Fatores ambientais associados ao sobrepeso infantil Environmental factors associated with childhood overweight

OBJETIVO: Avaliar os fatores ambientais intra-uterinos, perinatais e familiares associados ao sobrepeso infantil, ainda controversos na literatura. MÉTODOS: Estudo transversal realizado com 627 crianças, de 6 a 10 anos, matriculadas em escolas urbanas públicas e privadas do município de Viçosa (MG). O estado nutricional das crianças foi classificado pelo índice de massa corporal, segundo a preconização do Centers for Disease Control and Prevention. Foram aferidas as medidas de peso, estatura, pregas cutâneas tricipital e subescapular, circunferências da cintura e do quadril e pressão arterial das crianças, sendo os fatores ambientais obtidos por meio de questionário, segundo informações maternas. Classificou-se o estado nutricional das mães segundo a recomendação do World Health Organization. RESULTADOS: Do total de crianças, 87,9% eram eutróficas e 12,1% apresentavam sobrepeso. De acordo com a análise de regressão logística múltipla, os fatores associados ao sobrepeso infantil foram apresentar mãe obesa (OR: 6,92; p<0,001), ser filho unigênito (OR: 1,87; p=0,03), permacer tempo superior a 3 horas diárias em frente à televisão (OR: 1,91; p=0,04), não realizar educação física na escola (OR: 4,80; p=0,02) e ser do sexo masculino (OR: 2,60; p=0,001). CONCLUSÃO: Este estudo permite elucidar a identificação de fatores ambientais, potencialmente modificáveis, associados ao sobrepeso infantil no município de Viçosa. A determinação dos fatores ambientais é importante, uma vez que o aumento na prevalência do sobrepeso na infância não pode ser totalmente explicado pelos fatores genéticos.<br>OBJECTIVE: The objective of this study was to assess intrauterine, perinatal and family factors associated with childhood overweight, which are still controversial in the literature. METHODS: This cross-sectional study included a total of 627 children aged 6 to 10 years, who were enrolled in public and private schools in the city of Viçosa, Minas Gerais State. The nutritional status of the children was classified according to their body mass index, as recommended by the Centers for Disease Control and Prevention. The following data were collected: weight, height, tricipital and subscapular skinfold thicknesses, circumferences of the waist and hip, and blood pressure. The environmental factors were determined by means of a questionnaire, answered by the mother. The nutritional status of the mothers was classified according to the World Health Organization criteria. RESULTS: Out of 627 children, 551 were normal weight children and 76 were overweight. According to multiple logistic regression analysis, the following factors were associated with childhood overweight: maternal obesity (OR: 6.92; p<0.001); being an only child (OR: 1.87; p=0.03); watching television for more than 3 hours per day (OR: 1.91; p=0.04); not practicing physical education at school (OR: 4.80; p=0.02) and being male (OR: 2.60; p=0.001). CONCLUSION: This study elucidated the potentially modifiable environmental factors associated with childhood overweight in the city of Viçosa. The determination of the environmental factors is important, since the increased prevalence of childhood overweight cannot be fully explained by genetic factors

Breastfeeding Versus Formula-Feeding and Girls’ Pubertal Development

OBJECTIVE: To examine the association of breastfeeding or its duration with timing of girls’ pubertal onset, and the role of BMI as a mediator in these associations. METHODS: A population of 1,237 socio-economically and ethnically diverse girls, ages 6–8 years, was recruited across three geographic locations (New York City, Cincinnati, and the San Francisco Bay Area) in a prospective study of predictors of pubertal maturation. Breastfeeding practices were assessed using self-administered questionnaire/interview with the primary caregiver. Girls were seen on at least annual basis to assess breast and pubic hair development. The association of breastfeeding with pubertal timing was estimated using parametric survival analysis while adjusting for body mass index, ethnicity, birth-weight, mother’s education, mother’s menarcheal age, and family income. RESULTS: Compared to formula fed girls, those who were mixed-fed or predominantly breastfed showed later onset of breast development (Hazard Ratios 0.90 [95% CI, 0.75–1.09] and 0.74 [95% CI, 0.59–0.94], respectively). Duration of breastfeeding was also directly associated with age at onset of breast development (p trend = 0.008). Associations between breastfeeding and pubic hair onset were not significant. In stratified analysis, the association of breastfeeding and later breast onset was seen in Cincinnati girls only. CONCLUSION: The association between breast feeding and pubertal onset varied by study site. More research is needed about the environments within which breastfeeding takes place in order to better understand whether infant feeding practices are a potentially modifiable risk factor that may influence age at onset of breast development and subsequent risk for disease in adulthood