Comportamento alimentar e qualidade de vida : intersecções biopsicossociais em adolescentes

Introdução: A adolescência é um período de mudanças biológicas, sociais e psicológicas, nas quais os padrões alimentares podem causar proteção ou risco para transtornos alimentares, bem como, queda da qualidade de vida relacionada a saúde (QVRS) e desenvolvimento de obesidade. É notável que a obesidade cresce no Brasil e ao redor do mundo em números exponenciais. Junto a esse fenômeno muito estudado, há o crescimento das atitudes alimentares transtornadas (AAT), que são consideradas comportamentos de risco para transtornos alimentares que não possuem um critério diagnóstico. Alguns pesquisadores mostram a associação do excesso de peso com pior QVRS e maior AAT, mas em adolescentes brasileiros os dados são escassos sobre essas relações. Objetivo: Descrever as associações das atitudes alimentares transtornadas e qualidade de vida com aspectos biológicos, psicológicos e socioculturais em adolescentes do ensino médio de três escolas privadas do Sul do Brasil. Método: Trata-se de um estudo transversal com uma amostra de 380 estudantes do ensino médio privado. A atitude alimentar transtornada foi avaliada usando a Escala de Atitude Alimentar Transtornada, qualidade de vida relacionada à saúde (QVRS) pelo Pediatrics Quality of Life, a apreciação corporal pelo Body Apreciation Scale versão 2, o nível de atividade física pelo Questionário Internacional de Atividade Física, bullying e assédio sexual pelo Questionário de Olwes, questões sociais como classificação socioeconômica, pressão das mídias pelo questionário Atitudes Socioculturais em Relação à Aparência. Foram coletados dados como estadiamento puberal autorrelatado e avaliação antropométrica aferida. Resultados: Os participantes tinham, em média, 15,78±1,14 anos, na maioria meninas (54,2%), de cor branca (83,6%), na classe social A (35,9%), no período de desenvolvimento puberal (73,2%), com peso saudável (68,9%) e muito ativos (51,1%). A média das AATs foi de 63,25±16,68 e da QVRS foi de 70,40±12,72. A dimensão mais afetada da AAT foi de sentimentos para comer (6,82±2,63) e da QVRS foi a emocional (52,49±18,17). O modelo final da análise de regressão linear multivariada das AATs revelou os fatores independentemente associados com o escore total de AATs (r²=0,37), no qual explica 37% destas. De acordo com a força de associação, foram respectivamente associadas às atitudes alimentares transtornadas os seguintes fatores: atitudes socioculturais em relação à aparência (β=0,325, p<0,001), excesso de peso (β=0,265, p<0,001), apreciação corporal (β= -0,252, p<0,001) e assédio sexual (β=0,113, p=0,007). Já o modelo final da QVRS revelou que os fatores independentemente associados com o escore total da qualidade de vida (r²=0,287 – explica 28,7% da qualidade de vida), de acordo com a força de associação, foram apreciação corporal (β= 0,248, p<0,01), atividade física (β=0,229, p=0,001), EAAT- relacionamento com os alimentos (β=-0,184, p<0,01) e vítima de bullying (β=-0,136, p=0,003). Conclusão: Os aspectos relacionados às AAT de adolescentes, em ordem de associação, foram as atitudes socioculturais em relação à aparência, excesso de peso, a apreciação corporal com uma associação inversa e assédio sexual. A apreciação corporal, atividade física, AAT – subescala relacionamento com os alimentos e o bullying estão significativamente e independentemente associadas à QVRS.Introduction: Adolescence is a period of biological, social and psychological changes, in which eating patterns can cause protection or risk for eating disorders, as well as a decline in health-related quality of life (HRQoL) and development of obesity. It is remarkable that obesity is growing in Brazil and around the world in exponential numbers. Along with this much-studied phenomenon, there is the growth of Disordered Eating Attitudes (DEA), which are considered risk behaviors for eating disorders that do not have diagnostic criteria. Some researchers show an association between overweight and worse HRQoL and higher AAT, but in Brazilian adolescents, data on these relationships are scarce. Objective: To describe the association of DEA and HRQoL with biological, psychological and sociocultural aspects in high school adolescents from three private schools in southern Brazil. Method: This is a cross-sectional study with a sample of 380 students from private high schools. DEAs was assessed using the Disordered Eating Attitude Scale (DEAS), health-related quality of life (HRQL) by the Pediatrics Quality of Life, body appreciation by the Body Appreciation Scale version 2, physical activity level by the International Physical Activity Questionnaire, bullying and sexual harassment by the Olwes Questionnaire, social issues such as socioeconomic classification and media pressure by Sociocultural Attitudes towards Appearance questionnaire. Data such as self-reported pubertal staging and measured anthropometric assessment were collected. Results: Participants were on average 15.78±1.14 years old, mostly girls (54.2%), white (83.6%), in social class A (35.9%), in the period of pubertal development (73.2%), healthy weight (68.9%) and very active (51.1%). The mean of the DEAs was 63.25±16.68 and the HRQoL was 70.40±12.72. The most affected dimension of the DEA was the feelings to eat (6.82±2.63) and of the HRQoL was the emotional dimension (52.49±18.17). The final model of the multivariate linear regression analysis of the DEAs revealed the factors independently associated with the total score of DEAs (r²=0.37), which explains 37% of them. According to the strength of association, the following factors were respectively associated with disturbed eating attitudes: sociocultural attitudes towards appearance (β=0.325, p<0.001), overweight (β=0.265, p<0.001), body appreciation (β= -0.252, p<0.001) and sexual harassment (β=0.113, p=0.007). The final HRQoL model revealed that the factors independently associated with the total HRQoL score (r²=0.287 – explains 28.7% of them), according to the strength of association, were body appreciation (β= 0.248, p<0.01), physical activity (β=0.229, p=0.001), DEAs-relationship with food (β=-0.184, p<0.01) and victim of bullying (β=-0.136, p =0.003). Conclusion: Aspects related to DEAs in adolescents, in order of association, were sociocultural attitudes towards appearance, overweight, body appreciation with an inverse association and sexual harassment. Body appreciation, physical activity, DEAs–food relationship and bullying subscale are significantly and independently associated with HRQOL

Qualidade de vida em escolares com excesso de peso

Introdução: Qualidade de Vida Relacionada à Saúde (QVRS) é uma medida de saúde que abrange as dimensões física, psicológica e social. Há evidência de que o excesso de peso é capaz de determinar a QVRS de escolares. Avaliar a QVRS é relevante para a identificação do impacto do excesso de peso e monitoramento dos domínios mais afetados da QVRS, além de ser um indicador relevante para o manejo da obesidade. Ainda, os escolares com excesso de peso do sul do Brasil merecem atenção, visto que esta região possui uma prevalência de excesso de peso que supera as outras regiões do país. Objetivo: Identificar a QVRS entre adolescentes com excesso de peso e fatores associados, como gênero, idade e categorias de peso. Método: Estudo transversal com dados primários e dados de um outro banco, que juntos contavam com 276 crianças e adolescentes com idade entre 10 e 19 anos, com sobrepeso e obesidade, cujos responsáveis autorizaram a participação. Foram coletados dados antropométricos, de desenvolvimento puberal e resultantes do questionário Pediatric Quality of Life Inventory (PedsQL) 4.0 para a avaliação da QVRS. O PedsQL foi utilizado por ser considerado fácil, rápido e também por possuir caráter autoaplicativo. Os dados categóricos foram descritos por contagens e percentuais. Para a descrição das subescalas da QVRS, foram utilizadas medianas e percentis 25 e 75; e, para comparações entre grupos de faixa etária, gênero e categoria de peso, teste de Mann-Whitney.Introduction: Health-Related Quality of Life (HRQoL), is a health measure that covers physical, psychological and social dimensions. There is evidence that overweight is able to determine the HRQoL of school children. Evaluating HRQoL is relevant for the identification of the impact of overweight and monitoring the most affected domains of HRQoL, as well as being a relevant indicator for the management of obesity. Also, overweight schoolchildren in southern Brazil deserve attention, since this region has a prevalence of overweight that surpasses the other regions of the country. Objective: To identify HRQoL among overweight adolescents and associated factors, such as gender, age and weight categories. Method: A cross-sectional study with primary data and data from another bank, which together 276 children and adolescents aged from 10 to 19 years old, overweight and obese, who had been authorized to participate. Anthropometric data, pubertal development and Pediatric Quality of Life Inventory (PedsQL) 4.0 were collected for an HRQoL assessment. PedsQL was used because it is considered easy, fast and also because it has a selfapplicative character. Categorical data were described by counts and percentages. For a description of HRQoL subscales, they were median and 25th and 75th percentiles, and Mann-Whitney test for comparisons between age groups, gender and weight category. Results: The median total HRQoL was 78.3 (68.5-87.4). The smallest scale was the "emotional score" of 65 (50-80). It was found higher HRQL in boys in most domains (p <0.05), except in the "school domain" (p = 0.09). Regarding the age group, the median of the "physical domain" (p = 0.03) and the "social domain" (p = 0.02) were significantly lower in the group of schoolchildren under 14 years of age. When the weight categories were separated, obese schoolchildren differed in relation to the "physical domain" (p = 0.00), "school domain" (p = 0.04) and "total domain" (p = 0.02) of the HRQoL. However, there was no significant difference between the emotional, social and psychosocial domains. Conclusions: Through the self-evaluation of students with overweight and obesity, it can be concluded that there are losses in the HRQoL and also between the different domains, when separated by age, gender and weight category

Knowledge, Attitudes and Practices of Primary School Teachers on Nutrition and Food

Introdution: The teacher's formation is a paramount condition for the education in health. Objective: To develop a questionnaire and assess knowledge, attitudes and practices of early years school teachers. Methodology: a questionnaire about nutrition and feeding was applied. The subjects were teachers from pre-school to 5th grade of Elementary School. Results: There were 288 teachers in the survey. They were all in favor of the promotion of a healthy feeding in school. The source of information mostly used was the textbook. 76% thought they had good knowledge about a healthy diet. The average number of positive/correct answers was 21 (48%). Conclusions: The knowledge about nutrition and feeding were insufficient and the general performance in the questionnaire was low. Actions that aim at qualifying the teachers are urgent, so that they can develop the necessary tools to promote a healthy feeding in schools

Mudanças no estilo de vida após primeira consulta em ambulatório de obesidade infantojuvenil

Objective: To identify the main recommendations for the agreed changes in lifestyle and the adherence of overweight children in the time interval between the first and second outpatient visits. Method: Retrospective cohort. We analyzed the data from the visits of children and adolescents to the outpatient obesity clinic from January 1st 2008 to November 30th 2011. The children were free of genetic disease and did not use controlled medications. The data were collected directly from the standardized forms used in the visits, conducted by a multidisciplinary team. In the first visit, goals related to lifestyle, diet, and physical activity were proposed. When the patients reported at the second visit that they had achieved fully or partly an agreed goal, it was considered as “adherence.” The analysis was performed with PASW Statistics for Windows, Version 18.0 (SPSS Inc, Chicago, IL, USA). The project was approved by the Research and Ethics Committee. Results: A total of 305 subjects, with a mean age of 10 ± 3.8 years were analyzed, 51.1% of whom were female; of the total number of subjects, 261 (85,6%) attended the first and second visits. A total of 401 challenges were negotiated regarding changes in eating habits (adherence of 86.8%), 264 regarding physical activity (adherence of 70.2%), and 218 regarding changes in the lifestyle (adherence of 72.4%). Conclusions: Changes in eating habits were the most recommended and had greater adherence

Qualidade de vida relacionada à saúde em adolescentes com excesso de peso

Objective: To identify health-related quality of life in adolescents with excess weight and associated factors, such as gender, age, and weight categories. Method: A cross-sectional study with collected and secondary data from 276 adolescents aged between 10 and 19 years with overweight and obesity, and whose parents or guardians authorized their participation. Anthropometric data, pubertal development, and the PedsQL 4.0 questionnaire were collected for the health-related quality of life assessment. Categorical data were described as numbers and percentages. For the description of health-related quality of life subscales, medians and the 25th and 75th percentiles were used, as well as the Mann---Whitney test for comparisons between age group, gender, and weight categories. Results: The median health-related quality of life total score was 78.3 (68.5---87.4). The lowest scale was the ‘‘emotional score’’, 65 (50---80). Higher health-related quality of life was found in boys in most of the scores (p < 0.05), except for the ‘‘school score’’ (p = 0.09). Regarding the age group, the median of the ‘‘physical scores’’ (p = 0.03) and ‘‘social score’’ (p = 0.02) were significantly lower in the group younger than 14 years. When separated according to weight categories, it was verified that obese adolescents differed significantly in relation to the ‘‘physical score’’ (p = 0.00), ‘‘school score’’ (p = 0.04), and ‘‘total score’’ (p = 0.02) of the health-related quality of life. However, there was no significant difference between the emotional, social, and psychosocial scores. Conclusions: Adolescents with overweight and obesity show losses in the health-related quality of life and also between the different domains, when separated by age, gender, and weight categories.Objetivo: Identificar a qualidade de vida relacionada à saúde entre adolescentes com excesso de peso e fatores associados, como gênero, idade e categorias de peso. Método: Estudo transversal com dados coletados e secundários de 276 adolescentes entre 10 e 19 anos, com sobrepeso e obesidade, cujos responsáveis autorizaram a participac¸ão. Foram coletados dados antropométricos, desenvolvimento puberal e questionário PedsQL 4.0 para a avaliac¸ão da qualidade de vida relacionada à saúde. Os dados categóricos foram descritos por contagens e percentuais. Para a descric¸ão das subescalas da qualidade de vida relacionada à saúde foram usadas medianas e percentis 25 e 75 e teste de Mann-Whitney para comparac¸ões entre grupos de faixa etária, gênero e categorias de peso. Resultados: A mediana do escore total da qualidade de vida relacionada à saúde foi de 78,3 (68,5-87,4). A menor escala foi o ‘‘escore emocional’’ 65 (50-80). Encontramos a qualidade de vida relacionada à saúde maior nos meninos na maioria dos escores (p < 0,05), exceto o ‘‘escore escolar’’ (p = 0,09). Quanto à faixa etária, a mediana dos ‘‘escores físico’’ (p = 0,03) e ‘‘escore social’’ (p = 0,02) foram significativamente menores no grupo menor de 14 anos. Ao separar as categorias de peso, percebe-se que os adolescentes obesos diferem significativamente com relac¸ão ao ‘‘escore físico’’ (p = 0,00); ‘‘escore escolar’’ (p = 0,04) e ‘‘escore total’’ (p = 0,02) da qualidade de vida relacionada à saúde. Contudo, não houve diferenc¸a significativa entre os escores emocional, social e psicossocial. Conclusões: Adolescentes com sobrepeso e obesidade têm prejuízos na qualidade de vida relacionada à saúde e também entre os diferentes domínios, quando separados por faixa etária, gênero e categorias de peso

Changes in lifestyle after first visit at an outpatient obesity clinic for children and adolescents

Objetivo Identificar as principais recomendações de mudanças no estilo de vida pactuadas e a adesão das crianças entre a primeira e segunda consulta ambulatorial. Método Coorte retrospectiva. Foram analisados os dados dos atendimentos ambulatoriais realizados entre 1 de janeiro de 2008 e 30 de novembro de 2011 de crianças e adolescentes obesos, livres de doença genética ou de uso de medicamentos controlados. Na primeira consulta, foram propostas metas relacionadas aos hábitos de vida, aos hábitos alimentares e à atividade física. Foi considerada “adesão” quando o paciente relatou na segunda consulta que atingiu parcial/totalmente a pactuação. A análise foi realizada com o PASW Statistics for Windows, Version 18.0 (SPSS Inc., Chicago, IL, EUA). Projeto aprovado pelo Comitê de Ética e Pesquisa. Resultados Um total de 305 pacientes com idade média de 10 3,8 anos foram analisados, dentre os quais 51,1% eram meninas; do total, 261 (85,6%) compareceram à primeira e à segunda consulta. Forampactuados 401 desafios de mudança de hábitos alimentares (adesão de 86,8%), 264 de atividade física (adesão de 70,2%) e 218 hábitos de vida (adesão de 72,4%). Conclusões Mudanças de hábitos alimentares foram mais recomendadas e tiveram maior adesão.Objective To identify the main recommendations for the agreed changes in lifestyle and the adherence of overweight children in the time interval between the first and second outpatient visits. Method Retrospective cohort. We analyzed the data from the visits of children and adolescents to the outpatient obesity clinic from January 1st 2008 to November 30th 2011. The children were free of genetic disease and did not use controlledmedications.The data were collected directly from the standardized forms used in the visits, conducted by a multidisciplinary team. In the first visit, goals related to lifestyle, diet, and physical activity were proposed. When the patients reported at the second visit that they had achieved fully or partly an agreed goal, it was considered as “adherence.” The analysis was performed with PASW Statistics for Windows, Version 18.0 (SPSS Inc, Chicago, IL, USA). The project was approved by the Research and Ethics Committee. Results A total of 305 subjects, with a mean age of 10 3.8 years were analyzed, 51.1% of whomwere female; of the total number of subjects, 261 (85,6%) attended the first and second visits. A total of 401 challenges were negotiated regarding changes in eating habits (adherence of 86.8%), 264 regarding physical activity (adherence of 70.2%), and 218 regarding changes in the lifestyle (adherence of 72.4%). Conclusions Changes in eating habits were the most recommended and had greater adherence

Qualidade de vida em escolares com excesso de peso

Introdução: Qualidade de Vida Relacionada à Saúde (QVRS) é uma medida de saúde que abrange as dimensões física, psicológica e social. Há evidência de que o excesso de peso é capaz de determinar a QVRS de escolares. Avaliar a QVRS é relevante para a identificação do impacto do excesso de peso e monitoramento dos domínios mais afetados da QVRS, além de ser um indicador relevante para o manejo da obesidade. Ainda, os escolares com excesso de peso do sul do Brasil merecem atenção, visto que esta região possui uma prevalência de excesso de peso que supera as outras regiões do país. Objetivo: Identificar a QVRS entre adolescentes com excesso de peso e fatores associados, como gênero, idade e categorias de peso. Método: Estudo transversal com dados primários e dados de um outro banco, que juntos contavam com 276 crianças e adolescentes com idade entre 10 e 19 anos, com sobrepeso e obesidade, cujos responsáveis autorizaram a participação. Foram coletados dados antropométricos, de desenvolvimento puberal e resultantes do questionário Pediatric Quality of Life Inventory (PedsQL) 4.0 para a avaliação da QVRS. O PedsQL foi utilizado por ser considerado fácil, rápido e também por possuir caráter autoaplicativo. Os dados categóricos foram descritos por contagens e percentuais. Para a descrição das subescalas da QVRS, foram utilizadas medianas e percentis 25 e 75; e, para comparações entre grupos de faixa etária, gênero e categoria de peso, teste de Mann-Whitney.Introduction: Health-Related Quality of Life (HRQoL), is a health measure that covers physical, psychological and social dimensions. There is evidence that overweight is able to determine the HRQoL of school children. Evaluating HRQoL is relevant for the identification of the impact of overweight and monitoring the most affected domains of HRQoL, as well as being a relevant indicator for the management of obesity. Also, overweight schoolchildren in southern Brazil deserve attention, since this region has a prevalence of overweight that surpasses the other regions of the country. Objective: To identify HRQoL among overweight adolescents and associated factors, such as gender, age and weight categories. Method: A cross-sectional study with primary data and data from another bank, which together 276 children and adolescents aged from 10 to 19 years old, overweight and obese, who had been authorized to participate. Anthropometric data, pubertal development and Pediatric Quality of Life Inventory (PedsQL) 4.0 were collected for an HRQoL assessment. PedsQL was used because it is considered easy, fast and also because it has a selfapplicative character. Categorical data were described by counts and percentages. For a description of HRQoL subscales, they were median and 25th and 75th percentiles, and Mann-Whitney test for comparisons between age groups, gender and weight category. Results: The median total HRQoL was 78.3 (68.5-87.4). The smallest scale was the "emotional score" of 65 (50-80). It was found higher HRQL in boys in most domains (p <0.05), except in the "school domain" (p = 0.09). Regarding the age group, the median of the "physical domain" (p = 0.03) and the "social domain" (p = 0.02) were significantly lower in the group of schoolchildren under 14 years of age. When the weight categories were separated, obese schoolchildren differed in relation to the "physical domain" (p = 0.00), "school domain" (p = 0.04) and "total domain" (p = 0.02) of the HRQoL. However, there was no significant difference between the emotional, social and psychosocial domains. Conclusions: Through the self-evaluation of students with overweight and obesity, it can be concluded that there are losses in the HRQoL and also between the different domains, when separated by age, gender and weight category

Conhecimento, atitudes e práticas de professores de escola primária em nutrição e alimentação

Introdution The teacher’s formation is a paramount condition for the education in health. Objective To develop a questionnaire and assess knowledge, attitudes and practices of early years school teachers. Methodology a questionnaire about nutrition and feeding was applied. The subjects were teachers from pre-school to 5th grade of Elementary School. Results There were 288 teachers in the survey. They were all in favor of the promotion of a healthy feeding in school. The source of informationmostly used was the textbook. 76% thought they had good knowledge about a healthy diet. The average number of positive/correct answers was 21 (48%). Conclusions The knowledge about nutrition and feeding were insufficient and the general performance in the questionnaire was low. Actions that aim at qualifying the teachers are urgent, so that they can develop the necessary tools to promote a healthy feeding in schools.Introdução A formação do professor é condição indispensável para a educação em saúde. Objetivo Desenvolver um questionário e avaliar conhecimentos, atitudes e práticas de alimentação e nutrição de professores do ensino fundamental. Metodologia Foi elaborado e aplicado questionário sobre nutrição e alimentação. Os sujeitos foram professores da pré-escola ao 5° ano do Ensino Fundamental. Resultados Participaram da pesquisa 288 professores. Todos foram a favor da promoção da alimentação saudável na escola. A fonte de informação mais utilizada foi o livro didático. 76% consideraram ter bons conhecimentos sobre alimentação saudável. A média de respostas positivas/corretas foi 21 (48%). Conclusões Os conhecimentos sobre alimentação e nutrição foram insuficientes e o desempenho geral no questionário foi baixo. Ações que busquem qualificar o professor são urgentes, de forma que ele desenvolva as ferramentas necessárias para a promoção da alimentação saudável na escola

Conhecimento, atitudes e práticas de professores de escola primária em nutrição e alimentação

Introdution The teacher’s formation is a paramount condition for the education in health. Objective To develop a questionnaire and assess knowledge, attitudes and practices of early years school teachers. Methodology a questionnaire about nutrition and feeding was applied. The subjects were teachers from pre-school to 5th grade of Elementary School. Results There were 288 teachers in the survey. They were all in favor of the promotion of a healthy feeding in school. The source of informationmostly used was the textbook. 76% thought they had good knowledge about a healthy diet. The average number of positive/correct answers was 21 (48%). Conclusions The knowledge about nutrition and feeding were insufficient and the general performance in the questionnaire was low. Actions that aim at qualifying the teachers are urgent, so that they can develop the necessary tools to promote a healthy feeding in schools.Introdução A formação do professor é condição indispensável para a educação em saúde. Objetivo Desenvolver um questionário e avaliar conhecimentos, atitudes e práticas de alimentação e nutrição de professores do ensino fundamental. Metodologia Foi elaborado e aplicado questionário sobre nutrição e alimentação. Os sujeitos foram professores da pré-escola ao 5° ano do Ensino Fundamental. Resultados Participaram da pesquisa 288 professores. Todos foram a favor da promoção da alimentação saudável na escola. A fonte de informação mais utilizada foi o livro didático. 76% consideraram ter bons conhecimentos sobre alimentação saudável. A média de respostas positivas/corretas foi 21 (48%). Conclusões Os conhecimentos sobre alimentação e nutrição foram insuficientes e o desempenho geral no questionário foi baixo. Ações que busquem qualificar o professor são urgentes, de forma que ele desenvolva as ferramentas necessárias para a promoção da alimentação saudável na escola

Changes in lifestyle after first visit at an outpatient obesity clinic for children and adolescents

Objetivo Identificar as principais recomendações de mudanças no estilo de vida pactuadas e a adesão das crianças entre a primeira e segunda consulta ambulatorial. Método Coorte retrospectiva. Foram analisados os dados dos atendimentos ambulatoriais realizados entre 1 de janeiro de 2008 e 30 de novembro de 2011 de crianças e adolescentes obesos, livres de doença genética ou de uso de medicamentos controlados. Na primeira consulta, foram propostas metas relacionadas aos hábitos de vida, aos hábitos alimentares e à atividade física. Foi considerada “adesão” quando o paciente relatou na segunda consulta que atingiu parcial/totalmente a pactuação. A análise foi realizada com o PASW Statistics for Windows, Version 18.0 (SPSS Inc., Chicago, IL, EUA). Projeto aprovado pelo Comitê de Ética e Pesquisa. Resultados Um total de 305 pacientes com idade média de 10 3,8 anos foram analisados, dentre os quais 51,1% eram meninas; do total, 261 (85,6%) compareceram à primeira e à segunda consulta. Forampactuados 401 desafios de mudança de hábitos alimentares (adesão de 86,8%), 264 de atividade física (adesão de 70,2%) e 218 hábitos de vida (adesão de 72,4%). Conclusões Mudanças de hábitos alimentares foram mais recomendadas e tiveram maior adesão.Objective To identify the main recommendations for the agreed changes in lifestyle and the adherence of overweight children in the time interval between the first and second outpatient visits. Method Retrospective cohort. We analyzed the data from the visits of children and adolescents to the outpatient obesity clinic from January 1st 2008 to November 30th 2011. The children were free of genetic disease and did not use controlledmedications.The data were collected directly from the standardized forms used in the visits, conducted by a multidisciplinary team. In the first visit, goals related to lifestyle, diet, and physical activity were proposed. When the patients reported at the second visit that they had achieved fully or partly an agreed goal, it was considered as “adherence.” The analysis was performed with PASW Statistics for Windows, Version 18.0 (SPSS Inc, Chicago, IL, USA). The project was approved by the Research and Ethics Committee. Results A total of 305 subjects, with a mean age of 10 3.8 years were analyzed, 51.1% of whomwere female; of the total number of subjects, 261 (85,6%) attended the first and second visits. A total of 401 challenges were negotiated regarding changes in eating habits (adherence of 86.8%), 264 regarding physical activity (adherence of 70.2%), and 218 regarding changes in the lifestyle (adherence of 72.4%). Conclusions Changes in eating habits were the most recommended and had greater adherence