Ricardo Rodrigo Rech

Fatores associados a níveis pressóricos elevados em escolares de uma cidade de porte médio do sul do Brasil

OBJECTIVE To establish the prevalence of high blood pressure and associated factors among schoolchildren from Caxias do Sul, state of Rio Grande do Sul, Brazil. METHODS This school-based cross-sectional study assessed boys and girls aged 7 to 12 years from private and public schools. Three measurements of the childrens blood pressure were taken during one visit to the schools. Weight, height, and waist circumference were measured. We also assessed the childrens aerobic capacity (9-minute running test) and socioeconomic status. Statistical analysis was carried out using the chi-square test and logistic regression in order to control for confounding factors. RESULTS The sample included 1,413 children. Prevalence of schoolchildren with high blood pressure was 13.8% (systolic, diastolic, systolic/diastolic), and the proportion was higher (double) for obese and/or overweight children in comparison to normal-weight children. Children with increased waist circumference had 2.8 times greater chance of having high blood pressure levels than those with appropriate waist circumference (95% confidence interval 2.513-3.186 and p = 0.000). Individuals belonging to a high social class, defined according to the Brazilian National Economic Index, had 2.6 times greater chance of having high blood pressure. CONCLUSIONS In the present study, schoolchildren aged 7 to 12 years from Caxias do Sul had high prevalence of high blood pressure levels; increased waist circumference, high socioeconomic status, and low physical capacity were associated with this condition. We suggest that measures be taken to promote the practice of physical activity and dietary control to improve blood pressure levels and thus reduce risk factors.

Pontos de corte para a aptidão cardiorrespiratória e a triagem de fatores de risco para doenças cardiovasculares na infância

The main objective of the study was to analyze and propose news cardiorespiratory fitness cut offs points for 7 to 12-year old school students. The sample was composed of 1,413 students. Cardiorespiratory fitness was measured by the 9-minutes walking/running test. Total cholesterol and systolic and diastolic blood pressure were measured and with their results cardiovascular risk factors reference were designed. The Receiver Operating Characteristic curve between cardiorespiratory fitness and cardiovascular risk factors reference identified the cut offs point values. The bivariate analysis and odds ratio (OR) calculation was used to identify to what extent the individuals that did not reach the proposed cut offs points could show cardiovascular risk factors. The results showed that the cut offs points suggested in this study presented the best balance between sensibility and specificity. The bivariate analysis results showed increased chance of cardiovascular risk for the individuals that did not reach the cut offs points compared to those individuals who did.

Waist circumference as screening instrument for cardiovascular disease risk factors in schoolchildren

OBJECTIVE To propose cutoff points for waist circumference of schoolchildren for the identification of cardiovascular disease risk factors. METHODS This school-based cross-sectional study surveyed 1,413 schoolchildren aged 7 to 12 years old, selected by random cluster sampling. Waist circumference, total cholesterol and systolic and diastolic pressures were measured. Reference values for cardiovascular disease risk factors were developed from measures of total cholesterol and systolic and diastolic blood pressures. The receiver operating characteristic (ROC) curve and bivariate analysis, followed by calculation of sensitivity, specificity and odds ratio, were used in data analysis. RESULTS The cutoff points had area values under the ROC curve ranging between 0.603 and 0.949, while sensitivity and specificity ranged between 0.500 and 1.00. Among all proposals analyzed, the one presented by this study best balanced sensitivity and specificity values. Bivariate analysis followed by odds ratios calculation indicated that subjects with waist circumference above the proposed cutoff points have increased chances of presenting cardiovascular disease risk factors. CONCLUSIONS The cutoff points proposed in the present study seem to be a valid alternative and better balance sensibility and specificity than other proposals for screening students with increased chances of presenting cardiovascular disease risk factors.

Insatisfação com a imagem corporal em escolares do sexto ano da rede municipal de Caxias do Sul, no Rio Grande do Sul

OBJETIVO: Estimar a prevalencia de insatisfacao com a imagem corporal em escolares de 11 a 14 anos (meninos e meninas) de Caxias do Sul, no Rio Grande do Sul, e verificar as possiveis associacoes com estado nutricional, classe socioeconomica, sexo e escolaridade da mae. METODOS: Estudo transversal com 1.417 escolares. As variaveis antropometricas estudadas foram massa corporal total, estatura e circunferencia da cintura. A obesidade foi definida pelo indice de massa corporea, segundo sexo e idade. A imagem corporal foi avaliada por meio da escala de nove silhuetas. Foi realizada uma analise descritiva e bivariada entre as variaveis independentes e o desfecho. RESULTADOS: A prevalencia de insatisfacao com a imagem corporal foi de 71,5%. As variaveis sexo (RP 0,77, IC95% 0,60 - 0,98) e estado nutricional (RP 3,84, IC95% 2,72 - 5,41) apresentaram associacao estatistica com insatisfacao da imagem corporal. A escolaridade da mae, o nivel socioeconomico e a idade nao apresentaram associacao significante em relacao a insatisfacao com a imagem corporal. CONCLUSOES: As prevalencias de insatisfacao com a imagem corporal da populacao estudada encontram-se elevadas e devem ser motivo de preocupacao dos profissionais de saude.OBJECTIVE To estimate the prevalence of body image insatisfaction among schoolchildren aged 11 to 14 years from the municipality of Caxias do Sul, Southern Brazil, and to determine the possible associations with nutritional status, socioeconomic status, gender, and maternal education. METHODS A cross-sectional study was conducted and 1,417 children were evaluated regarding total body weight, height, and waist circumference. Obesity was defined based on the body mass index according to sex and age. Body image was evaluated using a nine-silhouette scale. A descriptive and bivariate analysis was carried out between the independent variables and the outcome. RESULTS The prevalence of body image insatisfaction was 71.5%. Gender (PR 0.77, 95%CI 0.60 - 0.98) and nutritional status (PR 3.84, 95%CI 2.72 - 5.41) were significantly associated with body image insatisfaction. Maternal education, socioeconomic level, and age did not present any association with body image insatisfaction. CONCLUSIONS The prevalence of body image insatisfaction in this population was high and should be a matter of concern to health professionals.

Body image insatisfaction in students from the sixth grade of public schools in Caxias do Sul, Southern Brazil

OBJETIVO: Estimar a prevalencia de insatisfacao com a imagem corporal em escolares de 11 a 14 anos (meninos e meninas) de Caxias do Sul, no Rio Grande do Sul, e verificar as possiveis associacoes com estado nutricional, classe socioeconomica, sexo e escolaridade da mae. METODOS: Estudo transversal com 1.417 escolares. As variaveis antropometricas estudadas foram massa corporal total, estatura e circunferencia da cintura. A obesidade foi definida pelo indice de massa corporea, segundo sexo e idade. A imagem corporal foi avaliada por meio da escala de nove silhuetas. Foi realizada uma analise descritiva e bivariada entre as variaveis independentes e o desfecho. RESULTADOS: A prevalencia de insatisfacao com a imagem corporal foi de 71,5%. As variaveis sexo (RP 0,77, IC95% 0,60 - 0,98) e estado nutricional (RP 3,84, IC95% 2,72 - 5,41) apresentaram associacao estatistica com insatisfacao da imagem corporal. A escolaridade da mae, o nivel socioeconomico e a idade nao apresentaram associacao significante em relacao a insatisfacao com a imagem corporal. CONCLUSOES: As prevalencias de insatisfacao com a imagem corporal da populacao estudada encontram-se elevadas e devem ser motivo de preocupacao dos profissionais de saude.OBJECTIVE To estimate the prevalence of body image insatisfaction among schoolchildren aged 11 to 14 years from the municipality of Caxias do Sul, Southern Brazil, and to determine the possible associations with nutritional status, socioeconomic status, gender, and maternal education. METHODS A cross-sectional study was conducted and 1,417 children were evaluated regarding total body weight, height, and waist circumference. Obesity was defined based on the body mass index according to sex and age. Body image was evaluated using a nine-silhouette scale. A descriptive and bivariate analysis was carried out between the independent variables and the outcome. RESULTS The prevalence of body image insatisfaction was 71.5%. Gender (PR 0.77, 95%CI 0.60 - 0.98) and nutritional status (PR 3.84, 95%CI 2.72 - 5.41) were significantly associated with body image insatisfaction. Maternal education, socioeconomic level, and age did not present any association with body image insatisfaction. CONCLUSIONS The prevalence of body image insatisfaction in this population was high and should be a matter of concern to health professionals.

Prevalência de alterações posturais em praticantes de musculação

INTRODUCAO: Atualmente, as academias de musculacao sao centros de promocao de saude procurados por um numero cada vez maior de pessoas. A execucao adequada dos exercicios resistidos em academia depende de um bom alinhamento postural. OBJETIVO: Verificar quantitativamente as principais alteracoes posturais em praticantes de exercicio resistido sistematizado (musculacao). METODOS: Foram realizadas avaliacoes posturais em 306 individuos, de ambos os sexos e faixa etaria entre 14 e 73 anos. As avaliacoes foram realizadas por academicos de fisioterapia devidamente treinados e padronizadas de modo que os dados fossem coletados da maneira mais objetiva possivel. RESULTADOS: Os resultados sao apresentados de maneira geral (total da amostra), alem de subdivididos conforme os generos masculino (n = 113) e feminino (n = 193) e de acordo com a faixa etaria, adotando-se as seguintes categorias: alunos menores de 21 anos (n = 74); entre 21 e 30 anos (n = 127); entre 31 e 50 anos (n = 40); e maiores de 50 anos (n = 65). Dentre os resultados, destacam-se as alteracoes na coluna vertebral (aumento da curvatura ou retificacao): 43,4% na regiao cervical, 55,2% na toracica e 73,8% na lombar. Alem disso, 48,0% apresentaram atitude escoliotica, sendo que em 37,0% foi observado presenca de gibosidade. CONCLUSOES: A principal conclusao do presente estudo e de que os praticantes de musculacao apresentam consideraveis indices de desvios posturais, enfatizando a necessidade de maior atencao sobre essa crescente populacao.

Prevalence of Obesity, Overweight and Eating Disorders in a School-Based Population in Southern Brazil

The health of school-age children and adolescents has been the focus of much attention, since at this stage of life students experience biological, social, emotional and cognitive changes. The aim of this study was to determine the prevalence rates of obesity, overweight and symptoms of eating disorders (ED) among the sixth-grade students of the municipal schools in Caxias do Sul in 2011. A school-based, cross-sectional study evaluated 1230 students (86.80% of the total). A self-report questionnaire and anthropometric measures of weight and height were used in the assessment. The prevalence rates of obesity, overweight and ED symptoms were 7.30%, 22.80% and 33.10%, respectively. The students dissatisfied with their body image were four times more likely (PR=4.01; CI 95%= 2.71–5.93) to have excess weight and nine times more likely (PR=9.30; CI 95%=6.29–13.78) to have symptoms for ED. The prevalence rates of ED symptoms, obesity and overweight of the evaluated students are high and warrant the attention of the community as a whole.

INSATISFAÇÃO COM A IMAGEM CORPORAL EM ADOLESCENTES DE ESCOLAS PÚBLICAS DE CAXIAS DO SUL – RS

Objective: The objective of this study was to assess the prevalence of body image (BI) dissatisfaction in school children from the sixth year of public schools in Caxias do Sul - RS. Material and Methods: 1,230 school children aged between 11 and 14 years were assessed in this school-based cross-sectional epidemiological study. A self-applicable questionnaire was used to evaluate variables, and the Body Shape Questionnaire (BSQ) was employed to assess dissatisfaction related to BI. Total body mass, height and waist circumference were measured. Results: BI dissatisfaction in the present study was found to be 18%. Boys were 60.3% less likely to be dissatisfied with their BI (PR=0.39-BI= 0.29-0.54) than girls. Overweight subjects were five times more likely to be dissatisfied with their BI (PR=5.67, BI =4.15 to 7.75). In addition, those with increased waist measurement were four times more likely to be dissatisfied with their BI (PR= 4.92, BI=3.61 to 6.71). Students of mothers with secondary or higher education were 30.6% less likely to be dissatisfied with their BI (PR = 0.69, BI= 0.50 to 0.96). Conclusions: Significant values were found for dissatisfaction related to body image and gender, nutritional status, waist circumference and maternal education. This should a concern for health and education professionals and for the local population as well. DESCRIPTORS: Body Image. Child. Adolescent.

Insatisfacción con la imagen corporal en escolares del sexto año de la red municipal de Caxias do Sul (Rio Grande do Sul, Brasil)

OBJETIVO: Estimar a prevalencia de insatisfacao com a imagem corporal em escolares de 11 a 14 anos (meninos e meninas) de Caxias do Sul, no Rio Grande do Sul, e verificar as possiveis associacoes com estado nutricional, classe socioeconomica, sexo e escolaridade da mae. METODOS: Estudo transversal com 1.417 escolares. As variaveis antropometricas estudadas foram massa corporal total, estatura e circunferencia da cintura. A obesidade foi definida pelo indice de massa corporea, segundo sexo e idade. A imagem corporal foi avaliada por meio da escala de nove silhuetas. Foi realizada uma analise descritiva e bivariada entre as variaveis independentes e o desfecho. RESULTADOS: A prevalencia de insatisfacao com a imagem corporal foi de 71,5%. As variaveis sexo (RP 0,77, IC95% 0,60 - 0,98) e estado nutricional (RP 3,84, IC95% 2,72 - 5,41) apresentaram associacao estatistica com insatisfacao da imagem corporal. A escolaridade da mae, o nivel socioeconomico e a idade nao apresentaram associacao significante em relacao a insatisfacao com a imagem corporal. CONCLUSOES: As prevalencias de insatisfacao com a imagem corporal da populacao estudada encontram-se elevadas e devem ser motivo de preocupacao dos profissionais de saude.OBJECTIVE To estimate the prevalence of body image insatisfaction among schoolchildren aged 11 to 14 years from the municipality of Caxias do Sul, Southern Brazil, and to determine the possible associations with nutritional status, socioeconomic status, gender, and maternal education. METHODS A cross-sectional study was conducted and 1,417 children were evaluated regarding total body weight, height, and waist circumference. Obesity was defined based on the body mass index according to sex and age. Body image was evaluated using a nine-silhouette scale. A descriptive and bivariate analysis was carried out between the independent variables and the outcome. RESULTS The prevalence of body image insatisfaction was 71.5%. Gender (PR 0.77, 95%CI 0.60 - 0.98) and nutritional status (PR 3.84, 95%CI 2.72 - 5.41) were significantly associated with body image insatisfaction. Maternal education, socioeconomic level, and age did not present any association with body image insatisfaction. CONCLUSIONS The prevalence of body image insatisfaction in this population was high and should be a matter of concern to health professionals.

OBESIDADE E SOBREPESO EM ESCOLARES DE UMA ESCOLA PÚBLICA NA SERRA GAÚCHA

Os objetivos do presente estudo foram verificar a prevalencia de obesidade e sobrepeso em uma escola publica municipal da serra gaucha em dois diferentes momentos: marco de 2008 e dezembro de 2009, e acompanhar uma coorte das criancas que permaneceram na escola no periodo. A obesidade e o sobrepeso foram definidos atraves dos pontos de corte de IMC para sexo e idade segundo a International Obesity Task Force. As prevalencias de obesidadeforam de 10,5% em 2008 e 10,7% em 2009 (sobrepeso = 16,2% em 2008 e 16,4% em 2009). Em relacao a coorte, aprevalencia de obesidade subiu de 8,2% para 11% e o sobrepeso de 15,1% para 23,3%. Conclui-se que as prevalencias de obesidade e sobrepeso encontram-se elevadas e aumentaram no periodo de 21 meses, fato que ser motivo de preocupacao das autoridades locais.