Paula Clara Santos

Association between overweight and early sexual maturation in Portuguese boys and girls

Objective: The purpose of this study was to examine the relationship between sexual maturation (SM), and the prevalence of overweight among boys and girls. Subjects and methods: The sample of this cross-sectional study included 819 children and adolescents (382 boys and 437 girls), aged 10–15 years old randomly selected from 30 schools in the Porto region. Anthropometrical measurements (body height, weight and skinfolds thickness) were determined by standard anthropometrical methods. Body mass index (BMI) was calculated from the ratio weight/height2 (kg/m2). The sum of tricipital and subscapular skinfolds (TriSub) was also used. Physicians collected data on Tanner stages during physical examination. Subjects were grouped using the quartiles of the decimal age adjusted for Tanner stages of SM and gender. Results: The prevalence of overweight was higher in early maturing boys (30.5%) and early maturing girls (32.7%). The late maturers presented a lower prevalence (p<0.05) of overweight (20.3% boys and 18.3% girls). Logistic regression analysis illustrates that early maturing is associated with an increased risk for overweight or obesity for boys (OR: 1.87 and 95% CI: 0.99–3.50) and girls (OR: 2.14 and 95% CI: 1.12–4.07), when compared with the boys and girls of the fourth quartile (p<0.05). Conclusions: We conclude that there is an association between early SM and the prevalence of overweight in both genders. Résumé. Objectif: Cette étude a pour but d’examiner l’association entre maturation sexuelle (MS) et la prévalence du surpoids chez les garçons et les filles. Sujets et méthodes: L’échantillon de cette étude transversale comprend 819 enfants et adolescents (382 garçons et 437 filles), âgés de 10 à 15 ans, pris au hasard parmi trente écoles de la région de Porto. Les mensurations anthropométriques (stature, poids et plis cutanés) ont été effectuées selon les méthodes anthropométriques standard. L’indice de masse corporelle (IMC) a été calculé à partir du rapport poids/stature2 (kg/m2) et on a utilisé la somme des plis tricipital et subscapulaire (TriSub). Au cours de l’examen, des médecins ont noté les stades de Tanner et les sujets ont été regroupés par quartiles d’âge décimal ajustés selon les stades de Tanner et le sexe. Résultats: La prévalence du surpoids est plus élevée chez les garçons et les filles à maturation précoce respectivement (30,5%) et (32,7%). La prévalence est plus faible (p<0,05) chez les enfants à maturation tardive (20,3% chez les garçons et 18,3% chez les filles). L’analyse de régression logistique exprime l’association entre maturation précoce et un risque accru de surpoids ou d’obésité chez les garçons (OR : 1,87 et 95%, IC : 0,99 – 3,50) et chez les filles (OR : 2,14 et 95%, IC : 1,12 – 4,07) en comparaison avec les garçons et les filles du quatrième quartile. Conclusion: Il existe une association entre une MS précoce et la prévalence du surpoids dans les deux sexes. Zusammenfassung. Vorhaben: Zweck dieser Studie war die Untersuchung der Beziehung zwischen sexueller Reifung und Prävalenz von Übergewicht bei Knaben und Mädchen. Probanden und Methoden: Die Querschnittsuntersuchung basierte auf einer Stichprobe von 819 10–15-jährigen Kindern und Jugendlichen (382 Knaben und 437 Mädchen), die nach Zufallskriterien aus 30 Schulen der Region Porto ausgewählt worden waren. Anthropometrische Messungen (Körperhöhe, Gewicht, Hautfaltendicke) wurden mit anthropometrischen Standardmethoden vorgenommen. Der Körpermasse-Index (body mass index, BMI) wurde aus dem Quotienten Gewicht/Körperhöhe2 (kg/m2) berechnet. Die Summe von Tripzeps- und subskapularer Hautfaltendicke (TriSub) wurde ebenfalls genutzt. Während der körperlichen Untersuchung erhoben Ärzte die Daten betreffend die Tanner-Stadien. Die Probanden wurden unter Berücksichtigung des Tanner-Stadiums der sexuellen Reifung und des Geschlechts nach Quartilen des Dezimalalters gruppiert. Ergebnisse: Die Prävalenz von Übergewicht war bei früh entwickelten Knaben (30,5%) und früh entwickelten Mädchen (32,7%) höher. Spätentwickler zeigten eine geringere Prävalenz (p<0,05) von Übergewicht (20,3% Knaben und 18,3% Mädchen). Die logistische Regressionsanalyse zeigt, dass eine frühe Reifung bei Knaben (OR: 1,87 and 95% CI: 0,99–3,50) und bei Mädchen (OR: 2,14 und 95% CI: 1,12–4,07) mit einem erhöhten Risiko von Übergewicht und Adipositas einhergeht, verglichen mit Knaben und Mädchen aus dem vierten Quartil (p<0,05). Zusammenfassung: Wir folgern, dass es bei beiden Geschlechtern eine Beziehung zwischen früher sexueller Reifung und Prävalenz von Übergewicht gibt. Resumen. Objetivo: El objetivo de este estudio fue examinar la relación entre la maduración sexual (MS) y la prevalencia de sobrepeso en chicos y chicas. Sujetos y métodos: La muestra de este estudio transversal incluía 819 niños y adolescentes (382 chicos y 437 chicas), de entre 10 y 15 años de edad, seleccionados de forma aleatoria en 30 escuelas de la región de Oporto. Las medidas antropométricas (estatura, peso y espesor de pliegues cutáneos) se determinaron por métodos antropométricos estandarizados. Se calculó el índice de masa corporal (IMC) mediante del cociente peso/estatura2 (kg/m2). Asimismo, se utilizó la suma de los pliegues tricipital y subescapular (TriSub). Durante el reconocimiento médico, varios médicos recogieron datos sobre los estadios de Tanner. Los sujetos se agruparon utilizando los cuartiles de la edad decimal ajustada para el género y para los estadios de MS de Tanner. Resultados: La prevalencia de sobrepeso fue superior en los chicos y chicas con maduración temprana (30,5% y 32,7%, respectivamente). Los maduradores tardíos presentaron una menor prevalencia (p<0,05) de sobrepeso (20,5% en chicos y 18,3% en chicas). El análisis de regresión logística muestra que la maduración temprana está asociada con un incremento del riesgo de sobrepeso u obesidad tanto en los chicos (OR: 1,87 y 95% IC: 0,99-3,50) como en las chicas (OR: 2,14 y 95% IC: 1,12–4,07), cuando se comparan con los chicos y chicas del 4° cuartil (p<0,05). Conclusiones: Existe una asociación entre la MS temprana y la prevalencia de sobrepeso en ambos géneros.

Physical activity and perceived environmental attributes in a sample of Portuguese adults: Results from the Azorean Physical Activity and Health Study

OBJECTIVES The aim of the present study was to determine whether the relation of perceived neighbourhood attributes to reported Physical Activity (PA) levels in Azorean adults varied by gender and body mass index (BMI). METHODS 7330 adult participants (4104 women), aged 38.1+/-9.3 years, from the 2004 Azorean Physical Activity and Health Study. They answered the Environmental Module and the short version of the International Physical Activity Questionnaire (IPAQ). Height and weight were self-reported. RESULTS After adjustments for age, BMI, education level and island of residence, the dimension Infrastructures, Access to destinations, Social environment and Aesthetics was positively associated with moderate PA level and Health-Enhancing Physical Activity (HEPA) level, only in women. When participants were categorized by BMI status, the same dimension was a significant predictor for moderate PA level in normal weight men and women, and for HEPA level only in overweight/obese women, after controlling for age, education level and island of residence. CONCLUSIONS The dimension Infrastructures, Access to destinations, Social environment and Aesthetics was predictors of higher PA levels in Azorean adults. Targeted programs for Azoreans to increase PA levels should consider that this set of environmental features seem to act synergistically and are positively associated with PA.

Metabolic risk factors, physical activity and physical fitness in azorean adolescents: a cross-sectional study

BackgroundThe prevalence of metabolic syndrome has increased over the last few decades in adolescents and has become an important health challenge worldwide. This study analyzed the relationships between metabolic risk factors (MRF) and physical activity (PA) and physical fitness (PF) in a sample of Azorean adolescents.MethodsA cross-sectional school-based study was conducted on 417 adolescents (243 girls) aged 15-18 from the Azorean Islands, Portugal. Height, weight, waist circumference, fasting glucose, HDL-cholesterol, triglycerides, and blood pressure were measured. A sum of MRF was computed, and adolescents were classified into three groups: no MRF, one MRF and two or more MRF. PA was assessed by a sealed pedometer. PF was assessed using five tests from the Fitnessgram Test Battery. Dietary intake was obtained using a semi-quantitative food frequency questionnaire.ResultsMean daily steps for girls and boys were 7427 ± 2725 and 7916 ± 3936, respectively. Fifty-nine percent of the adolescents showed at least one MRF and 57.6% were under the healthy zone in the 20 m Shuttle Run Test. Ordinal logistic regression analysis showed that after adjusting for sex, body mass index, socio-economic status and adherence to a Mediterranean diet, adolescents who were in the highest quartile of the pedometer step/counts (≥9423 steps/day) and those who achieved the healthy zone in five tests were less likely to have one or more MRF (OR = 0.56;95%CI:0.33-0.95; OR = 0.55;95%CI:0.31-0.98, respectively).ConclusionsDaily step counts and PF levels were negatively associated with having one or more MRF among Azorean adolescents. Our findings emphasize the importance of promoting and increasing regular PA and PF to reduce the public health burden of chronic diseases associated with a sedentary lifestyle.

Impact of compliance with different guidelines on physical activity during pregnancy and perceived barriers to leisure physical activity

Abstract The aims of the this prospective study were to analyse physical activity (PA) engagement during the first and second trimesters, considering the different guidelines published on PA, to document the individual characteristics associated with the accomplishment of these guidelines and to examine pregnant women’s perceived barriers to leisure PA, using a socioecological framework. A sample of 133 pregnant women in two stages – at 10–12 weeks’ gestation (T1) and 20–22 weeks’ gestation (T2) – were evaluated. PA was assessed by accelerometry during the T1 and T2 evaluation stages. Socio-demographic characteristics, lifestyle factors and barriers to leisure PA were assessed via questionnaire. A large proportion of women (ranging from 32% to 96%) did not reach the levels of PA recommended by the guidelines. There were no significant differences between T1 and T2 with regard to compliance with PA recommendations. A decrease in PA levels from T1 to T2 was noted for all recommendations. No associations were found between participants’ characteristics and adherence to the recommendations in T1 and T2. No significant differences were found in barriers to leisure PA between T1 and T2. The most commonly reported barriers to leisure PA were intrapersonal, not health related. Our results indicate that there were no differences between trimesters regarding compliance of PA recommendations, and perceived barriers were similar in both trimesters.

Metabolic syndrome and physical fitness in a sample of Azorean adolescents

BACKGROUND Metabolic syndrome, a predecessor of cardiovascular disease and type 2 diabetes, has become prevalent in adolescents. This study aimed to estimate the prevalence of metabolic syndrome and its components and to analyze the relationship between metabolic syndrome and overall physical fitness levels in a sample of Azorean adolescents. METHODS A cross-sectional school-based study, the Azorean Physical Activity and Health Study II, was conducted on 517 adolescents (297 girls, 220 boys) aged 15-18 years old from the Azorean Islands. Body height, weight, waist circumference, and arterial blood pressure were measured according to standards. Fasting intravenous blood samples were analyzed (high-density lipoprotein cholesterol, triglycerides, and glucose). Physical fitness was assessed using five tests from Fitnessgram Test Battery 8.0: Curl-up, push-up, trunk lift, pacer, and sit-and-reach. Adolescents were then classified as being in the healthy zone or above or under the healthy zone. Metabolic syndrome was defined according to the 2007 International Diabetes Federation‘s guidelines for adolescents. RESULTS The prevalence of metabolic syndrome was 5% (4.7% in girls and 5.5% in boys, P > 0.05). Waist circumference was the most prevalent component (32.9%), and hypertriglyceridemia the least (4.4%). Logistic regression analysis showed that after adjusting for pubertal stage and socioeconomic status, unfit adolescents (healthy zone criteria in <or=2 tests) were more likely [odds ratio (OR) = 3.414; 95% confidence interval (CI), 1.150-10.129] to be classified as having metabolic syndrome. CONCLUSIONS The prevalence of metabolic syndrome is high in Azorean adolescents. Unfit adolescents were more likely to have metabolic syndrome than fit adolescents. Improving overall physical fitness levels and abdominal obesity reduction may be important strategies in overcoming this public health problem and its consequences.

Relationship of milk intake and physical activity to abdominal obesity among adolescents.

What is already known about this subject Diet and physical activity (PA) are recognized as important factors to prevent abdominal obesity (AO). Studies have found an inverse relationship between milk intake or milk products and body weight and/or body fat in children and adolescents. Evidence suggests that low levels of PA are associated with AO in youth.

Association between dairy product intake and abdominal obesity in Azorean adolescents

BACKGROUND:Some studies have reported an inverse association between dairy product (DP) consumption and weight or fat mass loss.OBJECTIVES:The objective of our study was to assess the association between DP intake and abdominal obesity (AO) among Azorean adolescents.SUBJECTS/METHODS:This study was a cross-sectional analysis. A total of 903 adolescents (370 boys) aged 15–16 years was evaluated. Anthropometric measurements were collected (weight, height and waist circumference (WC)) and McCarthys cut-points were used to categorize WC. AO was defined when WC was ⩾90th percentile. Adolescent food intake was assessed using a self-administered semiquantitative food frequency questionnaire and DP intake was categorized in <2 and ⩾2 servings/day. Data were analyzed separately for girls and boys, and logistical regression was used to estimate the association between DPs and AO adjusting for potential confounders.RESULTS:The prevalence of AO was 54.9% (boys: 32.1% and girls: 70.7%, P<0.001). For boys and girls, DP consumption was 2.3±1.9 and 2.1±1.6 servings/day (P=0.185), respectively. In both genders, the proportion of adolescents with WC <90th percentile was higher among individuals who reported a dairy intake of ⩾2 servings/day compared with those with an intake <2 servings/day (boys: 71% vs 65% and girls: 36% vs 24%, P<0.05). After adjustments for confounders, two or more DP servings per day were a negative predictor of AO (odds ratio, 0.217; 95% confidence interval, 0.075–0.633) only in boys.CONCLUSION:We found a protective association between DP intake and AO only in boys.

Ability of Different Measures of Adiposity to Identify High Metabolic Risk in Adolescents

Introduction. This study aimed to evaluate the screening performance of different measures of adiposity: body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) for high metabolic risk in a sample of adolescents. Methods. A cross-sectional school-based study was conducted on 517 adolescents aged 15–18, from the Azorean Islands, Portugal. We measured fasting glucose, insulin, total cholesterol (TC), HDL-cholesterol, triglycerides, and systolic blood pressure. HOMA and TC/HDL-C ratio were calculated. For each of these variables, a Z-score was computed by age and sex. A metabolic risk score (MRS) was constructed by summing the Z-scores of all individual risk factors. High risk was considered when the individual had ≥1SD of this score. Receiver-operating characteristics (ROC) were used. Results. Linear regression analyses showed that, after adjusting for age and pubertal stage, all different measures of adiposity are positively and significantly associated with MRS in both sexes, with exception of WHtR for boys. BMI, WC, and WHtR performed well in detecting high MRS, indicated by areas under the curve (AUC), with slightly greater AUC for BMI than for WC and WHtR in both sexes. Conclusion. All measures of adiposity were significantly associated with metabolic risk factors in a sample of Portuguese adolescents.

Food consumption, physical activity and socio-economic status related to BMI, waist circumference and waist-to-height ratio in adolescents

OBJECTIVE To examine the association between obesity and food group intakes, physical activity and socio-economic status in adolescents. DESIGN A cross-sectional study was carried out in 2008. Coles cut-off points were used to categorize BMI. Abdominal obesity was defined by a waist circumference at or above the 90th percentile, as well as a waist-to-height ratio at or above 0·500. Diet was evaluated using an FFQ, and the food group consumption was categorized using sex-specific tertiles of each food group amount. Physical activity was assessed via a self-report questionnaire. Socio-economic status was assessed referring to parental education and employment status. Data were analysed separately for girls and boys and the associations among food consumption, physical activity, socio-economic status and BMI, waist circumference and waist-to-height ratio were evaluated using logistic regression analysis, adjusting the results for potential confounders. SETTING Public schools in the Azorean Archipelago, Portugal. SUBJECTS Adolescents (n 1209) aged 15-18 years. RESULTS After adjustment, in boys, higher intake of ready-to-eat cereals was a negative predictor while vegetables were a positive predictor of overweight/obesity and abdominal obesity. Active boys had lower odds of abdominal obesity compared with inactive boys. Boys whose mother showed a low education level had higher odds of abdominal obesity compared with boys whose mother presented a high education level. Concerning girls, higher intake of sweets and pastries was a negative predictor of overweight/obesity and abdominal obesity. Girls in tertile 2 of milk intake had lower odds of abdominal obesity than those in tertile 1. Girls whose father had no relationship with employment displayed higher odds of abdominal obesity compared with girls whose father had high employment status. CONCLUSIONS We have found that different measures of obesity have distinct associations with food group intakes, physical activity and socio-economic status.

Effects of Training and Detraining on Physical Fitness, Physical Activity Patterns, Cardiovascular Variables, and HRQoL after 3 Health-Promotion Interventions in Institutionalized Elders.

The purpose of this study is to assess the effects of different strategies of health on the levels of physical activity (PA), physical fitness (PF), cardiovascular disease (CVD) risk factors and quality of life (QoL) of the institutionalized elderly. Concurrently studies were made of the effect of detraining on these same variables. In this investigation we carried out a prospective longitudinal study with an experimental design, with 1 year plus 3 months of a detraining period. Methodology. (a) A questionnaire with socio-demographic characteristics and a QoL scale (MOS SF-36); (b) Functional Fitness Test to assess PF; (c) An MTI Actigraph to evaluate the PA; (d) Biochemical analysis of blood, blood pressure and bio-impedance. The Main Results Indicated That: (i) ST significantly improved strength and body flexibility and AT the aerobic endurance, agility/dynamic balance and lower strength and flexibility; (ii) Implications of detraining were more evident on the PA groups in the lower body flexibility, which is associated with agility/dynamic balance and lower strength in the AT group; (iii) Cardiovascular variables improved significantly especially blood pressure, cholesterol and glucose in the ST and HDL in the AT group; not having undergone significant changes with the detraining. The results of this thesis contribute positively to highlight the importance of PA in the promotion of health, prevention and reduction of CVD risk factors and the improvement of the PF and QoL.