descriptive-correlational design with random unrestricted probabilistic of 2,084 schoolchildren sample enrolled in six primary schools in Tabasco. Data was collected through the "Four by One-day physical activity questionnaire", in addition to anthropometric assessments. Results: The results showed that 46.3% of schoolchildren are overweight and obese and that the physical activities most frequently carried out by schoolchildren are very light, indicating lower energy expenditure. It is also reflected that from 62% of very inactive infants, girls represent 34.7%, indicating they are more inactive compared to boys. It was found a statistically significant negative relationship (rs = -, 105, p =, 001) of physical activity with nutritional status.

Resumo Objetivo: O principal objetivo desta pesquisa é descrever a relação entre nível de atividade física e o estado nutricional de escolares em Tabasco, um estado pertencente à região sudeste do México. Materiais e métodos: foi utilizado um desenho descritivo-correlacional com amostragem probabilística irrestrita aleatória em uma amostra de 2.084 escolares matriculados em seis escolas primárias de Tabasco. Os dados foram coletados por meio do "questionário de atividade física de quatro por um dia", além de avaliações antropométricas. Resultados: Os resultados mostraram que 46,3% dos escolares estão com sobrepeso e obesos e que as atividades físicas mais frequentemente realizadas pelos escolares são muito leves, indicando menor gasto energético. Também se reflete que, de 62% dos bebês muito inativos, as meninas representam 34,7%, indicando que são mais inativas em comparação aos meninos. Foi encontrada uma relação negativa estatisticamente significativa (rs = -, 105, p =, 001) da atividade física com o estado nutricional.

Résumé Objectif: Le principal objectif de cette recherche est de décrire la relation entre le niveau d'activité physique et l'état nutritionnel des écoliers de Tabasco, un état de la région sud-est du Mexique. Matériel et méthodes: Un plan descriptif-corrélationnel a été utilisé avec un échantillon aléatoire sans restriction de 2084 élèves inscrits dans six écoles primaires de Tabasco. Les données ont été collectées par le biais du «Four by One-day Physical Activity Questionnaire¼, en plus d'évaluations anthropométriques. Résultats: Les résultats ont montré que 46,3% des écoliers sont en surpoids ou obèses et que les activités physiques qu'ils pratiquent le plus fréquemment sont de très légère intensité, ce qui indique une faible dépense énergétique. Il ressort également que parmi les 62% d'enfants très inactifs, les filles représentent 34,7%, ce qui indique qu'elles sont plus inactives que les garçons. Une relation négative statistiquement significative (rs = -.105, p = .001) de l'activité physique avec l'état nutritionnel a été trouvée.

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Physical training is recommended for obese paediatric populations. We investigated the effects of recreational judo training (JT) upon body composition and distribution, cardiorespiratory fitness, and heart rate variability (HRV) in overweight or obese children. A controlled trial (RBR-9d94td) was conducted with 35 children (8-13 years) assigned into groups according to their body mass index (BMI): eutrophic (EU; n = 15; z-BMI ≤ +l and ≥ -2) and overweight or obese (OB; n = 20; z-BMI > +1 and ≤ +3). The 12-week JT included 60-min sessions performed 2 times/week at 65-75% maximal heart rate (HR). BMI, waist circumference, blood pressure, HRV, peak oxygen uptake (VO2peak), gas exchange threshold (GET), and body fractioning were assessed. Significant reductions in OB (P < 0.05) occurred for whole body and trunk fat (~3%), trunk/limb fat-ratio (~4%), resting HR (~3%), and sympathovagal balance (log LF:HF, ~85%). Increases (P < 0.05) occurred in lean mass (~8%), parasympathetic modulation (log HF, ~4%), VO2peak (~5-10%), and VO2 (~15%), speed (~10%) and slope (~13%) at GET. Markers of cardiorespiratory fitness (relative VO2, slope and speed at GET) in OB approached EU after JT. In conclusion, a relatively short JT intervention to improved body composition, autonomic modulation, and physical fitness in obese children.

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Obesity is currently considered a global epidemic, and its implications in mortality and morbidity in a paediatric patient and in adulthood are increasingly important. The objective of this article is to review in detail the definition of obesity according to age group, and, in turn, the epidemiology of this entity worldwide and in South America. Available evidence about pathophysiology and, additionally, associated comorbidities are reported in some of the most important and clinically relevant body systems. The recommendations on pharmacological and nonpharmacological management through changes in lifestyle and relevant aspects of bariatric surgery in the paediatric population are also described.

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OBJECTIVE: To evaluate agreement of the body adiposity index (BAI) and paediatric body adiposity index (BAIp) in estimating body fat compared with dual-energy X-ray absorptiometry (DXA) and to propose cut-off points for these indices to classify excess adiposity in Brazilian children and adolescents. DESIGN: Cross-sectional study. Measures of weight, height, hip circumference, BMI and body fat percentage (%BF) assessed by DXA were taken, and BAI and BAIp were calculated. The Bland-Altman plot was used to estimate agreement between the methods, and the receiver-operating characteristic curve to determine the cut-off points for BAI and BAIp per age and sex in comparison with DXA. SETTING: Viçosa, Minas Gerais, Brazil. SUBJECTS: Children and adolescents aged 8-19 years (n 1049). RESULTS: Of the children and adolescents, 52·4 % were girls. BAI and BAIp had satisfactory performance by the receiver-operating characteristic curve, except for the 18-19 years age group, whose BAIp had better predictive capacity than BAI. The agreement analysis showed that BAI overestimated %BF by 2·64 %, on average, using DXA; while BAIp underestimated %BF by 3·37 %. CONCLUSIONS: BAI and BAIp showed low agreement with the body fat obtained by DXA, requiring caution when interpreting body composition data in children and adolescents.

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Subendocardial viability ratio (SEVR) is a reliable index of myocardial supply-workload balance. This study sought to investigate whether overweight/obese children and adolescents have altered SEVR and to identify which are the associated factors. This cross-sectional study involved 789 individuals. Central haemodynamic was measured by radial applanation tonometry. Diastolic time was shorter (496 ± 122 vs 537 ± 140 ms, P = .014) and diastolic pressure-time index was lower (2681 ± 412 vs 2814 ± 423 mm Hg seconds, P = .024) in overweight/obese compared with eutrophic girls. SEVR was lower in girls than in boys (1.34 ± 0.39 vs 1.48 ± 0.41, P = .018) but only among overweight/obese. SEVR may be affected by small variations in the temporal determinants of cardiac cycle.

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INTRODUCTION: The growing prevalence of obesity is currently considered the most important nutritional disorder. It is characterized, according to the World Health Organization (WHO) as a worldwide epidemic in developing and developed countries. In an associated form, there is an increasing prevalence of dyslipidaemia. Aiming to improve the current situation and prevent the progression of the epidemic, the American Academy of Pediatrics recently reinforced the need for cholesterol screening in overweight children older than two years. OBJECTIVE: To determine overweight and lipid profile in children aged between six and nine years. METHODS: A descriptive, cross-sectional study with children from Vitoria, ES. For nutritional classification the Z-score > + 1 SD body mass index-for-age (according to WHO / 2007) was used; for the lipid profile the Atherosclerosis Prevention Guidelines in Childhood were used. Anthropometric measurements (weight, height, waist circumference and triceps skinfold thickness) followed the standard techniques described by WHO. Data were organized and analysed using SPSS, version 8.5 and calculated the absolute, relative and mean (SD) frequencies and the association between overweight, lipid profile and other variables is adopted as significant when p < 0.05. RESULTS: The sample comprised a total of 511 children of both sexes (46.7% male), with a mean age of 101.6 ± 11.1 months. Overweight was found in 197 (38.5%) children: overweight in 71 (13.9%) and obesity in 126 (24.6%). Total cholesterol was elevated in 167 (32.7%) as were high LDL-C (136-27%). High triglycerides were found in 21 participants (4.1%). Significant association was found between waist circumference and high levels of triglycerides (p = 0.019) and HDL-C (p = 0.033). CONCLUSION: Excess weight of the sample investigated is considered high and its health effects are important, with an increased total cholesterol greater than 32%. The high levels of HDL-C are protective factors for coronary heart disease, although the lipid profile had been changed.

INTRODUÇÃO: A prevalência crescente da obesidade é atualmente considerado o distúrbio nutricional mais importante. Caracteriza-se, de acordo com a Organização Mundial de Saúde (OMS) como uma epidemia mundial nos países em desenvolvimento e desenvolvidos. Numa forma associada, há um aumento da prevalência da dislipidemia. Com o objetivo de melhorar a situação actual e prevenir a progressão da epidemia, a Academia Americana de Pediatria reforçou recentemente a necessidade de triagem de colesterol em crianças com sobrepeso com idade superior a dois anos. OBJETIVO: Determinar o perfil sobrepeso e lipídico em crianças com idade entre seis e nove anos. MÉTODO: Estudo descritivo, transversal com crianças de Vitória, ES. Para a classificação nutricional do Z-score> + 1 SD índice para idade de massa corporal (segundo a OMS / 2007) foi utilizada; para o perfil lipídico as Diretrizes Prevenção da Aterosclerose na Infância foram utilizados. As medidas antropométricas (peso, altura, circunferência da cintura e dobra cutânea tricipital) seguiu as técnicas padrão descritas pela OMS. Os dados foram as frequências (SD) absolutos, relativos e média e a associação entre, perfil lipídico excesso de peso e outras variáveis organizados e analisados usando SPSS, versão 8.5 e calculada é adotado como significativo quando p <0,05. RESULTADOS: A amostra foi composta por um total de 511 crianças de ambos os sexos (46,7% do sexo masculino), com idade média de 101,6 ± 11,1 meses. O excesso de peso foi encontrado em 197 (38,5%) crianças: Excesso de peso em 71 (13,9%) e obesidade em 126 (24,6%). O colesterol total foi elevada em 167 (32,7%) eram como níveis elevados de LDL-C (136-27%). Triglicéridos elevados foram encontrados em 21 participantes (4,1%). associação significativa foi encontrada entre a circunferência da cintura e níveis elevados de triglicéridos (p = 0,019) e HDL-C (p = 0,033). CONCLUSÃO: O excesso de peso da amostra investigada é considerada alta e seus efeitos sobre a saúde são importantes, com um colesterol total aumentou mais de 32%. Os altos níveis de HDL-C são fatores de proteção para a doença cardíaca coronária, embora o perfil lipídico tinha sido mudado.

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We know of no studies comparing parent-reported sleep with accelerometer-estimated sleep in their relation to paediatric adiposity. We examined: (i) the reliability of mother-reported sleep compared with accelerometer-estimated sleep; and (ii) the relationship between both sleep measures and child adiposity. The current cross-sectional study included 303 Mexican American mother-child pairs recruited from Kaiser Permanente Northern California. We measured sleep duration using maternal report and accelerometry and child anthropometrics. Concordance between sleep measures was evaluated using the Bland-Altman method. We conducted zero-ordered correlations between mother-reported sleep, accelerometer-estimated sleep and child BMI z-scores (BMIz). Using linear regression, we examined three models to assess child BMIz with mother-reported sleep (model 1), accelerometer-estimated sleep (model 2) and both sleep measures (model 3). Children had an average age of 8.86 years (SD = 0.82). Mothers reported that their child slept 9.81 ± 0.74 h [95% confidence interval (CI): 9.72, 9.89], compared to 9.58 ± 0.71 h (95% CI: 9.50, 9.66) based on accelerometry. Mother-reported sleep and accelerometer-estimated sleep were correlated (r = 0.33, P < 0.001). BMIz outcomes were associated negatively with mother-reported sleep duration (model 1: ß = -0.13; P = 0.02) and accelerometer-estimated sleep duration (model 2: ß = -0.17; P < 0.01). Accounting for both sleep measures, only accelerometer-measured sleep was related to BMIz (model 3: ß = -0.14, P = 0.02). Each sleep measure was related significantly to adiposity, independent of covariates. Accelerometry appeared to be a more reliable measure of children's sleep than maternal report, yet maternal report may be sufficient to examine the sleep-adiposity relationship when resources are limited.

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