A comparison between overweight cutoff points for detection of high blood pressure in adolescents

OBJETIVOS: Avaliar a acurácia de três pontos de corte na determinação da pressão arterial elevada em adolescentes, dada a forte relação entre o excesso de peso e valores elevados de pressão arterial. MÉTODOS: Participaram do estudo 1.021 adolescentes de ambos os sexos, selecionados de maneira aleatória nas escolas públicas e particulares de Londrina (PR). O peso corporal foi aferido por meio de balança digital, e a estatura, por um estadiômetro portátil com extensão máxima de 2 metros. A pressão arterial foi avaliada através de um aparelho automático. A capacidade do índice de massa corporal de detectar a pressão arterial elevada foi averiguada por meio da curva ROC e seus parâmetros (sensibilidade, especificidade e área sob a curva). RESULTADOS: Os pontos de corte da proposta nacional apresentaram maior acurácia (masculino: 0,636±0,038; feminino: 0,585±0,043) quando comparados aos pontos de corte das propostas internacional (masculino: 0,594±0,040; feminino: 0,570±0,044) e norte-americana (masculino: 0,612±0,039; feminino: 0,578±0,044). CONCLUSÃO: A proposta nacional foi a que apresentou melhor acurácia na indicação de valores elevados de pressão arterial.OBJECTIVES: To evaluate the accuracy of three different cutoff points for the detection of high blood pressure in adolescents, given the strong relationship between overweight and high blood pressure levels. METHODS: A total of 1,021 adolescents of both sexes were enrolled in the study, selected at random from public and private schools in Londrina, Brazil. Their body weight was measured using a digital balance, and their height with a portable stadiometer with a maximum extension of 2 meters. Arterial blood pressure was measured using an automatic apparatus. The capacity of body mass index to detect high blood pressure was gauged using ROC curves and their parameters (sensitivity, specificity, and area under the curve). RESULTS: The cutoff points proposed in a Brazilian standard exhibited greater accuracy (males: 0.636±0.038; females: 0.585±0.043) than the cutoff points proposed in an international (males: 0.594±0.040; females: 0.570±0.044) and a North-American standard (males: 0.612±0.039; females: 0.578±0.044). CONCLUSIONS: The Brazilian proposal offered greatest accuracy for indicating high blood pressure levels

Abdominal obesity: prevalence, sociodemographic- and lifestyle-associated factors in adolescents

Objectives: The aim of this study was to determine the prevalence of abdominal obesity and its associated factors among adolescents, independent of confounders. Methods: A sample of 14–17-year-old individuals (n=1.231), who were students from Londrina/PR-Brazil public schools, was studied. A questionnaire about physical activity, sedentary behaviour and socioeconomic conditions was applied. Anthropometry was composed of body weight (kg), height (m), body mass index (BMI=kg/m²) and waist circumference (cm). The association of abdominal obesity and independent variables was assessed using the chi-square test and the magnitude of associations was verified using Binary Logistic Regression in an unadjusted model and adjusted for confounders (gender, age, socioeconomic status, physical activity and sedentary behaviour). The confidence interval and statistical significance were set at 95% and 5%, respectively, using SPSS v15.0. Results: The abdominal obesity prevalence was 17.5% (CI = 15.4%–19.6%), and was higher in boys than in girls. Adolescents with abdominal obesity had higher values of body weight, height, body mass index and sedentary behaviour compared to eutrophic individuals. Being male increased the risk of abdominal obesity by 36% in adolescents. This risk was two times higher in those with high levels of sedentary behaviour. Conclusion: Abdominal obesity was significantly associated with gender and high levels of sedentary behaviour, regardless of confounding factors. Lifestyle habits are important modifiable risk factors that can effectively contribute to the reduction of obesity from an early age

Influência da prática habitual de atividade física e da gordura de tronco sobre a glicemia de jejum em mulheres na menopausa

Study Model: Original Study. Objective: To examine the relationship between the practice of physical activity (PA) with total body fat, trunk fat and fasting glucose in postmenopausal women.Methods: Sixty postmenopausal women, mean age of 61.0 years, from the city of Presidente Prudente SP, were assessed. Body mass (BM) and height were measured to calculate Body Mass Index (BMI). Total body fat (BF) and trunk fat mass (TFM) were estimated using DEXA. Fasting glucose was measured and classified according to the reference values of the American Diabetes Association (1997). The usual practice of PA was estimated using triaxial accelerometer, model GT3X (Actigraph,Pensacola,FL,USA) and classified according to Sasaki (2010). Comparisons were made between women with normal blood fasting glucose levels (NBG) and high blood fasting glucose(HBG) levels by the Kruskal-Wallis test. Spearman correlation coefficient was used and then the binary logistic regression to test the association between PA level and body composition with fasting glucose.Results: Women with HBG showed higher values of BM (p=0,040), BMI (=0,002) and BF (=0,046), and lower values of light (p=0,019), moderate (p=0,041) and moderate+vigorous (p=0,041) PA. The moderate and moderate+vigorous PA showed, respectively, a significant negative correlation with BF (p=0,003 and p+0,003) and TFM (p=0,021 and p=0,021). The FM presented negative correlation with moderate + vigorous (p=0,049). Women with lower TFM and classified as active showed protective factor (OR=0.133 [CI 0.023 to 0.7841] for impaired fasting glucose. Conclusion: The practice of moderate+vigorous intensity PA, held at least 150 minutes per week, is associated with lower trunk fat, and presents protective factor for impaired fasting glucose and risk of diabetes mellitus ins postmenopausal women.Modelo de estudo: Estudo OriginalObjetivo: Examinar a relação entre a prática habitual da atividade física (AF) com a gordura corporal total, gordura do tronco e glicemia de jejum em mulheres na menopausa. Métodos: Foram avaliadas 60 mulheres na menopausa com média de idade de 61,0 anos, da cidade de Presidente Prudente - SP. A massa corporal (MC) e a estatura foram mensuradas para o cálculo de Índice de Massa Corporal (IMC). A gordura corporal total (GC) e a gordura de tronco (TrG) foram estimadas por meio do DEXA. A glicemia sanguinea foi dosada e classificada de acordo com os valores de referência da American Diabetes Association (1997). A prática habitual de AF foi estimada utilizando acelerômetro triaxial (Actigraph) e classificada de acordo com Sasaki (2010). Foi realizada a comparação entre mulheres com valores de glicemia normal e glicemia alterada por meio do teste Kruskal-Wallis. Foi utlizado o coeficiente de correlação de Spearman e em seguida a regressão logística binária para verificar a associação entre nível de AF e compoisção corporal com glicemia de jejum. Resultados: Mulheres que apresentavam hiperglicemia obtiveram maiores valores de MC (p=0,040), IMC (p=0,002) e GC (p=0,046), além de valores menores de AF (p=0,019), moderada (p=0,041) e de moderada+vigorosa (p=0,041). A variável AF moderada e moderada+vigorosa, apresentaram, respectivamente, correlação negativa significante percentual de GC (p=0,003) e com TrG(p=0,021 e p=0,021), quando analisado os valores absolutos de GC foi observado correlação negativa com a soma moderda+vigorosa (p=0,049). As mulheres que obtiveram menore valores de TrG e que foram classificadas como suficientemente ativas apresentaram fator de proteção (RC=0,133 [IC=0,023-0,784]) para glicemia de jejum alterada.Conclusão: A prática de AF de intensidade moderada-vigorosa, realizada pelo menos 150 minutos semanais, associado à baixa gordura de tronco, é um fator protetor para a hiperglicemia em mulheres na menopausa

Physical Activity Is Associated With Improved Eating Habits During the COVID-19 Pandemic

The aim of this study was to analyze the association between physical activity andeating habits during the COVID-19 pandemic among Brazilian adults. A sample of1,929 participants answered an online survey, however 1,874 were included in theanalysis. The impact of the COVID-19 pandemic on eating habits was assessedinquiring about participants’ intake of fruits, vegetables, fried foods, and sweetsduring the pandemic. Physical activity was assessed by asking participants abouttheir weekly frequency, intensity and number of minutes/hours engaging in structuredphysical activities per week. Participants were then stratified into categories based onmoderate-to-vigorous intensity (0–30; 31–90; 91–150; 151–300; and >300 min/week)and into active (≥150 min) or inactive (<150 min). Increased sweets consumption wasthe most commonly reported change to eating habits (42.5%), followed by an increase inthe consumption of vegetables (26.6%), fruits (25.9%), and fried foods (17.9%). Physicalactivity practice was related to lower consumption of fried foods (OR = 0.60; p < 0.001)and sweets (OR = 0.53; p < 0.001). A cluster analysis revealed subjects with higherthe level of physical activity was more likely to follow a healthy diet (p < 0.001). Thus,physical activity was positively associated with healthier eating habits. Health authoritiesmust recommend regular physical as a strategy to improve overall health during theCOVID-19 pandemic. Future studies should address the physical activity interventionsto improve health status during a pandemic

Increased Screen Time Is Associated With Alcohol Desire and Sweetened Foods Consumption During the COVID-19 Pandemic

Background: Elevated screen time has been associated with addictive behaviors, such as alcohol and sugar intake and smoking. Considering the substantial increase in screen time caused by social isolation policies, this study aimed to analyze the association of increased screen time in different devices during the COVID-19 pandemic with consumption and increased desire of alcohol, smoking, and sweetened foods in adults. Methods: A sample of 1,897 adults with a mean age of 37.9 (13.3) years was assessed by an online survey, being composed by 58% of women. Participants were asked whether screen time in television, cell phone, and computer increased during the pandemic, as well as how much time is spent in each device. Closed questions assessed the frequency of alcohol and sweetened food consumption, smoking, and an increased desire to drink and smoke during the pandemic. Educational level, age, sex, feeling of stress, anxiety, depression, and use of a screen device for physical activity were covariates. Binary logistic regression models considered adjustment for covariates and for mutual habits. Results: Increased television time was associated with increased desire to drink (OR = 1.46, 95% CI: 1.12; 1.89) and increased sweetened food consumption (OR = 1.53, 95% CI: 1.18; 1.99), while an increase in computer use was negatively associated with consumption of alcohol (OR = 0.68, 95% CI: 0.53; 0.86) and sweetened foods (OR = 0.78, 95% CI: 0.62; 0.98). Increased cell phone time was associated with increased sweetened food consumption during the pandemic (OR = 1.78, 95% CI: 1.18; 2.67). Participants with increased time in the three devices were less likely to consume sweetened foods for ≥5 days per week (OR = 0.63, 95% CI: 0.39; 0.99) but were twice as likely to have sweetened food consumption increased during pandemic (OR = 2.04, 95% CI: 1.07; 3.88). Conclusion: Increased screen time was differently associated with consumption and desire for alcohol and sweets according to screen devices. Increased time in television and cell phones need to be considered for further investigations of behavioral impairments caused by the pandemic

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income&nbsp;countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was &lt;1.1 kg m–2 in the vast majority of&nbsp;countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

Transitions of cardio-metabolic risk factors in the Americas between 1980 and 2014

Describing the prevalence and trends of cardiometabolic risk factors that are associated with non-communicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure, and diabetes in the Americas, between 1980 and 2014

Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults.

BACKGROUND: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. METHODS: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). FINDINGS: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m2 per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese. INTERPRETATION: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults. FUNDING: Wellcome Trust, AstraZeneca Young Health Programme