Ana Carolina Barco Leme

Preventing obesity among Brazilian adolescent girls: Six-month outcomes of the Healthy Habits, Healthy Girls-Brazil school-based randomized controlled trial

BACKGROUND School-based trials to prevent and reduce prevalence of pediatric obesity in low-income countries are necessary. In Brazil, addressing adolescent obesity is a public health priority. OBJECTIVE To evaluate the impact of a group randomized controlled trial involving a 6-month multicomponent school-based obesity prevention program targeting adolescent girls. METHODS The Healthy Habits, Healthy Girls-Brazil program recruited participants (n=253; 16.05±0.05 years) from ten eligible public technical schools in São Paulo, Brazil. The program was adapted from an Australian intervention study, which is based on the Social Cognitive Theory. The primary outcome measure was body mass index (BMI), and secondary outcomes included BMI z score, waist circumference, and various sedentary and dietary health-related behaviours. RESULTS Although changes in BMI were not statistically significant, differences favored the intervention group (adjusted mean difference, -0.26kg/m(2),se SE=0.018, p=0.076). Statistically significant intervention effects were found for waist circumference (-2.28cm; p=, p=0.01), computer screen time on the weekends (0.63h/day, p; p=0.02), total sedentary activities on the weekends (-0.92h/day, p<0.01), and vegetable intake (1.16servings/day, p=0.01). CONCLUSION These findings provide some evidence for the benefit of a school-based intervention to prevent unhealthy weight gain in adolescent girls living in low-income communities.

Teasing and weight-control behaviors in adolescent girls

OBJECTIVE: To analyze the association between weight teasing, body satisfaction and weight control behaviors. METHODS: Cross-sectional study based on adaptation and validity research of a North American questionnaire for adolescent girls about physical activity, nutrition, body image, perceptions, and behaviors. The variables used to conduct the study were weight control behaviors, body satisfaction and presence of teasing by family members. Descriptive analyses were carried out by chi-square test, being significant p<0.05. RESULTS: A total of 159 adolescent girls, with 16.2±1.3 years old were enrolled in this study. Of the total, 60.1% reported that family members did not tease them. The teasing was associated with weight dissatisfaction (p<0.001), body shape (p=0.006), belly (p=0.001), waist (p=0.001), face (p=0.009), arms (p=0.014) and shoulders (p=0.001). As a consequence, there was association with unhealthy weight control behaviors (p<0.001), vomiting (p=0,011), diet (p=0.002) and use of laxatives (p=0.035). CONCLUSIONS: The teasing about body image by family members was associated with risk for unhealthy weight control behaviors in female adolescents.OBJETIVO: Analisar a associacao entre as provocacoes relativas ao peso, a satisfacao corporal e os comportamentos para controle de peso. METODOS: Estudo transversal baseado em pesquisa de adaptacao e validacao de um questionario norte-americano para adolescentes do sexo feminino sobre percepcoes, comportamentos, atividade fisica, alimentacao e imagem corporal. As variaveis utilizadas para a realizacao do estudo foram os comportamentos para controle de peso corporal, o grau de satisfacao corporal e a presenca de provocacoes relativas ao peso por parte de membros da familia. Realizaram-se analises descritivas pelo teste do qui-quadrado, considerando-se significante p<0,05. RESULTADOS: Participaram do estudo 159 adolescentes do sexo feminino, com idade de 16,2±1,3 anos. Do total, 60,1% relataram nao ter sofrido provocacoes relativas ao peso por membros da familia. As provocacoes associavam-se a insatisfacao com peso (p<0,001), forma do corpo (p=0,006), abdome (p=0,001), cintura (p=0,001), rosto (p=0,009), bracos (p=0,014) e ombros (p=0,001). Consequentemente, houve associacao com comportamentos nao saudaveis para controlar o peso (p<0,001), provocar vomito (p=0,011), realizar dieta (p=0,002) e tomar laxantes (p=0,035). CONCLUSOES: As provocacoes relativas a imagem corporal por membros da familia relacionam-se ao risco para comportamentos nao saudaveis para controle de peso em adolescentes do sexo feminino.

Dietary intake and meal frequency of Brazilian girls attending a school-based randomized controlled trial

– This paper aims to evaluate the effects of a school-based obesity prevention program targeting Brazilian adolescent girls on dietary intake and meal frequency. , – It was a six-month school-based group randomized controlled trial with female adolescents. The intervention was based on the Social Cognitive Theory and focused on ten nutrition and physical activity key messages. Diet intake was measured using a validated food frequency questionnaire, and the food items were aggregate into the eight food groups of the Brazilian Food Guide Pyramid. The meals frequency assessed were breakfast, lunch, dinner and snack-in-between-meals, the frequency ranged from never to everyday. Linear mixed models were used to examine the dietary effects and chi-squared test to identify proportional differences among groups in meal frequency. All analyses followed intention-to-treat principles and alpha levels of p ≤ 0.05 were set. , – After six months from baseline, changes in the fruits (mean [SE] 12.48 kcal [7.86], p = 0.005), vegetables (8.80 kcal [7.11], p = 0.006) and sugar (−55.98 kcal [50.70], p = 0.036) groups were demonstrated. Proportional difference was shown for snack-in-between-meals (p = 0.001), and the frequency most cited was for “five to six days” per week. , – The “Healthy Habits, Healthy Girls-Brazil” showed promise in the adolescents’ dietary intake and could be used as framework for future interventions. Also, the methods used for dietary intake can be enhanced and implemented for future studies.

The “Healthy Habits, Healthy Girls” randomized controlled trial for girls: study design, protocol, and baseline results

O objetivo deste artigo e descrever o delineamento, protocolo de estudo e resultados do baseline do programa “Habitos Saudaveis, Meninas Saudaveis”. A intervencao sera avaliada por meio de um ensaio randomizado controlado em 10 escolas publicas de Sao Paulo, Brasil. As variaveis foram mensuradas no baseline e serao avaliadas apos 7 e 12 meses do baseline: indice de massa corporal, circunferencia da cintura, dieta, mediadores sociais cognitivos da nutricao e atividade fisica, nivel de atividade fisica, comportamentos sedentarios, autopercepcao fisica e autoestima global. Resultados do baseline demonstraram que 32,4% do grupo intervencao e 23,4% do controle estavam acima do peso, e para ambos uma grande porcentagem nao atingiu as recomendacoes diarias de atividade fisica moderada/vigorosa, e tempo de tela. Para a maioria das variaveis, com excecao de idade (p = 0,000) e circunferencia da cintura (p = 0,014), nao houve diferenca significante entre os grupos. Ha uma lacuna na literatura brasileira sobre ensaios randomizados controlados para prevenir obesidade em adolescentes. Este trabalho pode apresentar uma importante contribuicao para a area.

What do the adolescents prefer: food from school or competitive foods?

Abstract Objective: To identify and justify adolescents’ food choices during recess at school and to get to know school staff vision about the students’ acceptance of the Brazilian School Meal Program. Material and Methods: It´s a cross-sectional study in a public school in Sao Paulo, based on the Theory of the So-cial Representations. Eighty-three adolescents were selected and asked to identify their food choices du -ring recess at school. Complementary to this survey, twelve school staff members answered an interview aimed at identifying their own view on the students’ acceptance of the Brazilian School Meal. Data analysis was done using the Discourse of Collective Subject technique, identifying the methodological figures – key-expressions and central ideas – for the construction of their discourse. Results: Although the adolescents don’t like the meals offered by the program, they adhere to it since it is the only alterna -tive they have at school. Nevertheless, it is common for them to buy food in establishments nearby or to bring it from home as a complement or a substitute for the school meal. In the school staff´s vision the adolescents like the school meal. However, they considered that some of the foods are not part of the adolescents’ eating habits or do not attract them due to their organoleptic characteristics.

Food pyramid intake and nutrient profiles of Brazilian girls

Purpose This paper aims to evaluate the impact of the groups from the Brazilian Food Pyramid on macro and micronutrient content of food consumed by adolescent girls from a school-based study. Design/methodology/approach Baseline data from “Healthy Habits, Healthy Girls” school-based randomized control trial was used for this study. A sample of the girls aged 14 to 18 years old (n = 253) from ten schools in Brazil was evaluated. Participants completed validated food frequency questionnaire, from which, the total kilocalories and/or grams from each food groups were calculated. Descriptive statistics, t-student test and linear regression were used for the analysis with a significant level of p < 0.05. Findings Mean daily intake of the girls was 2,887.09 (standard error 91.50) kcal/day. There was a positive significant association between relative intake of the “Oil and Fats” group and protein (ranged from 24.95 to 96.12 kcal/d), fats (48.36 to 192.62 kcal/d), iron (56.93 to 162.85 kcal/d) and sodium (208.08 to 699.69 kcal/d) contents. In regards to the intake of “Sugars and Sweets” group, there was a positive significant association for carbohydrates (97.53 to 491.70 kcal/day), total fiber (0.56 to 2.64 kcal/d), iron (0.85 to 4.40 kcal/d) and sodium (175.59 to 838.48 kcal/d) content. Originality/value Findings demonstrate that girls over consumed the “Oils and Fats” and “Sugars and Sweets” groups reflecting on increased of important macro and micronutrients of their diet. Therefore, consuming up to 1 serving size of these groups is a good way to promote healthy eating among this population.

Ensayo randomizado controlado para niñas “Hábitos Saludables, Niñas Saludables”: delineación, protocolo de estudio y resultados iniciales

O objetivo deste artigo e descrever o delineamento, protocolo de estudo e resultados do baseline do programa “Habitos Saudaveis, Meninas Saudaveis”. A intervencao sera avaliada por meio de um ensaio randomizado controlado em 10 escolas publicas de Sao Paulo, Brasil. As variaveis foram mensuradas no baseline e serao avaliadas apos 7 e 12 meses do baseline: indice de massa corporal, circunferencia da cintura, dieta, mediadores sociais cognitivos da nutricao e atividade fisica, nivel de atividade fisica, comportamentos sedentarios, autopercepcao fisica e autoestima global. Resultados do baseline demonstraram que 32,4% do grupo intervencao e 23,4% do controle estavam acima do peso, e para ambos uma grande porcentagem nao atingiu as recomendacoes diarias de atividade fisica moderada/vigorosa, e tempo de tela. Para a maioria das variaveis, com excecao de idade (p = 0,000) e circunferencia da cintura (p = 0,014), nao houve diferenca significante entre os grupos. Ha uma lacuna na literatura brasileira sobre ensaios randomizados controlados para prevenir obesidade em adolescentes. Este trabalho pode apresentar uma importante contribuicao para a area.

Ensaio randomizado controlado para meninas “Hábitos Saudáveis, Meninas Saudáveis”: delineamento, protocolo de estudo e resultados do baseline

O objetivo deste artigo e descrever o delineamento, protocolo de estudo e resultados do baseline do programa “Habitos Saudaveis, Meninas Saudaveis”. A intervencao sera avaliada por meio de um ensaio randomizado controlado em 10 escolas publicas de Sao Paulo, Brasil. As variaveis foram mensuradas no baseline e serao avaliadas apos 7 e 12 meses do baseline: indice de massa corporal, circunferencia da cintura, dieta, mediadores sociais cognitivos da nutricao e atividade fisica, nivel de atividade fisica, comportamentos sedentarios, autopercepcao fisica e autoestima global. Resultados do baseline demonstraram que 32,4% do grupo intervencao e 23,4% do controle estavam acima do peso, e para ambos uma grande porcentagem nao atingiu as recomendacoes diarias de atividade fisica moderada/vigorosa, e tempo de tela. Para a maioria das variaveis, com excecao de idade (p = 0,000) e circunferencia da cintura (p = 0,014), nao houve diferenca significante entre os grupos. Ha uma lacuna na literatura brasileira sobre ensaios randomizados controlados para prevenir obesidade em adolescentes. Este trabalho pode apresentar uma importante contribuicao para a area.

Provocações e comportamentos para controle de peso em adolescentes do sexo feminino

OBJECTIVE: To analyze the association between weight teasing, body satisfaction and weight control behaviors. METHODS: Cross-sectional study based on adaptation and validity research of a North American questionnaire for adolescent girls about physical activity, nutrition, body image, perceptions, and behaviors. The variables used to conduct the study were weight control behaviors, body satisfaction and presence of teasing by family members. Descriptive analyses were carried out by chi-square test, being significant p<0.05. RESULTS: A total of 159 adolescent girls, with 16.2±1.3 years old were enrolled in this study. Of the total, 60.1% reported that family members did not tease them. The teasing was associated with weight dissatisfaction (p<0.001), body shape (p=0.006), belly (p=0.001), waist (p=0.001), face (p=0.009), arms (p=0.014) and shoulders (p=0.001). As a consequence, there was association with unhealthy weight control behaviors (p<0.001), vomiting (p=0,011), diet (p=0.002) and use of laxatives (p=0.035). CONCLUSIONS: The teasing about body image by family members was associated with risk for unhealthy weight control behaviors in female adolescents.OBJETIVO: Analisar a associacao entre as provocacoes relativas ao peso, a satisfacao corporal e os comportamentos para controle de peso. METODOS: Estudo transversal baseado em pesquisa de adaptacao e validacao de um questionario norte-americano para adolescentes do sexo feminino sobre percepcoes, comportamentos, atividade fisica, alimentacao e imagem corporal. As variaveis utilizadas para a realizacao do estudo foram os comportamentos para controle de peso corporal, o grau de satisfacao corporal e a presenca de provocacoes relativas ao peso por parte de membros da familia. Realizaram-se analises descritivas pelo teste do qui-quadrado, considerando-se significante p<0,05. RESULTADOS: Participaram do estudo 159 adolescentes do sexo feminino, com idade de 16,2±1,3 anos. Do total, 60,1% relataram nao ter sofrido provocacoes relativas ao peso por membros da familia. As provocacoes associavam-se a insatisfacao com peso (p<0,001), forma do corpo (p=0,006), abdome (p=0,001), cintura (p=0,001), rosto (p=0,009), bracos (p=0,014) e ombros (p=0,001). Consequentemente, houve associacao com comportamentos nao saudaveis para controlar o peso (p<0,001), provocar vomito (p=0,011), realizar dieta (p=0,002) e tomar laxantes (p=0,035). CONCLUSOES: As provocacoes relativas a imagem corporal por membros da familia relacionam-se ao risco para comportamentos nao saudaveis para controle de peso em adolescentes do sexo feminino.

Provocaciones y comportamientos para control de peso en adolescentes del sexo femenino

OBJECTIVE: To analyze the association between weight teasing, body satisfaction and weight control behaviors. METHODS: Cross-sectional study based on adaptation and validity research of a North American questionnaire for adolescent girls about physical activity, nutrition, body image, perceptions, and behaviors. The variables used to conduct the study were weight control behaviors, body satisfaction and presence of teasing by family members. Descriptive analyses were carried out by chi-square test, being significant p<0.05. RESULTS: A total of 159 adolescent girls, with 16.2±1.3 years old were enrolled in this study. Of the total, 60.1% reported that family members did not tease them. The teasing was associated with weight dissatisfaction (p<0.001), body shape (p=0.006), belly (p=0.001), waist (p=0.001), face (p=0.009), arms (p=0.014) and shoulders (p=0.001). As a consequence, there was association with unhealthy weight control behaviors (p<0.001), vomiting (p=0,011), diet (p=0.002) and use of laxatives (p=0.035). CONCLUSIONS: The teasing about body image by family members was associated with risk for unhealthy weight control behaviors in female adolescents.OBJETIVO: Analisar a associacao entre as provocacoes relativas ao peso, a satisfacao corporal e os comportamentos para controle de peso. METODOS: Estudo transversal baseado em pesquisa de adaptacao e validacao de um questionario norte-americano para adolescentes do sexo feminino sobre percepcoes, comportamentos, atividade fisica, alimentacao e imagem corporal. As variaveis utilizadas para a realizacao do estudo foram os comportamentos para controle de peso corporal, o grau de satisfacao corporal e a presenca de provocacoes relativas ao peso por parte de membros da familia. Realizaram-se analises descritivas pelo teste do qui-quadrado, considerando-se significante p<0,05. RESULTADOS: Participaram do estudo 159 adolescentes do sexo feminino, com idade de 16,2±1,3 anos. Do total, 60,1% relataram nao ter sofrido provocacoes relativas ao peso por membros da familia. As provocacoes associavam-se a insatisfacao com peso (p<0,001), forma do corpo (p=0,006), abdome (p=0,001), cintura (p=0,001), rosto (p=0,009), bracos (p=0,014) e ombros (p=0,001). Consequentemente, houve associacao com comportamentos nao saudaveis para controlar o peso (p<0,001), provocar vomito (p=0,011), realizar dieta (p=0,002) e tomar laxantes (p=0,035). CONCLUSOES: As provocacoes relativas a imagem corporal por membros da familia relacionam-se ao risco para comportamentos nao saudaveis para controle de peso em adolescentes do sexo feminino.