Risia Cristina Egito de Menezes

Excesso de peso em crianças e adolescentes no Estado de Pernambuco, Brasil: prevalência e determinantes

This study aimed to determine the prevalence of overweight and associated risk factors in children and adolescents in Pernambuco State, Brazil, in 2006. The cross-sectional, population-based study included 1,435 individuals from 5 to 19 years of age. Poisson regression was used to evaluate the association between selected variables and overweight. Prevalence was 13.3% for overweight (95%CI: 11.6-15.1) and 3.8% for obesity. Adjusted prevalence ratios showed that higher family income, maternal schooling, possession of household consumer goods, living in urban areas, and maternal overweight were associated with overweight in children and adolescents. The high prevalence of overweight in Pernambuco emphasizes the need for public health measures targeting all families regardless of socioeconomic status.

Determinantes do déficit estatural em menores de cinco anos no Estado de Pernambuco

OBJECTIVE To describe the prevalence of stunting in children under five and identify factors associated. METHODS Population-based cross-sectional study conducted in 1991, 1997 and 2006 in the state of Pernambuco, northeastern Brazil. The following variables associated with the prevalence of stunting (height-for-age < -2 z-score) were studied: socioeconomic condition, maternal and child characteristics, and health care provided. A hierarchical model was used in the multiple logistic regression to assess the impact of explanatory variables on childrens stunting. RESULTS The prevalence of child malnutrition (height-for-age) was reduced by 65% from 1991 to 2006. Socioeconomic variables (per capita family income, maternal education, number of people living in the household and access to consumer goods), maternal height and birth weight were associated with stunting in children under five. CONCLUSIONS All the determinants studied improved over the study period though not consistently. Despite significant reduction of child malnutrition in Pernambuco there remain differences regarding stunting, and children with better socioeconomic conditions have more favorable outcomes.OBJETIVO: Descrever o deficit estatural de menores de cinco anos e identificar fatores associados. METODOS: Estudo transversal de base populacional realizado em 1991, 1997 e 2006 no Estado de Pernambuco. A analise da prevalencia e fatores associados ao deficit estatural (altura para idade < -2 escore Z) incluiu: condicoes socioeconomicas, caracteristicas maternas e da crianca e de assistencia a saude. A regressao logistica multipla utilizou o modelo hierarquizado, para avaliar o impacto das variaveis explanatorias sobre o deficit de estatura das criancas. RESULTADOS: A prevalencia da desnutricao em criancas pelo indice altura para idade diminuiu 65% entre 1991 e 2006. As variaveis socioeconomicas (renda familiar per capita, escolaridade materna, numero de pessoas na residencia e acesso a bens de consumo), a altura materna e o peso ao nascer permaneceram entre os fatores associados ao deficit estatural das criancas. CONCLUSOES: Todos os determinantes analisados melhoraram no periodo analisado, nem sempre de forma igualitaria. Apesar da reducao expressiva da desnutricao nas criancas pernambucanas, ainda existem diferenciais em relacao ao deficit de estatura, sendo mais favoraveis para as criancas em melhores condicoes socioeconomicas.

Prevalência e determinantes do excesso de peso em pré-escolares

OBJETIVO: Identificar a prevalencia do excesso de peso e sua associacao com as condicoes socioeconomicas, ambientais, bens de consumo, estado nutricional materno e assistencia a saude em pre-escolares. METODOS: Estudo transversal com 954 pre-escolares do estado de Pernambuco, no ano de 2006. Foi realizada regressao logistica multipla, utilizando-se o modelo hierarquizado. Razoes de chances de excesso de peso (bruta e ajustada para confundimento) foram calculadas para cada variavel de exposicao. RESULTADOS: A prevalencia de excesso de peso foi de 8,1% para o estado e 9% para a regiao metropolitana de Recife (PE). No interior urbano e rural, foram encontradas prevalencias de 9,7 e 6,8%, respectivamente. Maiores prevalencias de excesso de peso foram observadas entre criancas pertencentes a familias com melhores condicoes socioeconomicas: maior renda familiar per capita e nivel de escolaridade, acesso a bens de consumo, melhores condicoes de moradia e saneamento basico e de assistencia a saude. O modelo final de regressao logistica multipla indicou que a escolaridade materna, os bens de consumo e o indice de massa corporal da mae foram os fatores que melhor explicaram o excesso de peso das criancas. CONCLUSOES: As prevalencias do excesso de peso superam as de desnutricao entre pre-escolares no estado, e esse excesso acomete principalmente as criancas de familias com condicoes socioeconomicas mais favorecidas.

Prevalence and determinants of overweight in preschool children

OBJECTIVE To examine the prevalence of overweight and its association with socioeconomic and environmental factors, ownership of household goods, maternal nutritional status, and healthcare in preschoolers. METHODS Cross-sectional study with 954 preschoolers from the state of Pernambuco, Brazil, 2006. Multiple logistic regression with hierarchical modeling was conducted. Odds ratios for overweight (crude and adjusted for confounders) were calculated for each independent variable. RESULTS The prevalence of overweight was 8.1% for the state as a whole and 9% for the Recife Metropolitan Region. In urban and rural areas, the prevalence was 9.7 and 6.8%, respectively. A high prevalence of overweight was found among children whose families lived in better socioeconomic conditions (per capita family income, high educational achievement and access to household goods, better housing and sanitation, and healthcare). The logistic regression final model indicated that maternal educational achievement, ownership of household goods, and maternal body mass index were the determinants that best explained child overweight. CONCLUSIONS Overweight was more prevalent than malnutrition among preschoolers. The prevalence was highest among children living in more privileged socioeconomic conditions.

Fatores associados ao declínio do déficit estatural em crianças e adolescentes em Pernambuco

OBJETIVO: Analisar a evolucao do deficit estatural em criancas e adolescentes e identificar seus fatores associados. METODOS: Estudo transversal, com dados das Pesquisas Estaduais de Saude e Nutricao realizadas em Pernambuco nos anos de 1997 e 2006. A amostra do tipo probabilistica (aleatoria estratificada), com representatividade para os estratos urbanos e rurais do estado. Para a coleta de dados foram utilizados questionarios com perguntas pre-codificadas referentes a informacoes sobre as variaveis socioeconomicas, demograficas e antropometricas (das maes, criancas e adolescentes). A populacao estudada foi de, respectivamente, 1.853 e 1.484 criancas e adolescentes de cinco a 19 anos. A analise de regressao multipla com selecao hierarquizada foi utilizada para avaliar a associacao das variaveis explanatorias sobre o deficit estatural. RESULTADOS: A prevalencia do deficit de estatura apresentou reducao significante de 43% (de 16,9% em 1997 para 9,6% em 2006). As variaveis socioeconomicas e a estatura materna estiveram associadas a este declinio, com reducoes variando de 39% a 60% entre os estratos analisados. Na analise dos determinantes do deficit estatural, no ano de 2006, permaneceram como significantes: a renda familiar per capita (<0,25 salario minimo), a posse de bens domesticos (< tres), o maior numero de pessoas por domicilio, a menor escolaridade e menor estatura materna. CONCLUSOES: A reducao do deficit de estatura refletiu a melhoria nas condicoes sociais e economicas. Entretanto, permanecem necessarios a manutencao e incremento de politicas publicas, de modo a aumentar o poder aquisitivo dos mais pobres e universalizar o acesso da populacao a servicos de saude e educacao.OBJETIVO: Analizar la evolucion de la disminucion del deficit de estatura en ninos y adolescentes e identificar sus factores asociados. METODOS: Estudio transversal, con datos de las Investigaciones Estatales de Salud y Nutricion realizadas en Pernambuco (Noreste de Brasil) en los anos de 1997 y 2006. La muestra de tipo probabilistica (aleatoria estratificada), con representacion de los estratos urbanos y rurales del estado. Para la colecta de datos fueron utilizados cuestionarios con preguntas pre-codificadas referentes a informaciones sobre las variables socioeconomicas, demograficas y antropometricas (de las madres, ninos y adolescentes). La poblacion estudiada fue de, respectivamente, 1.853 y 1.484 ninos y adolescentes de cinco a 19 anos. El analisis de regresion multiple con seleccion jerarquizada fue utilizado para evaluar la asociacion de las variables explicativas sobre el deficit de estatura. RESULTADOS: La prevalencia del deficit de estatura presento reduccion significativa de 43% (de 16,9% en 1997 a 9,6% en 2006). Las variables socioeconomicas y la estatura materna estuvieron asociadas a esta disminucion, con reducciones variando de 39% a 60% entre los estratos analizados. En el analisis de los determinantes del deficit de estatura, en el ano 2006, permanecieron como significativos: la renta familiar per capita (<0,25 salario minimo), la posesion de bienes domesticos (< tres), el mayor numero de personas por domicilio, la menor escolaridad y menor estatura materna. CONCLUSIONES: La reduccion del deficit de estatura reflejo la mejoria en las condiciones sociales y economicas. Sin embargo, permanecen necesarios el mantenimiento e incremento de politicas publicas, de modo a aumentar el poder adquisitivo de los mas pobres y universalizar el acceso de la poblacion a servicios de salud y educacion.OBJECTIVE To analyze the evolution of stunting among children and adolescents and identify their associated factors. METHODS This was a cross-sectional study using data from the state health and nutrition surveys that were conducted in Pernambuco (Northeastern Brazil) in 1997 and 2006. The sample was probabilistic (random and stratified) and was representative of urban and rural strata of the state. Questionnaires containing precoded questions relating to information on socioeconomic, demographic and anthropometric variables (of the mothers, children and adolescents) were used for data gathering. The population studied comprised 1853 children and 1484 adolescents between the ages of five and 19 years. Multiple regression analysis with hierarchical selection was used to evaluate associations between explanatory variables relating to stunting. RESULTS The prevalence of stunting presented a significant reduction of 43% (from 16.9% in 1997 to 9.6% in 2006). Socioeconomic variables and maternal height were associated with this decline. The reductions ranged from 39% to 60% among the strata analyzed. Analysis on determinants of stunting showed that in 2006, the following remained significant: per capita family income (< 0.25 minimum salary), possession of domestic goods (< three), greater number of people per household, lower schooling level and lower maternal height. CONCLUSIONS The reduction in stunting reflected improvements in social and economic conditions. However, it remains necessary to maintain and improve public policies, in order to increase the purchasing power of the poorest people and to achieve universal access to health and education services for the population.

Determinants of stunting in children under five in Pernambuco, Northeastern Brazil

OBJECTIVE To describe the prevalence of stunting in children under five and identify factors associated. METHODS Population-based cross-sectional study conducted in 1991, 1997 and 2006 in the state of Pernambuco, northeastern Brazil. The following variables associated with the prevalence of stunting (height-for-age < -2 z-score) were studied: socioeconomic condition, maternal and child characteristics, and health care provided. A hierarchical model was used in the multiple logistic regression to assess the impact of explanatory variables on childrens stunting. RESULTS The prevalence of child malnutrition (height-for-age) was reduced by 65% from 1991 to 2006. Socioeconomic variables (per capita family income, maternal education, number of people living in the household and access to consumer goods), maternal height and birth weight were associated with stunting in children under five. CONCLUSIONS All the determinants studied improved over the study period though not consistently. Despite significant reduction of child malnutrition in Pernambuco there remain differences regarding stunting, and children with better socioeconomic conditions have more favorable outcomes.OBJETIVO: Descrever o deficit estatural de menores de cinco anos e identificar fatores associados. METODOS: Estudo transversal de base populacional realizado em 1991, 1997 e 2006 no Estado de Pernambuco. A analise da prevalencia e fatores associados ao deficit estatural (altura para idade < -2 escore Z) incluiu: condicoes socioeconomicas, caracteristicas maternas e da crianca e de assistencia a saude. A regressao logistica multipla utilizou o modelo hierarquizado, para avaliar o impacto das variaveis explanatorias sobre o deficit de estatura das criancas. RESULTADOS: A prevalencia da desnutricao em criancas pelo indice altura para idade diminuiu 65% entre 1991 e 2006. As variaveis socioeconomicas (renda familiar per capita, escolaridade materna, numero de pessoas na residencia e acesso a bens de consumo), a altura materna e o peso ao nascer permaneceram entre os fatores associados ao deficit estatural das criancas. CONCLUSOES: Todos os determinantes analisados melhoraram no periodo analisado, nem sempre de forma igualitaria. Apesar da reducao expressiva da desnutricao nas criancas pernambucanas, ainda existem diferenciais em relacao ao deficit de estatura, sendo mais favoraveis para as criancas em melhores condicoes socioeconomicas.

Introduction of soft drinks and processed juice in the diet of infants attending public day care centers

OBJECTIVE: Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice. METHODS: A cross-sectional study with the mothers of 636 children (aged 0 to 36 months) from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands. RESULTS: The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices. CONCLUSIONS: The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature.. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits.

Desnutrição e excesso de peso em crianças e adolescentes: uma revisão de estudos brasileiros

OBJETIVO: Revisar la literatura brasilena de 2001 a 2010 sobre las prevalencias y los factores asociados al deficit de estatura y al exceso de peso en ninos y adolescentes de cinco a 19 anos. FUENTES DE DATOS: La investigacion fue realizada en las bases de datos Pubmed y Bireme, utilizandose los descriptores a continuacion: «desnutricion», «deficit estatural», «obesidad», «sobrepeso», «IMC», «nino», «escolar», «adolescente», «Brasil» y «determinantes». Se consideraron los siguientes criterios de seleccion: articulo original de base poblacional, evaluacion de los factores asociados, por medio de analisis estadistico de regresion, y articulos publicados entre 2000 y 2009. SINTESIS DE LOS DATOS: En lo que se refiere al deficit estatural, solamente dos estudios atendieron a los criterios establecidos, presentando variaciones de 3,5 a 16,7%, e indicacion de la condicion social y de la escolaridad de los jovenes como factores asociados. De los 12 estudios que investigaron el exceso de peso, 66,6% fueron realizados en la region Sur de Brasil y ninguno incluyo al Norte del pais. La mayoria presento delineacion transversal. Las prevalencias variaron de 13,9 a 38,9%, siendo los principales factores asociados: estandares socioeconomicos, influencia familiar y estilo de vida sedentario. CONCLUSIONES: Las asociaciones de las variables ingresos y nivel de escolaridad con el deficit de estatura y el sobrepeso, aunque con tendencias opuestas, llaman la atencion. Se sugiere la realizacion de mas estudios, en especial en las regiones Norte y Nordeste de Brasil.

Estado nutricional de crianças e adolescentes de um município do semiárido do Nordeste brasileiro

Objective: To evaluate the nutritional status of schoolchildren, resident in a semiarid region in the Northeastern Brazil. Methods: This is a cross-sectional study, involving 860 children and adolescents aged from 5-19 years-old, enrolled in three public schools in the county. The selection of schools was non-probabilistic type and unintentional. The initial population, which integrated the database, was composed by 1,035 children and teenagers, and 175 students (16.9%) were excluded because of inconsistency in the anthropometric data, resulting in a sample of 860 students. The following outcomes were considered: stunting (malnutrition), overweight and obesity (overweight), being the height/age and body mass index/age (BMI/Age), indices respectively used. Children and adolescents with height <-2 standard deviations and overweight and obese weight z score ≥1 were considered stunted. The statistical analysis was descriptive. Results: The prevalence of stunting and overweight/obesity was 9.1% and 24.0%, respectively. Overweight and stunting were higher in adolescents aged 15 and over, compared to other age groups analyzed. In relation to gender, malnutrition presented itself in a similar way, but overweight was more frequent among females. Conclusions: The results revealed that excess weight, here represented by the sum of overweight and obesity, was more prevalent than stunting (malnutrition), highlighting the urgent need for attention to this problem in order to design interventions capable of contributing to the improvement of schoolchildren nutritional status.Objective:To evaluate the nutritional status of schoolchildren, resident in a semiarid region in the Northeastern Brazil.Methods:This is a cross-sectional study, involving 860 children and adolescents aged from 5-19 years-old, enrolled in three public schools in the county. The selection of schools was non-probabilistic type and unintentional. The initial population, which integrated the database, was composed by 1,035 children and teenagers, and 175 students (16.9%) were excluded because of inconsistency in the anthropometric data, resulting in a sample of 860 students. The following outcomes were considered: stunting (malnutrition), overweight and obesity (overweight), being the height/age and body mass index/age (BMI/Age), indices respectively used. Children and adolescents with height <-2 standard deviations and overweight and obese weight z score ≥1 were considered stunted. The statistical analysis was descriptive.Results:The prevalence of stunting and overweight/obesity was 9.1% and 24.0%, respectively. Overweight and stunting were higher in adolescents aged 15 and over, compared to other age groups analyzed. In relation to gender, malnutrition presented itself in a similar way, but overweight was more frequent among females.Conclusions:The results revealed that excess weight, here represented by the sum of overweight and obesity, was more prevalent than stunting (malnutrition), highlighting the urgent need for attention to this problem in order to design interventions capable of contributing to the improvement of schoolchildren nutritional status.

Malnutrition and excess weight in children and adolescents: a review of Brazilian studies

OBJETIVO: Revisar la literatura brasilena de 2001 a 2010 sobre las prevalencias y los factores asociados al deficit de estatura y al exceso de peso en ninos y adolescentes de cinco a 19 anos. FUENTES DE DATOS: La investigacion fue realizada en las bases de datos Pubmed y Bireme, utilizandose los descriptores a continuacion: «desnutricion», «deficit estatural», «obesidad», «sobrepeso», «IMC», «nino», «escolar», «adolescente», «Brasil» y «determinantes». Se consideraron los siguientes criterios de seleccion: articulo original de base poblacional, evaluacion de los factores asociados, por medio de analisis estadistico de regresion, y articulos publicados entre 2000 y 2009. SINTESIS DE LOS DATOS: En lo que se refiere al deficit estatural, solamente dos estudios atendieron a los criterios establecidos, presentando variaciones de 3,5 a 16,7%, e indicacion de la condicion social y de la escolaridad de los jovenes como factores asociados. De los 12 estudios que investigaron el exceso de peso, 66,6% fueron realizados en la region Sur de Brasil y ninguno incluyo al Norte del pais. La mayoria presento delineacion transversal. Las prevalencias variaron de 13,9 a 38,9%, siendo los principales factores asociados: estandares socioeconomicos, influencia familiar y estilo de vida sedentario. CONCLUSIONES: Las asociaciones de las variables ingresos y nivel de escolaridad con el deficit de estatura y el sobrepeso, aunque con tendencias opuestas, llaman la atencion. Se sugiere la realizacion de mas estudios, en especial en las regiones Norte y Nordeste de Brasil.