Gisele Queiroz Carvalho

Circunferência da cintura e relação cintura/estatura: úteis para identificar risco metabólico em adolescentes do sexo feminino?

OBJECTIVE: To evaluate if the waist circumference and the waist-to-height ratio (WHTR) are predictors of cardiovascular risk factors in female adolescents. METHODS: 113 adolescents aged 14 to 19 years old were assessed according to anthropometric data (weight, height, waist circumference), biochemical and clinical parameters (total cholesterol, LDL-C, HDL-C, triglyceride, fasting glucose, insulin, homeostasis model to assess insulin resistance - HOMA-IR), leptin, homocysteine and blood pressure. The cut points used for identification of abdominal fat were waist and WHTR values >90th percentile. RESULTS: Teenagers with abdominal obesity presented greater values of triglycerides (except for WHTR), insulin, HOMA-IR, leptin and systolic and diastolic blood pressure, while the HDL-C was reduced in the group with waist circumference >90th percentile, however without statistical significance (p=0.052). CONCLUSIONS: The present study showed that waist and WHTR are useful measures to identify female adolescents with a high cardiovascular risk, however the waist circumference presented a better performance.

Body fat location and cardiovascular disease risk factors in overweight female adolescents and eutrophic female adolescents with a high percentage of body fat

BACKGROUND Excessive body fat, mainly abdominal fat, is associated with higher cardiovascular risk. However, a fat localisation measurement that would be more indicative of risk in adolescents has not yet been established. OBJECTIVE This study was conducted in order to evaluate the correlation between body fat location measurements and cardiovascular disease risk factors in female adolescents. MATERIALS AND METHODS A total of 113 girls - 38 eutrophic according to their body mass index but with a high percentage of body fat, 40 eutrophic with adequate body fat, and 35 with excessive weight - were evaluated using 15 anthropometrical measurements and 10 cardiovascular risk factors. RESULTS The central skinfold was the best measurement for predicting variables such as glycaemia and high-density lipoprotein; waist circumference for insulin and homeostasis model assessment; coronal diameter for total cholesterol and low-density lipoprotein; sagittal abdominal diameter for triglycerides and leptin; hip circumference for blood pressure; and the central/peripheral skinfold ratio for homocysteine. The correlation between the measurements and the number of risk factors showed that waist circumference and the waist/stature ratio produced the best results. CONCLUSIONS The results suggest that the body fat distribution in adolescents is relevant in the development of cardiovascular risk factors. Simple measurements such as waist circumference and the waist/stature ratio were the best predictors of a risk of disease and they should therefore be associated with the body mass index in clinical practice in order to identify those adolescents at higher risk.

Composição corpórea, alterações bioquímicas e clínicas de adolescentes com excesso de adiposidade

BACKGROUND adolescents with excess body fat and eutrophic had the same metabolic changes expected in obese individuals. OBJECTIVE to evaluate body composition, anthropometric changes, biochemical and clinical characteristics of female adolescents. METHODS a total of 113 adolescents from public schools in Viçosa, MG, divided into three groups: group 1 - consisting of eutrophic adolescents with excess body fat; group 2 - eutrophic with body fat within normal limits; and group 3 - with excess weight and body fat. Weight, height, waist and hip circumference, blood pressure were measured. The body mass index (BMI) and waist-hip ratio were calculated. The percentage of body fat was obtained by bioelectrical impedance horizontally, following its own protocol for this evaluation. The assessment of the percentage of body fat and biochemistry was performed after 12 hours of fasting, and analyzed the lipid profile, blood glucose and insulin, homocysteine, leptin and C-reactive protein. Insulin resistance was calculated by HOMA index. RESULTS the group of eutrophic adolescents, with higher adiposity, behaved in relation to blood pressure, HDL and glucose levels, similarly to adolescents who are overweight. It can be seen that the HOMA index, insulin and leptin increased with increasing body fat. More than half of adolescents had total cholesterol and CRP levels above recommended levels. The most obvious metabolic disorder related to the lipid profile for both groups studied. CONCLUSION excess adiposity in normal weight adolescents may be related to clinical and biochemical changes similar to those found in adolescents who are overweight.FUNDAMENTO: Adolescentes con exceso de adiposidad y eutroficas presentan las mismas alteraciones metabolicas esperadas en individuos obesos. OBJETIVO: Evaluar la composicion corporal, alteraciones antropometricas, bioquimicas y clinicas de adolescentes del sexo femenino. METODOS: Fueron evaluadas 113 adolescentes de escuelas publicas de Vicosa, MG, divididas en tres grupos: grupo 1 - constituido por adolescentes eutroficas con exceso de grasa corporal; grupo 2 - eutroficas con grasa corporal dentro de los limites de normalidad; y grupo 3 - con exceso de peso y de grasa corporal. Peso, estatura, circunferencia de la cintura y cadera, presion arterial fueron medidos. El indice de masa corporal (IMC) y la relacion cintura-cadera fueron calculados. El porcentaje de grasa corporal fue obtenido por la impedancia bioelectrica horizontal, siguiendo protocolo propio para la referida evaluacion. La evaluacion del porcentaje de grasa corporal y bioquimica fue realizada despues de 12 horas de ayuno, siendo analizados perfil lipidico, glucemia y insulina, homocisteina, leptina y Proteina C Reactiva. La resistencia a la insulina fue calculada por el indice HOMA. RESULTADOS: El grupo de las adolescentes eutroficas, con elevada adiposidad, se comporto, en relacion a la presion arterial, fraccion HDL y glucemia, de modo semejante a las adolescentes con exceso de peso. Se pudo notar que el indice HOMA, la insulina y la leptina aumentaron de acuerdo con el aumento de la grasa corporal. Mas de la mitad de las adolescentes presentaba valores de colesterol total y PCR encima de los niveles recomendados. La alteracion metabolica mas evidente se relaciono al perfil lipidico para los grupos estudiados. CONCLUSION: El exceso de adiposidad en adolescentes eutroficas puede estar relacionado a alteraciones bioquimicas y clinicas semejantes a aquellas encontradas en adolescentes con exceso de peso.

Peripheral expression of inflammatory markers in overweight female adolescents and eutrophic female adolescents with a high percentage of body fat

The objective of this study was to evaluate the peripheral expression of inflammatory markers in adolescents with different nutritional status and its correlation with parameters of the metabolic syndrome. Seventy-two female postpubescent adolescents were divided into 3 groups: eutrophic (Co), eutrophic with a high body fat percentage (HBF), and overweight (OW). Data related to the parameters of the metabolic syndrome and the peripheral expression of tumour necrosis factor (TNF)-α, interleukin (IL)-6, and IL-10 were evaluated. Higher values of glycemia and insulin resistance were found in the HBF group than in the Co group. No differences related to the peripheral expression of the cytokines were found among the groups. In the HBF group, a positive correlation was observed between TNF-α and IL-6, IL-10 and the proinflammatory cytokines, and IL-6 and glycemia. In the OW group, a positive correlation was found between IL-6 and triglycerides. Adolescents with normal weight but body fat excess present a metabolic profile and body composition similar to those of overweight adolescents. This suggests that these adolescents have a risk of developing cardiovascular diseases similar to that of overweight adolescents. The positive correlation between IL-10 and TNF-α and IL-6 suggests an attempt to inhibit the production of these cytokines by IL-10.

Body composition, biochemical and clinical changes of adolescents with excessive adiposity

BACKGROUND adolescents with excess body fat and eutrophic had the same metabolic changes expected in obese individuals. OBJECTIVE to evaluate body composition, anthropometric changes, biochemical and clinical characteristics of female adolescents. METHODS a total of 113 adolescents from public schools in Viçosa, MG, divided into three groups: group 1 - consisting of eutrophic adolescents with excess body fat; group 2 - eutrophic with body fat within normal limits; and group 3 - with excess weight and body fat. Weight, height, waist and hip circumference, blood pressure were measured. The body mass index (BMI) and waist-hip ratio were calculated. The percentage of body fat was obtained by bioelectrical impedance horizontally, following its own protocol for this evaluation. The assessment of the percentage of body fat and biochemistry was performed after 12 hours of fasting, and analyzed the lipid profile, blood glucose and insulin, homocysteine, leptin and C-reactive protein. Insulin resistance was calculated by HOMA index. RESULTS the group of eutrophic adolescents, with higher adiposity, behaved in relation to blood pressure, HDL and glucose levels, similarly to adolescents who are overweight. It can be seen that the HOMA index, insulin and leptin increased with increasing body fat. More than half of adolescents had total cholesterol and CRP levels above recommended levels. The most obvious metabolic disorder related to the lipid profile for both groups studied. CONCLUSION excess adiposity in normal weight adolescents may be related to clinical and biochemical changes similar to those found in adolescents who are overweight.FUNDAMENTO: Adolescentes con exceso de adiposidad y eutroficas presentan las mismas alteraciones metabolicas esperadas en individuos obesos. OBJETIVO: Evaluar la composicion corporal, alteraciones antropometricas, bioquimicas y clinicas de adolescentes del sexo femenino. METODOS: Fueron evaluadas 113 adolescentes de escuelas publicas de Vicosa, MG, divididas en tres grupos: grupo 1 - constituido por adolescentes eutroficas con exceso de grasa corporal; grupo 2 - eutroficas con grasa corporal dentro de los limites de normalidad; y grupo 3 - con exceso de peso y de grasa corporal. Peso, estatura, circunferencia de la cintura y cadera, presion arterial fueron medidos. El indice de masa corporal (IMC) y la relacion cintura-cadera fueron calculados. El porcentaje de grasa corporal fue obtenido por la impedancia bioelectrica horizontal, siguiendo protocolo propio para la referida evaluacion. La evaluacion del porcentaje de grasa corporal y bioquimica fue realizada despues de 12 horas de ayuno, siendo analizados perfil lipidico, glucemia y insulina, homocisteina, leptina y Proteina C Reactiva. La resistencia a la insulina fue calculada por el indice HOMA. RESULTADOS: El grupo de las adolescentes eutroficas, con elevada adiposidad, se comporto, en relacion a la presion arterial, fraccion HDL y glucemia, de modo semejante a las adolescentes con exceso de peso. Se pudo notar que el indice HOMA, la insulina y la leptina aumentaron de acuerdo con el aumento de la grasa corporal. Mas de la mitad de las adolescentes presentaba valores de colesterol total y PCR encima de los niveles recomendados. La alteracion metabolica mas evidente se relaciono al perfil lipidico para los grupos estudiados. CONCLUSION: El exceso de adiposidad en adolescentes eutroficas puede estar relacionado a alteraciones bioquimicas y clinicas semejantes a aquellas encontradas en adolescentes con exceso de peso.

Measurements of body fat distribution: assessment of collinearity with body mass, adiposity and height in female adolescents

OBJECTIVE : To verify the correlation between body fat location measurements with the body mass index (BMI), body fat percentage (BF%) and height, according to the nutritional status in female adolescents. METHODS : A controlled cross-sectional study was carried out with 113 adolescents (G1: 38 with normal weight, but with high body fat level, G2: 40 with normal weight and G3: 35 overweight) from public schools in Viçosa-MG, Brazil. The following measures were assessed: weight, height, waist circumference (WC), umbilical circumference (UC), hip circumference (HC), thigh circumference, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-thigh ratio (WTR), conicity index (CI), sagittal abdominal diameter (SAD), coronal diameter (CD), central (CS) and peripheral skinfolds (PS). The BF% was assessed by tetrapolar electric bioimpedance. RESULTS : The increase in central fat, represented by WC, UC, WHtR, SAD, CD and CS, and the increase in peripheral fat indicated by HC and thigh circumference were proportional to the increase in BMI and BF%. WC and especially the UC showed the strongest correlations with adiposity. Weak correlation between WHR, WTR, CI and CS/PS with adiposity were observed. The height showed correlation with almost all the fat location measures, being fair or weak with waist measurements. CONCLUSIONS : The results indicate colinearity between body mass and total adiposity with central and peripheral adipose tissue. We recommend the use of UC for assessing nutritional status of adolescents, as it showed the highest capacity to predict adiposity in each group, and also showed fair or weak correlation with height.Resumo Objetivo Verificar a correlacao entre medidas de localizacao da gordura corporal com indice de massa corporal (IMC), percentual de gordura corporal (%GC) e estatura, de acordo com o estado nutricional em adolescentes do sexo feminino. Metodos Realizou‐se estudo transversal controlado, com 113 adolescentes (G1: 38 eutroficas mas com gordura corporal elevada; G2: 40 eutroficas e G3: 35 com excesso de peso), de 14 a 19 anos, de escolas publicas de Vicosa‐MG. Aferiu‐se peso, estatura, circunferencia da cintura (CC), circunferencia umbilical (CUm), circunferencia do quadril (CQ), circunferencia da coxa, relacao cintura/quadril (RCQ), relacao cintura/estatura (RCE), relacao cintura/coxa (RCC), indice de conicidade (IC), diâmetro abdominal sagital (DAS), diâmetro coronal (DC), pregas cutâneas centrais (PCC) e perifericas (PCP). Avaliou‐se o %GC por bioimpedância eletrica tetrapolar. Resultados O aumento da gordura central, representada pela CC, CUm, RCE, DAS, DC e PCC, e o aumento da gordura periferica indicado pela CQ e da coxa foram proporcionais ao aumento do IMC e %GC. A CC e principalmente CUm apresentaram as correlacoes mais fortes com a adiposidade, enquanto RCQ, RCC, IC e PCC/PCP as mais fracas. A estatura apresentou correlacao com praticamente todas as medidas de localizacao de gordura, sendo de fraca a regular com as medidas da cintura. Conclusoes Os resultados indicam colinearidade entre massa corporal e adiposidade total com tecido adiposo central e periferico. Recomenda‐se o emprego da CUm na avaliacao do estado nutricional de adolescentes, pois ela apresentou maior capacidade para predizer adiposidade em cada grupo, alem de correlacao fraca a regular com a estatura.Objective To verify the correlation between body fat location measurements with the body mass index (BMI), percentage of body fat (%BF) and stature, according to the nutritional status in female adolescents.

Índice glicêmico: uma abordagem crítica acerca de sua utilização na prevenção e no tratamento de fatores de risco cardiovasculares

Cardiovascular diseases are considered a great public health problem since they are the main cause of death in Brazil and in the world. These diseases have a multifactorial etiology. Besides genetic susceptibility, other factors such as age, hypertension, dyslipidemia, obesity, diabetes mellitus, physical inactivity and some inadequate dietary habits are considered important risk factors for the development of cardiovascular diseases. However, there are several controversies concerning how the quality of the ingested carbohydrate influences the development of such diseases, regardless of amount. The glycemic index is an indicator of carbohydrate quality. Its use in free living conditions has been questioned, due to the interference of several factors which are difficult to control under such conditions. The aim of this paper was to critically analyze studies that evaluated the effect of the glycemic index of foods in the manifestation of cardiovascular diseases and its risk factors.

Artigo OriginalMedidas de localização da gordura corporal: uma avaliação da colinearidade com massa corporal, adiposidade e estatura em adolescentes do sexo femininoMeasurements of location of body fat: an assessment of colinearity with body mass, adiposity and stature in female adolescents

OBJECTIVE : To verify the correlation between body fat location measurements with the body mass index (BMI), body fat percentage (BF%) and height, according to the nutritional status in female adolescents. METHODS : A controlled cross-sectional study was carried out with 113 adolescents (G1: 38 with normal weight, but with high body fat level, G2: 40 with normal weight and G3: 35 overweight) from public schools in Viçosa-MG, Brazil. The following measures were assessed: weight, height, waist circumference (WC), umbilical circumference (UC), hip circumference (HC), thigh circumference, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-thigh ratio (WTR), conicity index (CI), sagittal abdominal diameter (SAD), coronal diameter (CD), central (CS) and peripheral skinfolds (PS). The BF% was assessed by tetrapolar electric bioimpedance. RESULTS : The increase in central fat, represented by WC, UC, WHtR, SAD, CD and CS, and the increase in peripheral fat indicated by HC and thigh circumference were proportional to the increase in BMI and BF%. WC and especially the UC showed the strongest correlations with adiposity. Weak correlation between WHR, WTR, CI and CS/PS with adiposity were observed. The height showed correlation with almost all the fat location measures, being fair or weak with waist measurements. CONCLUSIONS : The results indicate colinearity between body mass and total adiposity with central and peripheral adipose tissue. We recommend the use of UC for assessing nutritional status of adolescents, as it showed the highest capacity to predict adiposity in each group, and also showed fair or weak correlation with height.Resumo Objetivo Verificar a correlacao entre medidas de localizacao da gordura corporal com indice de massa corporal (IMC), percentual de gordura corporal (%GC) e estatura, de acordo com o estado nutricional em adolescentes do sexo feminino. Metodos Realizou‐se estudo transversal controlado, com 113 adolescentes (G1: 38 eutroficas mas com gordura corporal elevada; G2: 40 eutroficas e G3: 35 com excesso de peso), de 14 a 19 anos, de escolas publicas de Vicosa‐MG. Aferiu‐se peso, estatura, circunferencia da cintura (CC), circunferencia umbilical (CUm), circunferencia do quadril (CQ), circunferencia da coxa, relacao cintura/quadril (RCQ), relacao cintura/estatura (RCE), relacao cintura/coxa (RCC), indice de conicidade (IC), diâmetro abdominal sagital (DAS), diâmetro coronal (DC), pregas cutâneas centrais (PCC) e perifericas (PCP). Avaliou‐se o %GC por bioimpedância eletrica tetrapolar. Resultados O aumento da gordura central, representada pela CC, CUm, RCE, DAS, DC e PCC, e o aumento da gordura periferica indicado pela CQ e da coxa foram proporcionais ao aumento do IMC e %GC. A CC e principalmente CUm apresentaram as correlacoes mais fortes com a adiposidade, enquanto RCQ, RCC, IC e PCC/PCP as mais fracas. A estatura apresentou correlacao com praticamente todas as medidas de localizacao de gordura, sendo de fraca a regular com as medidas da cintura. Conclusoes Os resultados indicam colinearidade entre massa corporal e adiposidade total com tecido adiposo central e periferico. Recomenda‐se o emprego da CUm na avaliacao do estado nutricional de adolescentes, pois ela apresentou maior capacidade para predizer adiposidade em cada grupo, alem de correlacao fraca a regular com a estatura.Objective To verify the correlation between body fat location measurements with the body mass index (BMI), percentage of body fat (%BF) and stature, according to the nutritional status in female adolescents.

Composición corporal, alteraciones bioquímicas y clínicas de adolescentes con exceso de adiposidad

BACKGROUND adolescents with excess body fat and eutrophic had the same metabolic changes expected in obese individuals. OBJECTIVE to evaluate body composition, anthropometric changes, biochemical and clinical characteristics of female adolescents. METHODS a total of 113 adolescents from public schools in Viçosa, MG, divided into three groups: group 1 - consisting of eutrophic adolescents with excess body fat; group 2 - eutrophic with body fat within normal limits; and group 3 - with excess weight and body fat. Weight, height, waist and hip circumference, blood pressure were measured. The body mass index (BMI) and waist-hip ratio were calculated. The percentage of body fat was obtained by bioelectrical impedance horizontally, following its own protocol for this evaluation. The assessment of the percentage of body fat and biochemistry was performed after 12 hours of fasting, and analyzed the lipid profile, blood glucose and insulin, homocysteine, leptin and C-reactive protein. Insulin resistance was calculated by HOMA index. RESULTS the group of eutrophic adolescents, with higher adiposity, behaved in relation to blood pressure, HDL and glucose levels, similarly to adolescents who are overweight. It can be seen that the HOMA index, insulin and leptin increased with increasing body fat. More than half of adolescents had total cholesterol and CRP levels above recommended levels. The most obvious metabolic disorder related to the lipid profile for both groups studied. CONCLUSION excess adiposity in normal weight adolescents may be related to clinical and biochemical changes similar to those found in adolescents who are overweight.FUNDAMENTO: Adolescentes con exceso de adiposidad y eutroficas presentan las mismas alteraciones metabolicas esperadas en individuos obesos. OBJETIVO: Evaluar la composicion corporal, alteraciones antropometricas, bioquimicas y clinicas de adolescentes del sexo femenino. METODOS: Fueron evaluadas 113 adolescentes de escuelas publicas de Vicosa, MG, divididas en tres grupos: grupo 1 - constituido por adolescentes eutroficas con exceso de grasa corporal; grupo 2 - eutroficas con grasa corporal dentro de los limites de normalidad; y grupo 3 - con exceso de peso y de grasa corporal. Peso, estatura, circunferencia de la cintura y cadera, presion arterial fueron medidos. El indice de masa corporal (IMC) y la relacion cintura-cadera fueron calculados. El porcentaje de grasa corporal fue obtenido por la impedancia bioelectrica horizontal, siguiendo protocolo propio para la referida evaluacion. La evaluacion del porcentaje de grasa corporal y bioquimica fue realizada despues de 12 horas de ayuno, siendo analizados perfil lipidico, glucemia y insulina, homocisteina, leptina y Proteina C Reactiva. La resistencia a la insulina fue calculada por el indice HOMA. RESULTADOS: El grupo de las adolescentes eutroficas, con elevada adiposidad, se comporto, en relacion a la presion arterial, fraccion HDL y glucemia, de modo semejante a las adolescentes con exceso de peso. Se pudo notar que el indice HOMA, la insulina y la leptina aumentaron de acuerdo con el aumento de la grasa corporal. Mas de la mitad de las adolescentes presentaba valores de colesterol total y PCR encima de los niveles recomendados. La alteracion metabolica mas evidente se relaciono al perfil lipidico para los grupos estudiados. CONCLUSION: El exceso de adiposidad en adolescentes eutroficas puede estar relacionado a alteraciones bioquimicas y clinicas semejantes a aquellas encontradas en adolescentes con exceso de peso.