WAIST/HEIGHT RATIO: A MARKER OF NUTRITIONAL ALTERATION IN PRESCHOOL CHILDREN

Introduction: The prevalence of obesity in Brazil is progressively increasing among children. In obese individuals, the concentration of fat in the abdominal region is a predictive marker for future health problems. Among the indicators of central adiposity, the waist-to-height ratio (WHR) has been shown to be more sensitive for predicting future health hazards than waist circumference alone. Objective: To analyze the relationship between the WHR and the classification of nutritional status of preschool children. Methods: A cross-sectional study with 711 preschool children in daycare in Taubate, SP. The sampling was probabilistic, having the nursery as the sampling unit. The weight, height and waist circumference of each child were measured. For classifying children with excess weight (risk of overweight, overweight or obesity), or with overweight or obesity the cut-off points of the Z-scores of Body Mass Index (zBMI), proposed by the Ministry of Health (2009), were used, from the point of view of the World Health Organization. The data were analyzed using the ROC (Receiver Operator Curve). Results: The area under the curve (AUC) of WHR for excess weight was 0.851 (p< 0.0001), and for overweight or obesity together was 0.886 (p< 0.0001). Values of 0.52 and 0.54 of the WHR were the cut-off points for optimization of Sensitivity/Specificity respectively for excess weight or overweight or obesity. Conclusion: The WHR is a useful tool in basic health care for children at the beginning of preschool age, for the assessment of nutritional status and central adiposity

Mothers’ conceptions about excess weight in infancy and the nutritional status of their children

OBJECTIVE: To analyze maternal conceptions about excess weight in infancy and the nutritional status of their preschool-aged children. METHODS: A mixed, exploratory study was performed using semi-structured interviews. Two study groups were defined: a group of 16 mothers of children with excess weight and a group of 15 mothers of eutrophic children. The interviews were submitted to content analysis using CHIC software (Classification Hiérarchique Implicative et Cohésitive¯). RESULTS: The mothers of children with excess weight tended to conceive thin children as malnourished, while those of normal weight children emphasized the influence of family and genetics as determinants of a child’s nutritional status. Although there was a certain consensus among the mothers that an unhealthy diet contributes to the risk of a child developing excess weight, the concept of genetics as a determinant of a child’s nutritional status was also present in the dialogue from the mothers of both groups. This result indicates a lack of clarity regarding the influence of eating behavior and family lifestyle on weight gain and the formation of a child’s eating habits. Both groups indicated that the mother has a decisive role in the eating habits of her child; however, the mothers of children with excess weight did not seem to take ownership of this concept when addressing the care of their own children. CONCLUSION: Differences in conceptions, including taking ownership of care, may contribute to the development of excess weight in preschool-aged children

The Mitigation Potential of Buffer Strips for Reservoir Sediment Yields: The Itumbiara Hydroelectric Power Plant in Brazil

Soil erosion and deposition mechanisms play a crucial role in the sustainability of both existing reservoirs and newly planned projects. Soil erosion is one of the most important factors influencing sediment transport yields, and, in the context of existing reservoirs, the surrounding watersheds supply both runoff and sediment yield to the receiving water body. Therefore, appropriate land management strategies are needed to minimize the influence of sediment yields on reservoir volume and, hence, the capacity of power generation. In this context, soil erosion control measures such as buffer strips may provide a practical and low-cost option for large reservoirs, but need to be tested at the catchment scale. This paper represents a study case for the Itumbiara hydroelectric power plant (HPP) in Brazil. Four different scenarios considering radially planted buffer strips of Vetivergrass with widths of 20 m, 40 m, 100 m and 200 m are analyzed. A semi-distributed hydrological model, SWAT, was used to perform the simulations. Results indicate a reduction of sediments transported to the reservoir of between 0.2% and 1.0% per year is possible with buffer strip provision, and that this reduction, over the life of Itumbiara HPP, may prove important for lengthening the productivity of the plant

Aleitamento materno, alimentação complementar, sobrepeso e obesidade em pré-escolares

OBJECTIVE: To analyze the association of overweight and obesity with breastfeeding and complementary feeding in pre-school children. METHODS: Cross-sectional study with 566 children, enrolled in private schools of the city of São Paulo, Southeastern Brazil, in 2004-2005. The dependent variable was overweight and obesity. Body Mass Index percentile curves were employed to classify children's nutritional status, considering values e"P85 andOBJETIVO: Analizar la asociación del sobrepeso y de la obesidad con el amamantamiento materno y la alimentación complementaria en preescolares. MÉTODOS: Estudio transversal envolviendo 566 niños matriculados en escuelas privadas en el municipio de Sao Paulo (Sureste de Brasil), 2004-2005. La variable dependiente fue sobrepeso y obesidad. Para la clasificación del estado nutricional de los niños fueron utilizadas las curvas de percentiles del índice de masa corporal para edad, clasificando como sobrepeso valores ?P85 yOBJETIVO: Analisar a associação do sobrepeso e da obesidade com o aleitamento materno e a alimentação complementar em pré-escolares. MÉTODOS: Estudo transversal envolvendo 566 crianças matriculadas em escolas particulares no município de São Paulo, SP, 2004-2005. A variável dependente foi sobrepeso e obesidade. Para a classificação do estado nutricional das crianças foram utilizadas as curvas de percentis do Índice de Massa Corporal para idade, classificando como sobrepeso valores e"P85

INFANT GROWTH DURING THE FIRST YEAR OF LIFE

Objective: The aim of this study was to describe and analyse the profile of growth in normal infants during the first year of life, including their patterns of weight and length, and the duration of breastfeeding. Methods: This is a retrospective cohort study conducted based on 85 records of infants who met the inclusion criteria. The total duration of breastfeeding was recorded along with weight and length at three ages: birth, 6 and 12 months. The data were analysed as Z-scores based on WHO (2006) using the software products MedCalc 12.0 and GraphPad Prism 6.0. Results: Although 76.5% of the infants showed a growth pattern compatible with WHO references at 12 months of age, the others presented as overweight as at risk of being overweight. A significant correlation was observed between birth weight and BMI Z-score at two ages: 6 months (r = 0.26; p = 0.01) and 12 months (r = 0.32; p = 0.002). A correlation between birth weight and length Z-score was also found at 6 months (r = 0.4034; p = 0.0001) and 12 months (r = 0.3309; p = 0.002). Birth length was also correlated with length Z-score at 6 months (r = 0.4829; p<0.0001) and 12 months (r = 0.3407; p = 0.0014). Breastfeeding duration did not show any correlation with anthropometric data at 6 and 12 months of age. Conclusion: The growth pattern of the sample during the first year of life was found to be appropriate or faster than normal. Growth pattern also seems to be influenced by anthropometric characteristics at birth, which does not depend on breastfeeding duration

Prevalence of overweight and obesity in two to six year old children registered in private schools in São Paulo

OBJETIVO: verificar a prevalência de sobrepeso e obesidade segundo sexo e idade em crianças de 2 a 6 anos de idade, alunos de escolas particulares no município de São Paulo. MÉTODO: foram realizadas medidas de peso e de altura para verificação do estado nutricional de oitocentos e seis crianças de ambos os sexos. Para a classificação do estado nutricional das crianças foram utilizadas as curvas de percentis do Índice de Massa Corporal (IMC = Peso (kg) / Altura² (cm)) para idade, conforme padrão de referência do Multicentre Growth Study, recomendado pela Organização Mundial de Saúde que classifica como sobrepeso valores de percentis >; 85 e < 97 e para a obesidade valores < 97. Para análise da relação entre sexo, idade da criança e estado nutricional utilizou-se modelo linear generalizado de regressão múltipla (glm) com ligação logarítmica e família binomial, que permite, diretamente, a estimação das razões de prevalências. A prevalência de sobrepeso+obesidade foi 37,2% para o sexo masculino e 33,4% para o sexo feminino. A razão de prevalência (RP) mostrou que não existe diferença significativa entre obesidade e sobrepeso+obesidade para sexo e idade. CONCLUSÃO: observaram-se prevalências de sobrepeso e de obesidade superiores às prevalências médias da população brasileira. Os resultados encontrados neste estudo reforçam a preocupação com a obesidade infantil que aparentemente vem crescendo, em idades mais precoces como dos pré-escolares.To verify the prevalence of overweight and obesity according to gender and age in two to six years old children registered in private schools of São Paulo. METHODS: the measured of weight and height in order to assess the nutritional state of eight hundred and six children from both sexes. In order to perform the classification of the nutritional state of children we used the percentiles curves of Body Mass Index (BMI = Weight (kg) / Height (cm)²) for age as reference standard of Multicentre Growth Study, currently recommended for the World Health Organization that classifies as overweight the percentiles values e" 85 to ; 97. In order to analyze the relation between sex, age and nutritional status we used the linear model generalized of multiple regressions (glm) with logarithmic relating, and binomial family, which provides, directly, the value of the ratios of prevalence (RP). RESULTS: The prevalence of overweight + obesity was 37.2% for male and 33.4% for female children. The prevalence ratios (PR) showed that a significant difference between obesity and overweight + obesity for sex and age does not exist. CONCLUSION: Prevalence of overweight and obesity superior than the average prevalence of the Brazilian population were observed. The results found in this study strengthen the concern with the infantile obesity that apparently is increasingly growing in precocious ages as of the preschool ones children

Historical streamflow series analysis applied to furnas HPP reservoir watershed using the SWAT model

Over the last few years, the operation of the Furnas Hydropower Plant (HPP) reservoir, located in the Grande River Basin, has been threatened due to a significant reduction in inflow. In the region, hydrological modelling tools are being used and tested to support decision making and water sustainability. In this study, the streamflow was modelled in the area of direct influence of the Furnas HPP reservoir, and the Soil and Water Assessment Tool (SWAT) model performance was verified for studies in the region. Analyses of sensitivity and uncertainty were undertaken using the Sequential Uncertainty Fitting algorithm (SUFI-2) with a Calibration Uncertainty Program (SWAT-CUP). The hydrological modelling, at a monthly scale, presented good results in the calibration (NS 0.86), with a slight reduction of the coefficient in the validation period (NS 0.64). The results suggested that this tool could be applied in future hydrological studies in the region of study. With the consideration that special attention should be given to the historical series used in the calibration and validation of the models. It is important to note that this region has high demands for water resources, primarily for agricultural use. Water demands must also be taken into account in future hydrological simulations. The validation of this methodology led to important contributions to the management of water resources in regions with tropical climates, whose climatological and geological reality resembles the one studied here

Secular trend of growth of preschool, Brazil

INTRODUÇÃO: a análise da distribuição temporal de eventos do processo saúde-doença é uma das estratégias de investigação mais antigas e valiosas para a epidemiologia e para a saúde pública. OBJETIVO: analisar a evolução do perfil antropométrico de pré-escolares, que frequentavam creches municipais da cidade de Taubaté em 1997 e 2007. MÉTODO: foram analisadas variáveis do banco de dados de 2 estudos transversais: um realizado em 1997, com 755 crianças, e outro de 2007, com 1448 crianças. Os dados analisados foram: idade da criança, sexo, peso, estatura e índice de massa corporal (IMC). A transformação dos valores antropométricos em escores Z foi realizada pelo referencial do CDC/NCHS (2000). As comparações entre os dois momentos foram feitas pelo χ-quadrado e pelo teste t-Student, (α = 0,05). RESULTADOS: evidenciou-se tendência de crescimento positiva entre 1997 e 2007 com um aumento significante nos valores médios de escore Z de estatura em ambos os sexos, meninos: 0,04 para 0,39 e meninas: 0,05 para 0,33, e de peso, meninos; -0,03 para 0,26 e meninas: 0,03 para 0,21. As médias de IMC não revelaram diferença significante (meninos de - 0,02 para 0,07 e meninas de 0,09 para 0,12). Observou-se também, entre 1997 e 2007, um aumento na prevalência de crianças emagrecidas, de 9,8 para 12,6% e de crianças com excesso de peso, de 17,0 para 20,9%. CONCLUSÃO: os pré-escolares da cidade de Taubaté tiveram uma tendência secular de crescimento bastante significativa entre 1997 e 2007, mais de estatura do que de peso, que se acompanhou de um aumento na prevalência de crianças emagrecidas e, principalmente, com excesso de peso. Isso indica que, possivelmente, a melhoria das condições de bem estar da população, além de repercutir positivamente no crescimento estatural dos pré-escolares, também pode resultar na instalação de um intenso e precoce processo de transição nutricional, inclusive fora das grandes regiões metropolitanas.INTRODUCTION: the analysis of the temporal distribution of events in the health-disease process is one of the strategies of the oldest and most valuable research in epidemiology and public health. OBJECTIVE: To analyze changes in the anthropometric profile of preschool children that frequented public day-care centers of Taubate, Brazil. METHOD: 755 children in 1997 and 1448 in 2007 were evaluated. The study variables were: age, sex, weight, stature and body mass index (BMI). The transformation of the anthropometric values in Z scores was carried through the reference data of the CDC/NCHS (2000). The comparisons between the two moments were made by χ-squared and t-Student tests (α = 0,05). RESULTS: positive secular trend of growth was observed between 1997 and 2007 with a significant increase in the average values of Z scores of stature in both sexes, boys: 0,04 to 0,39 and girls: 0,05 to 0,33, and of weight, boys; -0,03 to 0,26 and girls: 0,03 to 0,21. The averages of BMI showed no significant difference (boys 0,02 to 0,07 and girls 0,09 to 0,12). There was an increase of thinness prevalence, 9,8 to 12,6% children, and also of weight excess, 17,0 to 20,9%, between 1997 and 2007. CONCLUSIONS: Preschool children from the city of Taubaté showed a quite significant increase in the growth trend between 1997 and 2007, more height than weight, which was accompanied by an increased prevalence of thin children and especially overweight. This indicates that possibly the improvement of the population, and impact positively on growth in stature of preschool children, can also result in the installation of an early and intense nutritional transition process, even outside the major metropolitan areas

FACTORS ASSOCIATED WITH INFANT MORTALITY IN THE METROPOLITAN REGION OF CARIRI, CEARÁ, BRAZIL

Introduction: The identification of factors related to children’s deaths is very important in planning public health actions for restructure and improve the mother and child assistance, aimed in reducing child mortality. Objective: Analyze the factors associated with infant mortality in the metropolitan area of Cariri, Ceará, Brazil. Method: This is a cross-sectional study. All deaths occurring in children under one year old of the metropolitan region of Cariri, Ceará, Brazil, contained in the mortality information system and in live births’s information system, from January 2009 to December 2013. Newborn variables (sex, race/color, weight, age); maternal variables (maternal age and education and type of gestation); assistance variables (labor type) were extracted from the SUS (Sistema Único de Saúde/Unified Health System) Informatics Department and presented in chart and tables in absolute and percentage frequency form. Results: In the five-year period, 816 infant deaths in 48321 births were registered associated to the following factors: 453 (55.5%) male, 471 (57.7%) drab and 514 (63%) low weight in birth, 458 (56.1%) with 20 to 34 years of age, 353 (43.2%) 8 years or more of schooling, 657 (80.5%) only pregnancy and 414 (50.7%) vaginal birth. Conclusion: Infant mortality variables in the metropolitan region of Cariri, Ceará, Brazil were associated mostly with deaths occurring in drab boys with birth weight below the normal, whose mothers were young, with good education and who had just one gestation, born of vaginal birth