Larissa Rosa da Silva

Excesso de peso e baixa estatura em crianças de comunidades urbana, rural e indígena

Changes in lifestyle have led to an increase of overweight in the juvenile population. However, there are limited studies about this topic in relation to an indigenous population. The aim of this study is to verify the overweight and height defi cit in children aged 8 and 9 years, of both sexes, from urban, rural and indigenous communities of the city of Nova Laranjeiras in the State of Paraná. The 277 (148 boys) students were divided into three groups: rural (n = 100), urban (n = 99) and Indian communities (n = 78). The measurements taken were body mass (kg), height (m) and body mass index. The statistics method was an analysis of covariance and chi-square test (P <.05). Among the 277 schoolchildren, the prevalence of overweight was 14.6% in the rural area, 27.1% in urban area and 30.3% in the indigenous area in boys, and 15.7% in rural areas, 17.6% in urban and 20% in Indian girls. There was no difference in the frequency of overweight among groups for both sexes. The prevalence of height defi cit was different between the groups; it was higher in indigenous children than urban and rural children. Among the Indians, 42.4% of boys and 51.1% girls had low stature. Only indigenous children were overweight and of low height, while being prevalent in 15.1% of boys and 11.1% girls. Low stature is frequent in indigenous populations, and it would be ideal to have more research to identify its causes and consequences. Children showed high rates of overweight in all regions, demonstrating that poor eating habits and a sedentary lifestyle are not only characteristics of urban centres.

Effects of 12 weeks of combined training without caloric restriction on inflammatory markers in overweight girls

ABSTRACT The objective of the present study was to investigate the effects of combined training without caloric restriction on inflammatory markers in overweight girls. Thirty-three girls (13–17 years) were assigned into overweight training (n = 17) or overweight control (n = 16) groups. Additionally, a normal-weight group (n = 15) was used as control for the baseline values. The combined training programme consisted of six resistance exercises (three sets of 6–10 repetitions at 60–70% 1 RM) followed by 30 min of aerobic exercise (walking/running) at 50–80% VO2peak, performed in the same 60 min session, 3 days/weeks, for 12 weeks. Body composition, dietary intake, aerobic fitness (VO2peak), muscular strength (1 RM), glycaemia, insulinemia, lipid profile and inflammatory markers (C-reactive protein, interleukin-6, tumour necrosis factor-alpha, interleukin-10, leptin, resistin and adiponectin) were measured before and after intervention. There was a significant decrease in body fat (P < 0.01) and increase in fat-free mass (P < 0.01), VO2peak (P < 0.01), 1 RM for leg press (P < 0.01) and bench press (P < 0.01) in the overweight training group. Concomitantly, this group presented significant decreases in serum concentrations of C-reactive protein (P < 0.05) and leptin (P < 0.05), as well as in insulin resistance (P < 0.05) after the experimental period. In conclusion, 12 weeks of combined training without caloric restriction reduced inflammatory markers associated with obesity in overweight girls.

Alterações posturais em crianças e adolescentes obesos e não-obesos

Nos ultimos anos, a obesidade assumiu proporcoes epidemicas, relacionando-se aos fatores de risco cardiovasculares e tambem ao aparecimento de alteracoes posturais, tanto no adulto como em criancas e adolescentes. O objetivo do presente estudo foi identificar e comparar a frequencia de alteracoes posturais e dor em escolares obesos e nao obesos de acordo com o genero. Foram analisadas 51 criancas e adolescentes, de 9 a 17 anos, de ambos os sexos, divididas em dois grupos: obesos (n=33) e nao-obesos (n=18), estes foram posteriormente subdivididos por sexo para as analises. A partir da massa corporal e da estatura, foi calculado o indice de massa corporal (IMC). Utilizou-se questionario elaborado pelos autores e validado em conteudo para avaliar a presenca ou nao de dor. Foram avaliados desvios posturais de ombro, cabeca e joelho, pelo uso de fotometria para analise angular e de dimensao. Os meninos obesos apresentaram maiores alteracoes posturais do que os nao-obesos somente na regiao do joelho (p<0,01). Entre as meninas, nao houve diferenca para nenhuma das regioes. A frequencia de dor nas meninas obesas foi significativamente maior do que nas nao-obesas (p<0,05). Conclui-se que as alteracoes nao sao exclusivas dos individuos obesos, mas o excesso de peso pode acentuar esses desvios. Mais estudos sao necessarios para diagnosticar, ja na infância, essas alteracoes, possibilitando intervencao precoce e boa postura na vida adulta.Obesity has reached epidemic proportions over recent years and is related to cardiovascular risk factors, as well as to the occurrence of postural changes in adults, children and adolescents. The objective of this study was to identify the prevalence of postural abnormalities and pain in schoolchildren. Fifty-one children and adolescents of both genders aged 9-17 years were divided into an obese (n = 33) and a non-obese group (n = 18). Weight and height were measured to calculate the body mass index. A questionnaire was used to assess the presence or absence of pain. Postural deviations of the shoulder, head and knees were analyzed by photometry using the Corel Draw12 software for the determination of angular measures and size. Obese boys showed greater postural changes in the region of the knees than non-obese ones (p<0.001). No significant differences in any of the regions analyzed were observed for girls. On the other hand, the prevalence of pain was significantly higher among obese girls than among non-obese girls. We conclude that postural changes are not limited to obese children, but excess weight may increase this deviation. Further studies are needed to diagnose these changes during childhood in order to permit early intervention and good posture in adult life.

Endothelial wall thickness, cardiorespiratory fitness and inflammatory markers in obese and non-obese adolescents

Background Increased carotid intima-media thickness (c-IMT) is considered a marker of early-onset atherosclerosis and it has been found in obese children and adolescents, but the risk factors associated with this population remain to be elucidated. Objective To compare and verify the relationship between c-IMT, metabolic profile, inflammatory markers, and cardiorespiratory fitness in obese and non-obese children and adolescents. Method Thirty-five obese subjects (19 boys) and 18 non-obese subjects (9 boys), aged 10-16 years, were included. Anthropometry, body composition, blood pressure, maximal oxygen consumption (VO2max), and basal metabolic rate were evaluated. Serum glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), blood lipids, C-reactive protein (CRP), and adiponectin were assessed. c-IMT was measured by ultrasound. Results The results showed that c-IMT, triglycerides, insulin, HOMA-IR, and CRP values were significantly higher in the obese group than in the non-obese group, and high-density lipoprotein cholesterol (HDL-c), adiponectin, and VO2max values were significantly lower in the obese group than in the non-obese group. The c-IMT was directly correlated with body weight, waist circumference, % body fat, and HOMA-IR and inversely correlated with % free fat mass, HDL-c, and VO2max. Conclusions Our findings show that c-IMT correlates not only with body composition, lipids, insulin resistance, and inflammation but also with low VO2max values in children and adolescents.

Postural changes in obese and non-obese children and adolescents

Nos ultimos anos, a obesidade assumiu proporcoes epidemicas, relacionando-se aos fatores de risco cardiovasculares e tambem ao aparecimento de alteracoes posturais, tanto no adulto como em criancas e adolescentes. O objetivo do presente estudo foi identificar e comparar a frequencia de alteracoes posturais e dor em escolares obesos e nao obesos de acordo com o genero. Foram analisadas 51 criancas e adolescentes, de 9 a 17 anos, de ambos os sexos, divididas em dois grupos: obesos (n=33) e nao-obesos (n=18), estes foram posteriormente subdivididos por sexo para as analises. A partir da massa corporal e da estatura, foi calculado o indice de massa corporal (IMC). Utilizou-se questionario elaborado pelos autores e validado em conteudo para avaliar a presenca ou nao de dor. Foram avaliados desvios posturais de ombro, cabeca e joelho, pelo uso de fotometria para analise angular e de dimensao. Os meninos obesos apresentaram maiores alteracoes posturais do que os nao-obesos somente na regiao do joelho (p<0,01). Entre as meninas, nao houve diferenca para nenhuma das regioes. A frequencia de dor nas meninas obesas foi significativamente maior do que nas nao-obesas (p<0,05). Conclui-se que as alteracoes nao sao exclusivas dos individuos obesos, mas o excesso de peso pode acentuar esses desvios. Mais estudos sao necessarios para diagnosticar, ja na infância, essas alteracoes, possibilitando intervencao precoce e boa postura na vida adulta.Obesity has reached epidemic proportions over recent years and is related to cardiovascular risk factors, as well as to the occurrence of postural changes in adults, children and adolescents. The objective of this study was to identify the prevalence of postural abnormalities and pain in schoolchildren. Fifty-one children and adolescents of both genders aged 9-17 years were divided into an obese (n = 33) and a non-obese group (n = 18). Weight and height were measured to calculate the body mass index. A questionnaire was used to assess the presence or absence of pain. Postural deviations of the shoulder, head and knees were analyzed by photometry using the Corel Draw12 software for the determination of angular measures and size. Obese boys showed greater postural changes in the region of the knees than non-obese ones (p<0.001). No significant differences in any of the regions analyzed were observed for girls. On the other hand, the prevalence of pain was significantly higher among obese girls than among non-obese girls. We conclude that postural changes are not limited to obese children, but excess weight may increase this deviation. Further studies are needed to diagnose these changes during childhood in order to permit early intervention and good posture in adult life.

Association between adiposity indicators, metabolic parameters and inflammatory markers in a sample of female adolescents

OBJECTIVE The aim of this study was to investigate the association between total and abdominal adiposity with metabolic parameters and inflammatory markers, in female adolescents. SUBJECTS AND METHODS The sample consisted of 53 adolescents aged 13 to 17 years from a public school in Curitiba, Brazil. The adiposity indicators studied were body mass index (BMI), waist circumference (WC), trunk fat mass (TKFM), total fat mass (TFM) and body fat percentage (BF%) measured by dual-energy X-ray absorptiometry. The metabolic and inflammatory parameters studied were systolic blood pressure (SBP), diastolic blood pressure (DBP), glucose, insulin, homeostasis model assessment index for insulin resistance (HOMA-IR), lipids, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), leptin, adiponectin and resistin. RESULTS Eighty percent of WC variation, 87% of TKFM and TFM, and 73% of BF% were predicted by BMI variation. There was a significant positive correlation between all indicators of adiposity with SBP, DBP, insulin, HOMA-IR, CRP and leptin. Triglycerides were positively correlated with BMI and WC, and adiponectin correlated negatively with BMI. TNF-α, IL-6, glucose, total cholesterol, and high- and low-density lipoprotein cholesterol did not correlate to the studied variables. CONCLUSION BMI showed a significant association with most of the parameters studied, and WC was slightly better than BMI to predict insulin resistance in this specific population.

Comparação de três equações para predição da gordura corporal por bioimpedância em jovens obesas

INTRODUCAO: A impedância bioeletrica (BIA) tem sido bastante utilizada para o monitoramento da composicao corporal em individuos de diferentes idades e estados nutricionais. Entretanto, nao se sabe qual das equacoes propostas para criancas e adolescentes e a mais recomendada para utilizacao em adolescentes com excesso de peso. Objetivo: Verificar a concordância dos metodos de BIA usando tres equacoes diferentes com a absorciometria de raio-X de dupla energia (DXA), para analise da composicao corporal de adolescentes com sobrepeso e obesidade. METODOS: Participaram do estudo 27 adolescentes do sexo feminino, com sobrepeso e obesidade. Foram avaliados o percentual de gordura corporal (%GC), a massa gorda (MG) e a massa livre de gordura (MLG) por DXA e por BIA utilizando as equacoes propostas por Houtkooper, Schaefer e Deurenberg. ANOVA oneway, graficos de Bland-Altman e o coeficiente de correlacao intraclasse foram utilizados para comparacao e verificacao da concordância entre os metodos. RESULTADOS: A BIA utilizando a equacao proposta por Houtkooper foi a unica que nao apresentou diferenca estatistica significativa na estimativa de %GC, MG e MLG em comparacao ao DXA e apresentou boa concordância com o DXA na estimativa de %GC (-1,9 ± 3,29%), MG (1,5 ± 2,59 kg) e MLG (1,4 ± 2,60 kg), bem como boa reprodutibilidade para %GC (CCI = 0,81), MG (0,96) e MLG (0,89). As equacoes de Schaefer e de Deurenberg apresentaram menor concordância com o DXA, superestimando a MG e subestimando a MLG e apresentaram reprodutibilidade de moderada a baixa na maioria das medidas da composicao corporal. CONCLUSAO: Quando comparamos as tres equacoes propostas para BIA com o DXA, verificamos que a equacao proposta por Houtkooper foi a que melhor concordou com DXA e apresentou boa reprodutibilidade para estimar %GC, MG e MLG em adolescentes com sobrepeso e obesidade.Introduction: The bioelectrical impedance (BIA) has been widely used for monitoring body composition of individuals of different ages and nutritional statuses. However, it is unknown which of the equations for children and adolescents is the most recommended to be used for adolescents who are overweight. Objective: To assess the agreement of the BIA method using three different equations with dual energy X-ray absorptiometry (DXA) for analysis of body composition in overweight and obesity. Methods: Twenty-seven female adolescents with overweight or obesity were included in this study. The percentage of body fat (%BF), fat mass (FM) and fat-free mass (FFM) were evaluated by DXA and BIA using the equations proposed by Houtkooper, Schaefer and Deurenberg. Oneway ANOVA, Bland-Altman plots and the intraclass correlation coefficient were used for comparison and verification of the agreement among the methods. Results: BIA using the equation proposed by Houtkooper was the only one that showed no statistically significant difference in the estimating %BF, FM and FFM compared to DXA and showed good agreement with DXA in estimating %BF (-1.9±3.29), FM (1.5±2.59) and FFM (1.4±2.60) and good reproducibility for %BF (0.81), FM (0.96) and FFM (0.89). The Schaefer and Deurenberg equations showed less agreement with DXA, overestimating the MG and underestimating the FFM, and presented moderate to low reproducibility in most measures of body composition. Conclusion: When we compared the three equations proposed to BIA with DXA, we find that the Houtkooper equation was the best agreed with DXA and showed good reproducibility for estimate %BF, FM and FFM in female adolescents with overweight and obesity.

Comparison of three equations for predicting the body fat by bioimpedance in young obese females

INTRODUCAO: A impedância bioeletrica (BIA) tem sido bastante utilizada para o monitoramento da composicao corporal em individuos de diferentes idades e estados nutricionais. Entretanto, nao se sabe qual das equacoes propostas para criancas e adolescentes e a mais recomendada para utilizacao em adolescentes com excesso de peso. Objetivo: Verificar a concordância dos metodos de BIA usando tres equacoes diferentes com a absorciometria de raio-X de dupla energia (DXA), para analise da composicao corporal de adolescentes com sobrepeso e obesidade. METODOS: Participaram do estudo 27 adolescentes do sexo feminino, com sobrepeso e obesidade. Foram avaliados o percentual de gordura corporal (%GC), a massa gorda (MG) e a massa livre de gordura (MLG) por DXA e por BIA utilizando as equacoes propostas por Houtkooper, Schaefer e Deurenberg. ANOVA oneway, graficos de Bland-Altman e o coeficiente de correlacao intraclasse foram utilizados para comparacao e verificacao da concordância entre os metodos. RESULTADOS: A BIA utilizando a equacao proposta por Houtkooper foi a unica que nao apresentou diferenca estatistica significativa na estimativa de %GC, MG e MLG em comparacao ao DXA e apresentou boa concordância com o DXA na estimativa de %GC (-1,9 ± 3,29%), MG (1,5 ± 2,59 kg) e MLG (1,4 ± 2,60 kg), bem como boa reprodutibilidade para %GC (CCI = 0,81), MG (0,96) e MLG (0,89). As equacoes de Schaefer e de Deurenberg apresentaram menor concordância com o DXA, superestimando a MG e subestimando a MLG e apresentaram reprodutibilidade de moderada a baixa na maioria das medidas da composicao corporal. CONCLUSAO: Quando comparamos as tres equacoes propostas para BIA com o DXA, verificamos que a equacao proposta por Houtkooper foi a que melhor concordou com DXA e apresentou boa reprodutibilidade para estimar %GC, MG e MLG em adolescentes com sobrepeso e obesidade.Introduction: The bioelectrical impedance (BIA) has been widely used for monitoring body composition of individuals of different ages and nutritional statuses. However, it is unknown which of the equations for children and adolescents is the most recommended to be used for adolescents who are overweight. Objective: To assess the agreement of the BIA method using three different equations with dual energy X-ray absorptiometry (DXA) for analysis of body composition in overweight and obesity. Methods: Twenty-seven female adolescents with overweight or obesity were included in this study. The percentage of body fat (%BF), fat mass (FM) and fat-free mass (FFM) were evaluated by DXA and BIA using the equations proposed by Houtkooper, Schaefer and Deurenberg. Oneway ANOVA, Bland-Altman plots and the intraclass correlation coefficient were used for comparison and verification of the agreement among the methods. Results: BIA using the equation proposed by Houtkooper was the only one that showed no statistically significant difference in the estimating %BF, FM and FFM compared to DXA and showed good agreement with DXA in estimating %BF (-1.9±3.29), FM (1.5±2.59) and FFM (1.4±2.60) and good reproducibility for %BF (0.81), FM (0.96) and FFM (0.89). The Schaefer and Deurenberg equations showed less agreement with DXA, overestimating the MG and underestimating the FFM, and presented moderate to low reproducibility in most measures of body composition. Conclusion: When we compared the three equations proposed to BIA with DXA, we find that the Houtkooper equation was the best agreed with DXA and showed good reproducibility for estimate %BF, FM and FFM in female adolescents with overweight and obesity.

FTO rs9939609 Does Not Interact with Physical Exercise but Influences Basal Insulin Metabolism in Brazilian Overweight and Obese Adolescents

Purpose The rs9939609 SNP (T > A) in FTO gene is associated with obesity and type 2 diabetes. The present study aimed at verifying whether this SNP influenced biochemical outcomes of children and adolescents who are overweight/obese submitted to a program of physical exercise and also if there was influence on basal levels of these biochemical variables. Methods The sample was composed by 432 children and adolescents grouped in three ways (obese, overweight, and normal weight); of these, 135 children and adoloescents who are obese and overweight were submitted to a physical exercise program for 12 weeks. All were genotyped by TaqMan SNP genotyping assay. Results The children and adolescents who are overweight/obese and carriers of AA genotype had higher levels of insulin (p=0.03) and HOMA (p=0.007) and lower levels of glucose (p=0.003), but the SNP did not modulate the response to physical exercise. Conclusions In our study, the rs9939609 AA genotype was associated with parameters related to insulin metabolism but did not interact with physical exercise.

Trp64Arg polymorphism of the ADRB3 gene associated with maximal fat oxidation and LDL‐C levels in non‐obese adolescents

OBJECTIVE To analyze the association between the Trp64Arg polymorphism of the ADRB3 gene, maximal fat oxidation rates and the lipid profile levels in non-obese adolescents. METHODS 72 schoolchildren, of both genders, aged between 11 and 17 years, participated in the study. The anthropometric and body composition variables, in addition to total cholesterol, HDL-c, LDL-c, triglycerides, insulin, and basal glycemia, were evaluated. The sample was divided into two groups according to the presence or absence of the polymorphism: non-carriers of the Arg64 allele, i.e., homozygous (Trp64Trp: n=54), and carriers of the Arg64 allele (Trp64Arg+Arg64Arg: n=18), in which the frequency of the Arg64 allele was 15.2%. The maximal oxygen uptake and peak of oxygen uptake during exercise were obtained through the symptom-limited, submaximal treadmill test. Maximal fat oxidation was determined according to the ventilatory ratio proposed in Lusks table. RESULTS Adolescents carrying the less frequent allele (Trp64Arg and Arg64Arg) had higher LDL-c levels (p=0.031) and lower maximal fat oxidation rates (p=0.038) when compared with non-carriers (Trp64Trp). CONCLUSIONS Although the physiological processes related to lipolysis and lipid metabolism are complex, the presence of the Arg 64 allele was associated with lower rates of FATMAX during aerobic exercise, as well as with higher levels of LDL-c in adolescents.