50 anos de residência médica do Departamento de Puericultura e Pediatria da Faculdade de Medicina de Ribeirão Preto da USP

The article presents the history of fifty years of the Pediatric Residency Training Program of Child Care and Pediatrics Department of School of Medicine of Ribeirão Preto of University of São Paulo, started in 1957, highlighting historical aspects, the number of places offered and the residents who have lawfully pursued activities by the year 2006.O artigo apresenta a trajetória de cinqüenta anos do Programa de Residência Médica do Departamento de Puericultura e Pediatria da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, que foi iniciado em 1957, destacando seus aspectos históricos, o número de vagas oferecidas e de médicos residentes que nele exerceram atividades, até o ano de 2006

Caring for Overweight Children and Adolescents at a Reference Clinic in Nutrology: Habits and Attendance

Introduction: The global obesity epidemic has mobilized health services to offer care at all levels, with reference outpatient clinics playing a prominent role in cases of greater complexity. Objectives: The present study aimed to identify soft drinks consumption and physical activity habits among children and adolescents diagnosed with overweight and obesity during the first visit at a secondary level nutrology outpatient clinic, and to verify attendance at follow-up visits in a 2-year period from the first visit. Materials and Methods: This is a retrospective, descriptive study based on data collection from medical records of overweighted or obese patients receiving first care at the Nutrology Clinic of the Municipal Health Secretariat from Ribeirão Preto, São Paulo, Brazil. The study population included children and adolescents aged between 2 and 18 years old cared for from January 2, 2013 to December 30, 2017. Age, weight, height, soft drinks consumption, physical activity, and attendance in scheduled follow-up visits during a 2-year period were analyzed. Results: During the study period, 316 patients were registered, including 302 (95.5%) diagnosed with obesity. Of these, 112 (35.4%) were children and 204 (64.6%) were adolescents. Only 2.0% of the children and adolescents did not consume soft drinks, while 23.5 and 26.2% of the children and adolescents, respectively, consumed them daily. Physical inactivity was reported by 31.8% of the children and by 35.8% of the adolescents. Among those who practiced some type of physical activity, 81.3% of the children and 78.2% of the adolescents did not meet the recommendation of moderate to vigorous activity for 60 minutes per day. Dropout rates within the 1st year were of 41.9% for children and of 34.3% for adolescents, increasing to 76.9% and 73.8%, respectively, within the 2nd year. Conclusion: There was a high consumption of soft drinks and low adherence to physical activity among patients who started outpatient follow-up. A small adherence to the follow-up program was also identified, with high dropout rates within the 2-year period following the first visit

Hábitos e consumo alimentar entre adolescentes eutróficos e com excesso de peso

Objetivo: Avaliar os hábitos e o consumo alimentar de adolescentes matriculados em duas escolas públicas da região oeste da cidade de Ribeirão Preto (SP). Método: Estudo tipo casocontrole que analisou o consumo alimentar de adolescentes eutróficos e com excesso de peso, pareados por idade e sexo, utilizando questionários de frequência alimentar e registro alimentar de 3 dias, comparados com o Guia Alimentar para a População Brasileira e analisados peloSoftware Virtual Nutri. Resultados: a média de idade dos 130 adolescentes estudados foi 196,8 meses. As médias de IMC e de porcentagem de gordura corporal foram de 29,5 e 49,4% e 21,0 e 29,1% para os grupos de excesso de peso e eutróficos, respectivamente (p < 0,01). Entre os eutróficos a média de ingestão diária foi 1915,5 calorias, enquanto os adolescentes com excesso de peso ingeriram 1761,8 calorias. A maioria dos adolescentes realizou as três refeições principais: café da manhã (86%), almoço (98,9%) e jantar (96,8%). Para os adolescentes eutróficos os percentuais médios de energia consumidos foram de 56,7% para carboidratos, 15,4% para proteínas, e 27,9% para lipídeos, enquanto que o grupo com excesso de peso consumiu 52,7%, 17,1% e 30,2%, respectivamente. Conclusões: o hábito alimentar dos adolescentes vem sendo modificado, com o consumo cada vez maior de alimentos com pequena contribuição nutricional e que podem trazer grandes prejuízos à saúde, daí a necessidade da atuação dos profissionaisda saúde no sentido de orientar e sensibilizá-los para a importância de medidas que contribuam para a adoção de um estilo de vida saudável.Objective: to know the food intake of eutrophic and overweight adolescents. Methods: casecontrol study that analyzed the food intake and habits of adolescents with normal weight and overweight, matched for age and sex, using a food frequency questionnaire and food diaries for 3 days, compared with the Food Guide for the Brazilian Population and analyzed by the software Virtual Nutri. Results: Mean body mass index (BMI) and percent body fat were 29.5 and 49.4 for the overweight  group and 21.0% and 29.1% for the normal group, respectively (p < 0.01). Among normal individuals the average daily intake of calories was 1915.5 while overweight adolescents consumed 1761.8 calories. Most adolescents ate the three main meals: breakfast (86%), lunch (98,9%) and dinner (96.8%). For eutrophic teenagers the average percentage of energy consumed was 56.7% for carbohydrates, 154% for proteins and 27.9% for lipids, while the overweight group consumed 52.7%, 17.1% and 30.2%, respectively. Conclusions: the study showed that both groups of adolescents consume the same types and similar amounts of foods, except when considering the group of cereals, roots and tubers whose consumption was higher among eutrophic adolescents (p < 0.01)

Eating habits and practice of physical activity among eutrophic and overweight adolescents

OBJECTIVES: To assess the eating habits and physical activity of adolescents enrolled in two public schools in the city of Ribeirão Preto (SP). METHODS: A case-control study was conducted to analyze the eating habits and practice of physical activity of a group of overweight adolescents and of a eutrophic control group matched for sex and age. The International Physical Activity Questionnaire (IPAQ short version) and a semi-quantitative food frequency questionnaire were applied and a 3-day food record was obtained. The nutritive value of the foods consumed was calculated with the Virtual Nutri® software. Body fat was estimated using the equations of Slaughter et al. Data were analyzed statistically by ANOVA and by the Fisher exact test. RESULTS: Fifty-one (44.7%) overweight and 63 (55.2%) eutrophic adolescents were studied. Mean BMI was 29.5 for the overweight group and 21.0 for the eutrophic group, and percent body fat was 49.4 and 29.1, respectively (p<0.01-ANOVA). The daily calorie intake of the eutrophic adolescents consisted of 56.7% carbohydrates, 15.4% proteins and 27.9% lipids and the intake of the overweight group was 52.7%, 17.1% and 30.2%, respectively. In the eutrophic group, 28.6% were considered to be very active and 60.3% active and in the overweight group these values were 23.5% and 70.6%, respectively. CONCLUSIONS: Information about the eating and physical activity habits of adolescents is of fundamental importance for subsidizing individual and community actions. Although adolescents report apparently adequate physical activity and calorie consumption, health professional should be aware of the high rates of overweight and obesity detected in this age range

Adolescent and puericulture

A partir do século XIX a adolescência passa a despertar grande interesse na sociedade em virtude do processo de desenvolvimento econômico, científico e social, o que impulsiona a criação de serviços de saúde direcionados ao atendimento dos indivíduos na segunda década de vida. Este artigo apresenta um breve histórico da Puericultura, da consolidação da Hebiatria e destaca a importância dos programas de atendimento em atenção básica à saúde do adolescente. Apoiado em alguns textos clássicos sobre o tema, procurou-se traçar um paralelo com os pioneiros programas de atendimento em puericultura para as crianças no sentido de incentivar as ações de prevenção de agravos e promoção da saúde dos adolescentes em nível primário, como estratégia para garantir boas condições de vidaFrom the nineteenth century, adolescence becomes aroused great interest in the society due to the process of economic, scientific and social development, which drives the creation of health services directed to the care of the people in the second decade of life. This article presents a brief history of Puericulture, the consolidation of Hebiatria and highlights the importance of services in an adolescent primary health care. Supported in some classic texts on the subject, it drew a parallel with the pioneer's paediatric health programs, to encouraging the actions of prevention and promotion of adolescent health at the primary level as a strategy to ensure healthy living condition

Epidemiological and Clinical Characteristics of Pediatric and Adolescent Obesity Enrolled in a Tertiary Referral Center

Objective: To describe some demographic, clinical and laboratory characteristics of obese children and adolescents admitted in an obesity ambulatory of a referral center located in the southeastern region of Brazil. Methods: This is a cross-sectional and observational study and the data (age, gender, type of delivery, birthweight, age of birth, breastfeeding, laboratory tests and maternal body mass index [BMI]) were collected from medical records. Results: The study included 89 patients, of which 45 (50.6%) were male. The mean age was 68.9 months, 50 (55.6%) were first-born, 51 (57.3%) were exclusively breastfed during the 1st 6 months of life, and 18 (20.1%) did not receive breast milk. The mean age of the mothers was 29 years old, 87 (98%) did prenatal assistance, and 69 (77.6%) had a BMI > 25 kg/m2. The results also showed that cesarean delivery (42.6%), low birthweight (6.7%), prematurity (8.7%) and early introduction of artificial food (20.1%) was not predominant among the patients. A total of 25 (28%) subjects had total cholesterol > 170 mg/dL, 35 (39.3%) with LDL-cholesterol > 110 mg/dL, 34 (38.2%) had HDL-cholesterol < 40 mg/dL, and 6 (6.7%) with triglycerides > 130 mg/dL. All of the patients had at least one altered biochemical test. Conclusion: Healthy lifestyle promotion should be included in every pediatric primary care program, and all children should receive counseling about healthy nutrition and physical activity since birth. Reducing childhood obesity is a major public health priority and primary prevention programs are a critical part to address the problem

Characteristics of sleep habits among adolescents living in the city of Ribeirão Preto (SP)

Introduction: Adolescence is the period of transition between childhood and adult life, characterized by changes in physical, emotional, sexual and social development. Although during this phase most individuals are healthy, it is known that health status is related to behaviors and habits such as a healthy diet, the regular practice of physical activity and good sleep quality, which contribute to optimum physical and cognitive performanceObjective: To determine some sleep characteristics of adolescents living in the city of Ribeirão Preto (SP).Methods: this was a cross-sectional descriptive study conducted at 14 schools in the city of Ribeirão Preto (SP) including adolescents aged 10 to 19 years who answered a questionnaire about sleep habits. The chi-square test was used to determine differences between genders with the aid of the EPI-INFO 7 software, with the level of significance set at p<0.05.Results: A total of 535 adolescents (65% girls) were included in the study. Of these, 47.7% studied during the morning period and 10.3% had a job and studied in the evening period. Regarding sleep duration, 242 (45%) slept less than 9 hours per night during week days and 256 (48%) during the weekends (Saturday and Sunday), Of the total number of adolescents studied, 75.5% reported that they went to bed when they felt sleepy, 90% reported delay in falling asleep, 84.3% used some type of electronic equipment before going to sleep, and 44% reported that they woke up during the night. In the morning, 70.3% needed to be awakened, and 44.7% reported a delay in waking up. During the daytime, 70% felt somnolent and 34% reported that they slept during the day. Girls reported that they felt more daytime sleepiness (71.3%) and slept more during the day (62.1%) than boys (28.7% and 37.9%, respectively), with the difference being statistically significant (p < 0.05).Conclusions: Almost half the adolescents investigated sleep less than the minimum time considered ideal. Furthermore, the most of adolescents went to the bed when they felt sleepy, used electronic devices before to sleep, had difficulties to fall asleep, need to be awake in the morning and felt sleepy during the day. A substantial proportion of adolescents studied awoke at night and slept during the day. Compared to boys, girls felt sleepy and slept during the day significantly.