Michele Pereira Netto

Prevalência e fatores determinantes da anemia em crianças assistidas em creches de Belo Horizonte - MG

OBJETIVO: Avaliar a prevalencia e fatores determinantes da anemia em criancas assistidas em creches de Belo Horizonte. METODOS: Trata-se de estudo transversal com 312 criancas, entre 7 e 59 meses, assistidas em creches de um Distrito Sanitario de Belo Horizonte. O diagnostico de anemia foi realizado por puncao digital e leitura em b-hemoglobinometro portatil, considerando-se anemia niveis de hemoglobina inferiores a 11,0g/dL. Foram aferidos peso e altura das criancas, sendo o estado nutricional classificado segundo criterio OMS (2006). As variaveis foram coletadas por meio de questionario aplicado aos pais ou responsaveis pelas criancas, contendo informacoes socioeconomicas, maternas e relacionadas a saude das criancas. Foi realizada a regressao logistica multipla para avaliar a associacao entre as variaveis e a anemia, com o controle das variaveis de confusao. RESULTADOS: A prevalencia de anemia na populacao estudada foi de 30,8%, sendo esta superior nas criancas com idade ≤ 24 meses (71,1%). Os fatores determinantes da anemia na analise ajustada foram: idade menor ou igual a 24 meses (OR: 9,08; IC: 3,96 − 20,83) e altura/idade < − 1 z escore (OR: 2,1; IC: 1,20 - 3,62). CONCLUSOES: A elevada prevalencia de anemia em criancas atendidas em creches de Belo Horizonte, especialmente naquelas menores de 24 meses e nas criancas com altura/idade < − 1 z escore demonstra a importância do cuidado nutricional com os lactentes, e reforca a necessidade de comprometimento das instituicoes de atendimento infantil no combate a esta deficiencia.

Fatores associados à anemia em lactentes nascidos a termo e sem baixo peso

OBJECTIVE: To investigate the factors involved in the genesis of infant iron deficiency anemia. METHODS: This is a cross-sectional study, which evaluated 104 children in their second year of life who were born at term with adequate weight in Vicosa, Minas Gerais, Brazil. An interview, a 24-hour recall to parents, and anthropometric assessment were used. Laboratory exams included blood count, ferritin, and serum retinol. This study was approved by the Ethics Committee of UFMG and UFV. Statistical analyses were conducted using the Epi Info and SPSS softwares. Poisson generalized linear regression model was used to determine the association of anemia with the study variables, with results expressed as prevalence ratio. RESULTS: Vitamin A deficiency and anemia were identified in 9.6% e 26% of the children, respectively. Infant anemia was associated with the date of onset of prenatal care, maternal use of iron after childbirth, paternal working status, prior use of iron by the child, and duration of breastfeeding. Thus, in the second year of life, lactating children of women who began prenatal care late and did not use iron compounds after birth, with unemployed parents, who never received iron compounds, and who were predominantly breastfed for more than four months had significantly higher prevalence of anemia. CONCLUSION: The results have demonstrated the importance of nutrition during pregnancy and infancy in the prevention of anemia in children.

Fatores associados à concentração de retinol sérico em lactentes

Objective: To verify the factors associated with the concen- tration of retinol in infants assisted in a health public system. Methods: Cross-sectional study carried out with 101 infants aged 18-24 months assisted at the health public system in the urban area of Vicosa city, Southeastern Brazil. The retinol concentration was analyzed by high perform- ance liquid chromatography. In order to identify the dietary practices the 24 hours recall information was obtained. The interviews were accomplished with infants parents or with their caretakers at home. Evaluation of the variables associ- ated to serum retinol levels was done by multiple linear regression analysis. Results: The prevalence of vitamin A deficiency was 39.6%. The factors positively associated with serum retinol levels were paternal years of education and the diet protein content. On the other hand, the number of household in- habitants and the infants age were negatively associated with the levels of retinol. Conclusions: Vitamin A deficiency is a public health problem among infants in Vicosa city. Socioeconomic, dietetic and biological variables are associated to serum concentration of retinol in infants.

Anemia-associated factors in infants born at term with normal weight

OBJECTIVE To investigate the factors involved in the genesis of infant iron deficiency anemia. METHODS This is a cross-sectional study, which evaluated 104 children in their second year of life who were born at term with adequate weight in Viçosa, Minas Gerais, Brazil. An interview, a 24-hour recall to parents, and anthropometric assessment were used. Laboratory exams included blood count, ferritin, and serum retinol. This study was approved by the Ethics Committee of UFMG and UFV. Statistical analyses were conducted using the Epi Info and SPSS softwares. Poisson generalized linear regression model was used to determine the association of anemia with the study variables, with results expressed as prevalence ratio. RESULTS Vitamin A deficiency and anemia were identified in 9.6% e 26% of the children, respectively. Infant anemia was associated with the date of onset of prenatal care, maternal use of iron after childbirth, paternal working status, prior use of iron by the child, and duration of breastfeeding. Thus, in the second year of life, lactating children of women who began prenatal care late and did not use iron compounds after birth, with unemployed parents, who never received iron compounds, and who were predominantly breastfed for more than four months had significantly higher prevalence of anemia. CONCLUSION The results have demonstrated the importance of nutrition during pregnancy and infancy in the prevention of anemia in children.

Daily meal frequency and associated variables in children and adolescents

OBJECTIVE To investigate the frequency distribution of daily meals and its relation to demographic, socioeconomic, behavioral, anthropometric and biochemical factors in children and adolescents. METHODS This was a cross-sectional study with a representative sample of 708 schoolchildren aged 7-14 years. Data on personal information, socioeconomic status, physical activity and number of meals were obtained through semi-structured questionnaire and consumption by 24-h recall and food record. Weight and height measurements were also performed to calculate the body mass index. Finally, blood samples were collected for analysis of total cholesterol, high- and low density lipoprotein, triglyceride, and glucose levels. Descriptive statistics, the Mann-Whitney test, and Poisson regression were used in statistical analysis. RESULTS Meal frequency <4 was associated in children, family income <3 Brazilian minimum wages (PR=5.42; 95% CI: 1.29-22.77; p=0.021) and adolescents, the number of sons in the family >2 (PR=1.53; 95% CI: 1.11-2.11; p=0.010). Even in the age group of 10-14 years, <4 meals was related to higher prevalence of body mass index (PR=1.33; 95% CI: 1.02-1.74; p=0.032) and low-density lipoprotein (PR=1.39; 95% CI: 1.03-1.87; p=0.030) higher after adjustments. CONCLUSION Lower frequency of meals was related to lower income in children and adolescents, larger number of sons in the family, and increased values of body mass index and low-density lipoprotein.

Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents

Abstract Objective: To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. Methods: Cross-sectional study was with 403 adolescents aged 10–14 years, from public and private schools. Anthropometric, clinical, and biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. Results: Regarding the nutritional status, 66.5% of the adolescents had normal weight, 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents who had high serum triglycerides, body mass index and waist circumference. Conclusions: Adolescents who had anthropometric, clinical and biochemical characteristics considered to be at risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective.

Evaluation of the predictive capacity of vertical segmental tetrapolar bioimpedance for excess weight detection in adolescents

OBJECTIVE To analyze the predictive capacity of the vertical segmental tetrapolar bioimpedance apparatus in the detection of excess weight in adolescents, using tetrapolar bioelectrical impedance as a reference. METHODS This was a cross-sectional study conducted with 411 students aged between 10 and 14 years, of both genders, enrolled in public and private schools, selected by a simple and stratified random sampling process according to the gender, age, and proportion in each institution. The sample was evaluated by the anthropometric method and underwent a body composition analysis using vertical bipolar, horizontal tetrapolar, and vertical segmental tetrapolar assessment. The ROC curve was constructed based on calculations of sensitivity and specificity for each point of the different possible measurements of body fat. The statistical analysis used Students t-test, Pearsons correlation coefficient, and McNemars chi-squared test. Subsequently, the variables were interpreted using SPSS software, version 17.0. RESULTS Of the total sample, 53.7% were girls and 46.3%, boys. Of the total, 20% and 12.5% had overweight and obesity, respectively. The body segment measurement charts showed high values of sensitivity and specificity and high areas under the ROC curve, ranging from 0.83 to 0.95 for girls and 0.92 to 0.98 for boys, suggesting a slightly higher performance for the male gender. Body fat percentage was the most efficient criterion to detect overweight, while the trunk segmental fat was the least accurate indicator. CONCLUSION The apparatus demonstrated good performance to predict excess weight.

Factors associated with the concentration of serum retinol in infants

Objective: To verify the factors associated with the concen- tration of retinol in infants assisted in a health public system. Methods: Cross-sectional study carried out with 101 infants aged 18-24 months assisted at the health public system in the urban area of Vicosa city, Southeastern Brazil. The retinol concentration was analyzed by high perform- ance liquid chromatography. In order to identify the dietary practices the 24 hours recall information was obtained. The interviews were accomplished with infants parents or with their caretakers at home. Evaluation of the variables associ- ated to serum retinol levels was done by multiple linear regression analysis. Results: The prevalence of vitamin A deficiency was 39.6%. The factors positively associated with serum retinol levels were paternal years of education and the diet protein content. On the other hand, the number of household in- habitants and the infants age were negatively associated with the levels of retinol. Conclusions: Vitamin A deficiency is a public health problem among infants in Vicosa city. Socioeconomic, dietetic and biological variables are associated to serum concentration of retinol in infants.

THE BABY-LED WEANING METHOD (BLW) IN THE CONTEXT OF COMPLEMENTARY FEEDING: A REVIEW

ABSTRACT Objective: To review the scientific findings on the baby-led weaning method (BLW) in the context of complementary feeding. Data sources: Two independent examiners searched the Medical Literature Analysis and Retrieval System Online (MEDLINE)/PubMed database in August 2016. No time-period was defined for the publication dates. The following descriptors were used: “baby-led weaning” OR “baby-led” OR “BLW”. Inclusion criteria were: original studies that were available in English, and which addressed the BLW method. Exclusion criteria were: references in other languages, opinion articles and literature reviews, editorials and publications that did not elaborate on the intended subject. Of the 97 references identified, 13 were included in the descriptive synthesis. Data synthesis: The BLW group of babies, when compared to the traditional eating group, were less prone to being overweight, less demanding of food, and ate the same foods as the family. The number of choking episodes did not differ between groups. Mothers who opted for the implementation of BLW had higher levels of schooling, held managerial positions at work, and were more likely to have breastfed until the sixth month of the child’s life. Concerns were raised about messes made during meals, wasting food, and choking, but most of the mothers recommended adopting the method. Health professionals were hesitant to indicate this method. Conclusions: BLW was recommended by mothers who followed the method with their own children. However, concerns have been reported, which, coupled with professionals’ fears about the inability of infants to self-feed, reflect a lack of knowledge about the method.

ANÁLISE HIERARQUIZADA DOS FATORES ASSOCIADOS À ANEMIA EM LACTENTES

ABSTRACT Objective: To evaluate the prevalence of anemia and the associated factors in infants assisted in health units of Vitória da Conquista, Bahia, Northeast Brazil. Methods: Cross-sectional study with a representative sample of 366 children aged 6 to 23 months. A questionnaire was applied to the caregiver, and the children’s anthropometric measurements and hemoglobin levels were collected. The associations were identified by Poisson regression with robust variances based on a hierarchical analysis model. Results: The prevalence of anemia was 26.8%, and the associated factors were: family income equal to or lower than one minimum wage (PR: 1.50; 95%CI 1.03-2.18), number of household members higher than five (PR: 1.50; 95%CI 1.07-2.11), use of unfiltered water (PR: 1.68; 95%CI 1.11-2.56), number of offspring higher than three (PR: 1.64; 95%CI 1.01-2.68), consumption of meat and/or viscera less than once/week (PR: 1.78; 95%CI 1.24-2.58) and age 6-11 months (PR: 1.75; 95%CI 1.20-2.55). Conclusions: Anemia in the infants assessed is a moderate public health problem, which is associated with socioeconomic, demographic, and dietary factors; thus, measures are necessary for its prevention.