A perceção que os pais têm do peso dos filhos pode influenciar a adoção de comportamentos saudáve... more A perceção que os pais têm do peso dos filhos pode influenciar a adoção de comportamentos saudáveis. O objetivo deste trabalho foi observar a perceção que os pais têm do peso dos filhos em dois períodos (2009 -2010 e 2016 -2017) e em vários subgrupos da população. Os dados foram recolhidos no âmbito de dois projetos nacionais (2009 -2010: n = 6577; 2016 -2017: n = 7594), em infantários e escolas primárias, públicas e privadas, em Portugal continental (crianças entre os três e os 10 anos). Através de um questionário, os pais descreveram os filhos em relação ao peso atual: 1) muito magro, 2) magro, 3) normal, 4) com algum peso a mais, ou 5) com muito peso em excesso. A altura e o peso das crianças foram recolhidos objetivamente e os pontos de corte da International Obesity Task Force foram usados para classificar o estado nutricional da criança. A acuidade da perceção parental foi calculada de acordo com o sexo, a idade, e o peso da criança, assim como com o peso dos pais; as diferenças entre os dois períodos foram registadas.
ObjectivesThis study aimed to describe the relationship between body size, form, and composition,... more ObjectivesThis study aimed to describe the relationship between body size, form, and composition, and children's lifestyle on health‐related quality of life (HRQoL).MethodsThis cross‐sectional study comprised 1333 children (9.05 ± 0.75 years; 683 females) living in mainland Portugal. Objective anthropometric measures were collected. Parents answered a standardized questionnaire related with children's lifestyle (e.g., sport participation, screen‐ and sleep‐time) and family socioeconomic status (e.g., parental education). HRQoL was measured using the Portuguese version of the KIDSCREEN‐27. Scores were categorized into low and high using a sex‐specific normative cut‐off from European children. A healthier score was created including positive scores for body weight, abdominal obesity, sport participation, sleep‐ and screen‐time.ResultsBody size, form and composition were correlated with children's physical wellbeing. However, sex differences were found in which parameters were associated with wellbeing. Among boys, the body mass index, waist circumference, waist‐to‐height ratio, subscapular and suprailiac skinfold were most correlated with wellbeing, while waist circumference and subscapular skinfold showed the strongest correlations for girls. Sleep duration and sport participation revealed a significant relationship with girls' HRQoL. A logistic regression analysis (adjusted for parental education) revealed that boys scoring 4 or 5 in the healthier index had an increased likelihood of high HRQoL level compared to those fulfilling none.ConclusionsFuture programs aimed at reducing obesity, particularly central obesity, and incorporating multiple health indicators and behaviors, such as sport participation and sleep duration may help improve children's health and wellbeing.
ObjectivesOur objective was to examine the relationship between the 2008 and 2015 economic crisis... more ObjectivesOur objective was to examine the relationship between the 2008 and 2015 economic crisis and children's physical activity (PA) outcomes, eating behaviors and obesity prevalence, while considering sex inequalities and familial socioeconomic status.MethodThis is a cross‐sectional study, including data collected in 2016/2017 among 5134 children aged 6–11 years (mean age: 8.11 ± 1.24; 50.0% boys). Children's height, weight, and waist circumference were objectively measured. Children's sleep‐ and screen‐time, participation in organized sports, and specific dietary habits were reported parental‐reported using a standardized questionnaire. An economic crisis impact score, with data from 10 indicators of economic needs in the family, was used to characterize the crisis' impact.ResultsFirst, the prevalence of overweight and obesity was higher in children whose families had a higher impact of the crisis. Second, children's intake of fruit and high‐fat food, screen‐time, sleep‐time, and participation in organized sports differed according to the level of impact of the economic crisis. Third, the association between health‐related behaviors and the impact of the economic crisis was stronger for girls compared to boys.ConclusionOur findings give us an indication of how economic crises may drive changes in health outcomes.
ObjectivesWe evaluated, for the first time in Portugal, the prevalence of overweight and obesity ... more ObjectivesWe evaluated, for the first time in Portugal, the prevalence of overweight and obesity according to parental education in a population of preschool‐aged Portuguese children in 2009/2010 and 2016/2017.MethodsAnthropometric data were collected in public and private preschools (n = 1996 in 2009/2010; n = 2077 in 2016/2017). Body mass index was calculated and weight status categories were based on the International Obesity Task Force cutoff points. Parental education level was self‐reported.ResultsPrevalence of overweight (17.1%–14.1%; p < 0.001) and obesity (6.6%–3.9%, p < 0.001) was lower in 2016/2017 than in 2009/2010, with higher rates being found in the north of the country. Parental education was significantly associated with childhood overweight and obesity and inequalities between low‐ and high‐education increased between the two periods.ConclusionsWhile a decrease in childhood overweight and obesity were positive findings, the prevalence is still high and shows pronounced socioeconomic differences. Policies for obesity prevention need to be inclusive and tackle inequalities, with interventions tailored to suit local contexts.
Objective: This study aims to analyze gender-specific associations between sports activity outsid... more Objective: This study aims to analyze gender-specific associations between sports activity outside of school and obesity, observing to what extent the local built environment contributes to the patterns found. Methods: A total of 2253 children aged 6.0-11.0 years were assessed: 49.3% girls and 50.7% boys. Children's weight and height were measured, age and sex-specific BMI cut-off points were used to define normal vs overweight/obesity. Children's organized sports (OS) activity was assessed by questionnaire, and local facilities for children's engagement in OS were analyzed. Logistic regression models were computed, adjusted for confounding variables. Results: Results showed greater overweight and obesity (25.1% vs 20.1%) and lower OS engagement (66.5% vs 73.8%) in girls as well as greater impact of OS engagement on weight status in girls (OR for having a normal weight = 1.434 in girls vs 1.043 in boys). Additionally, opportunities to engage in OS were scarce for girls. Conclusions: The gender gap in children's weight status and OS engagement might
American journal of biological anthropology, Apr 3, 2023
ObjectivesWe investigate associations between children exposure to stressful events, considering:... more ObjectivesWe investigate associations between children exposure to stressful events, considering: (1) the period in which the event took place, (2) the type of event, and (3) the cumulative effect of the events on children's weight, height and body mass index (BMI).MethodsA total of 8429 Portuguese children (3349 exposed to at least one stressful event during their lifetime; 50.2% males; mean age = 7.21 ± 1.85 years) were included in the analysis. The occurrence of stressful (i.e., adverse) events was reported in a parental questionnaire; children's weight and height were objectively measured.ResultsWhen the stress event took place in the first 2 years of life, compared with during pregnancy or after the 2 years, children were shorter; but the association was weak and only significant for boys. After adjustment for child's birthweight, gestational age, breastfeeding duration, number of siblings, and father's education, the experience of 3+ stressful events (vs. 1 or 2) was associated with higher weight and height in boys. No interaction effect was found between stress and BMI.DiscussionWe found some evidence of associations between exposure to stressful events and physical growth of boys. We highlight the complex relationship between exposure to stressful experiences and children's physical growth, particularly the different effects of specific characteristics of the stress event and the sex differences.
Background: Obesity is a significant global public health problem and the main cause of many chro... more Background: Obesity is a significant global public health problem and the main cause of many chronic diseases in both developed and developing countries. The increase in obesity in different populations worldwide cannot be explained solely by metabolic and genetic factors; environmental and social factors also have a strong association with obesity. Thus, it is believed that the current obesity epidemic is the result of a complex combination of genetic factors and an obesogenic environment .The purpose of this study was to evaluate individual variables and variables within the built and social environment for their potential association with overweight and obesity in an urban Brazilian population. Methods: Cross-sectional study was carried out in a sample of 3404 adults living in the urban area of the city. Information from the surveillance system for chronic diseases of Brazilian Ministry of Health was used and individual data was collected by telephone interviews. The database was geocoded using the Brazilian System of Postal Codes for participant residences. An updated, existing list based on the current addresses of supermarkets and hypermarkets in the city was used as an indicator variable of the availability and access to food. Georeferenced information on parks, public squares, places for practicing physical activity and the population density were also used to create data on the built environment. To characterize the social environment, we used the health vulnerability index (HVI) and georeferenced data for homicide locations. Results: The prevalence was 44% for overweight, poisson regression was used to create the final model. The environment variables that independently associated with overweight were the highest population density, very high health vulnerability index and the homicide rate adjusted for individuals variables. The results of the current study illustrate and confirm some important associations between individual and environmental variables and overweight in a representative sample of adults in the Brazilian urban context. The social environment variables relating to the socioeconomic deprivation of the neighborhood and the built environment variables relating to higher walkability were significantly associated with overweight and obesity in Belo Horizonte.
ObjectivesWe evaluated, for the first time in Portugal, the prevalence of overweight and obesity ... more ObjectivesWe evaluated, for the first time in Portugal, the prevalence of overweight and obesity according to parental education in a population of preschool‐aged Portuguese children in 2009/2010 and 2016/2017.MethodsAnthropometric data were collected in public and private preschools (n = 1996 in 2009/2010; n = 2077 in 2016/2017). Body mass index was calculated and weight status categories were based on the International Obesity Task Force cutoff points. Parental education level was self‐reported.ResultsPrevalence of overweight (17.1%–14.1%; p < 0.001) and obesity (6.6%–3.9%, p < 0.001) was lower in 2016/2017 than in 2009/2010, with higher rates being found in the north of the country. Parental education was significantly associated with childhood overweight and obesity and inequalities between low‐ and high‐education increased between the two periods.ConclusionsWhile a decrease in childhood overweight and obesity were positive findings, the prevalence is still high and shows ...
Background Comparable global data on health and nutrition of school-aged children and adolescents... more Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5-19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9-10 kg/m². In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3•5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes-gaining too little height, too much weight for their height compared with children in other countries, or both-occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks. Funding Wellcome Trust, AstraZeneca Young Health Programme, EU.
Enquadramento: A obesidade é um grave problema de saúde pública em todo o mundo devido ao seu imp... more Enquadramento: A obesidade é um grave problema de saúde pública em todo o mundo devido ao seu impacto negativo na saúde dos indivíduos e aos altos custos para os sistemas de saúde. O objetivo deste estudo foi avaliar a relação entre a proporção de população urbana e a prevalência de obesidade em todo o mundo e em Portugal. Métodos: Trata-se de um estudo transversal que utilizou dados disponíveis gratuitamente quanto à percentagem de população urbana e prevalência de obesidade, em nível global e nacional. Os dados recolhidos foram organizados por país, a nível mundial e, por regiões em Portugal. Posteriormente, os dados foram mapeados e os resultados foram representados através de gráficos de dispersão, com linha de regressão e o respetivo coeficiente de determinação. Resultados: Os resultados deste estudo mostram que existe uma correlação entre obesidade e urbanização (r = 0,502, p <0,01) em todo o mundo e em Portugal. Conclusões: As evidências sugerem que a obesidade poderá ser determinada por características ambientais, como o nível de urbanização do local onde as pessoas vivem e trabalham. A população urbana tende a ser menos ativa e ingerir mais alimentos altamente calóricos, o que leva ao sobrepeso e à obesidade
Objective To measure the impact of the economic crisis on the mental health correlates of Portugu... more Objective To measure the impact of the economic crisis on the mental health correlates of Portuguese children attending primary school during 2016. Methods Cross-sectional analysis of primary school-aged children and their parents (n = 1157), conducted in public and private schools of three Portuguese districts. Parent reports of children mental health symptoms (Strengths and Difficulties Questionnaire - SDQ) and children self-reports of health-related quality of life (KIDSCREEN-27) and depressive, anxiety and stress symptoms (Depression, Anxiety and Stress Scales, Children version - DASS-C), were compared according to a set of yes/no questions on how the economic crisis changed the normal aspects of routine life (e.g. During the financial crisis did you had to use savings? Started buying cheaper food?). Linear regression models were fitted for the SDQ, the KIDSCREEN-27 and the DASS-C as dependent variables adjusted for children sex, socioeconomic status and district of residence. R...
ObjectiveThis study aims to analyze gender‐specific associations between sports activity outside ... more ObjectiveThis study aims to analyze gender‐specific associations between sports activity outside of school and obesity, observing to what extent the local built environment contributes to the patterns found.MethodsA total of 2253 children aged 6.0‐11.0 years were assessed: 49.3% girls and 50.7% boys. Children's weight and height were measured, age and sex‐specific BMI cut‐off points were used to define normal vs overweight/obesity. Children's organized sports (OS) activity was assessed by questionnaire, and local facilities for children's engagement in OS were analyzed. Logistic regression models were computed, adjusted for confounding variables.ResultsResults showed greater overweight and obesity (25.1% vs 20.1%) and lower OS engagement (66.5% vs 73.8%) in girls as well as greater impact of OS engagement on weight status in girls (OR for having a normal weight = 1.434 in girls vs 1.043 in boys). Additionally, opportunities to engage in OS were scarce for girls.Conclusio...
Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, Jan 20, 2018
The aim of the study was to estimate the prevalence of high blood pressure (HBP) and its associat... more The aim of the study was to estimate the prevalence of high blood pressure (HBP) and its association with anthropometric indicators of adiposity in Portuguese schoolchildren. In this cross-sectional study, a nationally representative sample of 6-9-year-old children was analyzed. Weight and height (used to calculate body mass index [BMI]), blood pressure (BP), waist circumference (WC) and skinfold thickness (used to estimate body fat percentage [BFP]) were measured using standard techniques. BP was classified as high-normal BP or hypertension for values between the 90th and 95th percentiles or above the 95th percentile, respectively. A body adiposity index was calculated with principal component analysis using BMI, WC and BFP. Multinomial logistic regression models were used to estimate the strength of the association between anthropometric indicators and HBP. The prevalence of high-normal BP and hypertension was 4.5% and 3.7%, respectively. BP was positively correlated with all anth...
Background This study evaluated the association between lifestyle-related behavior patterns and w... more Background This study evaluated the association between lifestyle-related behavior patterns and weight status indicators in schoolchildren. Methods Cross-sectional study includes nationally representative sample of Portuguese schoolchildren (6–9 years old; n = 10,258). Weight status was assessed using the body mass index (BMI) and waist circumference (WC). Principal component analysis was used to identify lifestyle-related behavior patterns. Multiple linear regression models were used to estimate the association between behavior patterns, BMI, and WC. Results Six lifestyle-related behavior patterns were identified: pattern 1: consuming iced tea and soft drinks ≥2 times/week, having a television (TV) in the bedroom, watching TV ≥2 h/day, and consuming <2 portions of fruits/day; pattern 2: parents and children remaining physically inactive during leisure time; pattern 3: consuming ≤1 portion of vegetables and milk/day; pattern 4: having parents with excess weight; pattern 5: consum...
A perceção que os pais têm do peso dos filhos pode influenciar a adoção de comportamentos saudáve... more A perceção que os pais têm do peso dos filhos pode influenciar a adoção de comportamentos saudáveis. O objetivo deste trabalho foi observar a perceção que os pais têm do peso dos filhos em dois períodos (2009 -2010 e 2016 -2017) e em vários subgrupos da população. Os dados foram recolhidos no âmbito de dois projetos nacionais (2009 -2010: n = 6577; 2016 -2017: n = 7594), em infantários e escolas primárias, públicas e privadas, em Portugal continental (crianças entre os três e os 10 anos). Através de um questionário, os pais descreveram os filhos em relação ao peso atual: 1) muito magro, 2) magro, 3) normal, 4) com algum peso a mais, ou 5) com muito peso em excesso. A altura e o peso das crianças foram recolhidos objetivamente e os pontos de corte da International Obesity Task Force foram usados para classificar o estado nutricional da criança. A acuidade da perceção parental foi calculada de acordo com o sexo, a idade, e o peso da criança, assim como com o peso dos pais; as diferenças entre os dois períodos foram registadas.
ObjectivesThis study aimed to describe the relationship between body size, form, and composition,... more ObjectivesThis study aimed to describe the relationship between body size, form, and composition, and children's lifestyle on health‐related quality of life (HRQoL).MethodsThis cross‐sectional study comprised 1333 children (9.05 ± 0.75 years; 683 females) living in mainland Portugal. Objective anthropometric measures were collected. Parents answered a standardized questionnaire related with children's lifestyle (e.g., sport participation, screen‐ and sleep‐time) and family socioeconomic status (e.g., parental education). HRQoL was measured using the Portuguese version of the KIDSCREEN‐27. Scores were categorized into low and high using a sex‐specific normative cut‐off from European children. A healthier score was created including positive scores for body weight, abdominal obesity, sport participation, sleep‐ and screen‐time.ResultsBody size, form and composition were correlated with children's physical wellbeing. However, sex differences were found in which parameters were associated with wellbeing. Among boys, the body mass index, waist circumference, waist‐to‐height ratio, subscapular and suprailiac skinfold were most correlated with wellbeing, while waist circumference and subscapular skinfold showed the strongest correlations for girls. Sleep duration and sport participation revealed a significant relationship with girls' HRQoL. A logistic regression analysis (adjusted for parental education) revealed that boys scoring 4 or 5 in the healthier index had an increased likelihood of high HRQoL level compared to those fulfilling none.ConclusionsFuture programs aimed at reducing obesity, particularly central obesity, and incorporating multiple health indicators and behaviors, such as sport participation and sleep duration may help improve children's health and wellbeing.
ObjectivesOur objective was to examine the relationship between the 2008 and 2015 economic crisis... more ObjectivesOur objective was to examine the relationship between the 2008 and 2015 economic crisis and children's physical activity (PA) outcomes, eating behaviors and obesity prevalence, while considering sex inequalities and familial socioeconomic status.MethodThis is a cross‐sectional study, including data collected in 2016/2017 among 5134 children aged 6–11 years (mean age: 8.11 ± 1.24; 50.0% boys). Children's height, weight, and waist circumference were objectively measured. Children's sleep‐ and screen‐time, participation in organized sports, and specific dietary habits were reported parental‐reported using a standardized questionnaire. An economic crisis impact score, with data from 10 indicators of economic needs in the family, was used to characterize the crisis' impact.ResultsFirst, the prevalence of overweight and obesity was higher in children whose families had a higher impact of the crisis. Second, children's intake of fruit and high‐fat food, screen‐time, sleep‐time, and participation in organized sports differed according to the level of impact of the economic crisis. Third, the association between health‐related behaviors and the impact of the economic crisis was stronger for girls compared to boys.ConclusionOur findings give us an indication of how economic crises may drive changes in health outcomes.
ObjectivesWe evaluated, for the first time in Portugal, the prevalence of overweight and obesity ... more ObjectivesWe evaluated, for the first time in Portugal, the prevalence of overweight and obesity according to parental education in a population of preschool‐aged Portuguese children in 2009/2010 and 2016/2017.MethodsAnthropometric data were collected in public and private preschools (n = 1996 in 2009/2010; n = 2077 in 2016/2017). Body mass index was calculated and weight status categories were based on the International Obesity Task Force cutoff points. Parental education level was self‐reported.ResultsPrevalence of overweight (17.1%–14.1%; p &lt; 0.001) and obesity (6.6%–3.9%, p &lt; 0.001) was lower in 2016/2017 than in 2009/2010, with higher rates being found in the north of the country. Parental education was significantly associated with childhood overweight and obesity and inequalities between low‐ and high‐education increased between the two periods.ConclusionsWhile a decrease in childhood overweight and obesity were positive findings, the prevalence is still high and shows pronounced socioeconomic differences. Policies for obesity prevention need to be inclusive and tackle inequalities, with interventions tailored to suit local contexts.
Objective: This study aims to analyze gender-specific associations between sports activity outsid... more Objective: This study aims to analyze gender-specific associations between sports activity outside of school and obesity, observing to what extent the local built environment contributes to the patterns found. Methods: A total of 2253 children aged 6.0-11.0 years were assessed: 49.3% girls and 50.7% boys. Children's weight and height were measured, age and sex-specific BMI cut-off points were used to define normal vs overweight/obesity. Children's organized sports (OS) activity was assessed by questionnaire, and local facilities for children's engagement in OS were analyzed. Logistic regression models were computed, adjusted for confounding variables. Results: Results showed greater overweight and obesity (25.1% vs 20.1%) and lower OS engagement (66.5% vs 73.8%) in girls as well as greater impact of OS engagement on weight status in girls (OR for having a normal weight = 1.434 in girls vs 1.043 in boys). Additionally, opportunities to engage in OS were scarce for girls. Conclusions: The gender gap in children's weight status and OS engagement might
American journal of biological anthropology, Apr 3, 2023
ObjectivesWe investigate associations between children exposure to stressful events, considering:... more ObjectivesWe investigate associations between children exposure to stressful events, considering: (1) the period in which the event took place, (2) the type of event, and (3) the cumulative effect of the events on children's weight, height and body mass index (BMI).MethodsA total of 8429 Portuguese children (3349 exposed to at least one stressful event during their lifetime; 50.2% males; mean age = 7.21 ± 1.85 years) were included in the analysis. The occurrence of stressful (i.e., adverse) events was reported in a parental questionnaire; children's weight and height were objectively measured.ResultsWhen the stress event took place in the first 2 years of life, compared with during pregnancy or after the 2 years, children were shorter; but the association was weak and only significant for boys. After adjustment for child's birthweight, gestational age, breastfeeding duration, number of siblings, and father's education, the experience of 3+ stressful events (vs. 1 or 2) was associated with higher weight and height in boys. No interaction effect was found between stress and BMI.DiscussionWe found some evidence of associations between exposure to stressful events and physical growth of boys. We highlight the complex relationship between exposure to stressful experiences and children's physical growth, particularly the different effects of specific characteristics of the stress event and the sex differences.
Background: Obesity is a significant global public health problem and the main cause of many chro... more Background: Obesity is a significant global public health problem and the main cause of many chronic diseases in both developed and developing countries. The increase in obesity in different populations worldwide cannot be explained solely by metabolic and genetic factors; environmental and social factors also have a strong association with obesity. Thus, it is believed that the current obesity epidemic is the result of a complex combination of genetic factors and an obesogenic environment .The purpose of this study was to evaluate individual variables and variables within the built and social environment for their potential association with overweight and obesity in an urban Brazilian population. Methods: Cross-sectional study was carried out in a sample of 3404 adults living in the urban area of the city. Information from the surveillance system for chronic diseases of Brazilian Ministry of Health was used and individual data was collected by telephone interviews. The database was geocoded using the Brazilian System of Postal Codes for participant residences. An updated, existing list based on the current addresses of supermarkets and hypermarkets in the city was used as an indicator variable of the availability and access to food. Georeferenced information on parks, public squares, places for practicing physical activity and the population density were also used to create data on the built environment. To characterize the social environment, we used the health vulnerability index (HVI) and georeferenced data for homicide locations. Results: The prevalence was 44% for overweight, poisson regression was used to create the final model. The environment variables that independently associated with overweight were the highest population density, very high health vulnerability index and the homicide rate adjusted for individuals variables. The results of the current study illustrate and confirm some important associations between individual and environmental variables and overweight in a representative sample of adults in the Brazilian urban context. The social environment variables relating to the socioeconomic deprivation of the neighborhood and the built environment variables relating to higher walkability were significantly associated with overweight and obesity in Belo Horizonte.
ObjectivesWe evaluated, for the first time in Portugal, the prevalence of overweight and obesity ... more ObjectivesWe evaluated, for the first time in Portugal, the prevalence of overweight and obesity according to parental education in a population of preschool‐aged Portuguese children in 2009/2010 and 2016/2017.MethodsAnthropometric data were collected in public and private preschools (n = 1996 in 2009/2010; n = 2077 in 2016/2017). Body mass index was calculated and weight status categories were based on the International Obesity Task Force cutoff points. Parental education level was self‐reported.ResultsPrevalence of overweight (17.1%–14.1%; p < 0.001) and obesity (6.6%–3.9%, p < 0.001) was lower in 2016/2017 than in 2009/2010, with higher rates being found in the north of the country. Parental education was significantly associated with childhood overweight and obesity and inequalities between low‐ and high‐education increased between the two periods.ConclusionsWhile a decrease in childhood overweight and obesity were positive findings, the prevalence is still high and shows ...
Background Comparable global data on health and nutrition of school-aged children and adolescents... more Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5-19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9-10 kg/m². In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3•5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes-gaining too little height, too much weight for their height compared with children in other countries, or both-occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks. Funding Wellcome Trust, AstraZeneca Young Health Programme, EU.
Enquadramento: A obesidade é um grave problema de saúde pública em todo o mundo devido ao seu imp... more Enquadramento: A obesidade é um grave problema de saúde pública em todo o mundo devido ao seu impacto negativo na saúde dos indivíduos e aos altos custos para os sistemas de saúde. O objetivo deste estudo foi avaliar a relação entre a proporção de população urbana e a prevalência de obesidade em todo o mundo e em Portugal. Métodos: Trata-se de um estudo transversal que utilizou dados disponíveis gratuitamente quanto à percentagem de população urbana e prevalência de obesidade, em nível global e nacional. Os dados recolhidos foram organizados por país, a nível mundial e, por regiões em Portugal. Posteriormente, os dados foram mapeados e os resultados foram representados através de gráficos de dispersão, com linha de regressão e o respetivo coeficiente de determinação. Resultados: Os resultados deste estudo mostram que existe uma correlação entre obesidade e urbanização (r = 0,502, p <0,01) em todo o mundo e em Portugal. Conclusões: As evidências sugerem que a obesidade poderá ser determinada por características ambientais, como o nível de urbanização do local onde as pessoas vivem e trabalham. A população urbana tende a ser menos ativa e ingerir mais alimentos altamente calóricos, o que leva ao sobrepeso e à obesidade
Objective To measure the impact of the economic crisis on the mental health correlates of Portugu... more Objective To measure the impact of the economic crisis on the mental health correlates of Portuguese children attending primary school during 2016. Methods Cross-sectional analysis of primary school-aged children and their parents (n = 1157), conducted in public and private schools of three Portuguese districts. Parent reports of children mental health symptoms (Strengths and Difficulties Questionnaire - SDQ) and children self-reports of health-related quality of life (KIDSCREEN-27) and depressive, anxiety and stress symptoms (Depression, Anxiety and Stress Scales, Children version - DASS-C), were compared according to a set of yes/no questions on how the economic crisis changed the normal aspects of routine life (e.g. During the financial crisis did you had to use savings? Started buying cheaper food?). Linear regression models were fitted for the SDQ, the KIDSCREEN-27 and the DASS-C as dependent variables adjusted for children sex, socioeconomic status and district of residence. R...
ObjectiveThis study aims to analyze gender‐specific associations between sports activity outside ... more ObjectiveThis study aims to analyze gender‐specific associations between sports activity outside of school and obesity, observing to what extent the local built environment contributes to the patterns found.MethodsA total of 2253 children aged 6.0‐11.0 years were assessed: 49.3% girls and 50.7% boys. Children's weight and height were measured, age and sex‐specific BMI cut‐off points were used to define normal vs overweight/obesity. Children's organized sports (OS) activity was assessed by questionnaire, and local facilities for children's engagement in OS were analyzed. Logistic regression models were computed, adjusted for confounding variables.ResultsResults showed greater overweight and obesity (25.1% vs 20.1%) and lower OS engagement (66.5% vs 73.8%) in girls as well as greater impact of OS engagement on weight status in girls (OR for having a normal weight = 1.434 in girls vs 1.043 in boys). Additionally, opportunities to engage in OS were scarce for girls.Conclusio...
Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, Jan 20, 2018
The aim of the study was to estimate the prevalence of high blood pressure (HBP) and its associat... more The aim of the study was to estimate the prevalence of high blood pressure (HBP) and its association with anthropometric indicators of adiposity in Portuguese schoolchildren. In this cross-sectional study, a nationally representative sample of 6-9-year-old children was analyzed. Weight and height (used to calculate body mass index [BMI]), blood pressure (BP), waist circumference (WC) and skinfold thickness (used to estimate body fat percentage [BFP]) were measured using standard techniques. BP was classified as high-normal BP or hypertension for values between the 90th and 95th percentiles or above the 95th percentile, respectively. A body adiposity index was calculated with principal component analysis using BMI, WC and BFP. Multinomial logistic regression models were used to estimate the strength of the association between anthropometric indicators and HBP. The prevalence of high-normal BP and hypertension was 4.5% and 3.7%, respectively. BP was positively correlated with all anth...
Background This study evaluated the association between lifestyle-related behavior patterns and w... more Background This study evaluated the association between lifestyle-related behavior patterns and weight status indicators in schoolchildren. Methods Cross-sectional study includes nationally representative sample of Portuguese schoolchildren (6–9 years old; n = 10,258). Weight status was assessed using the body mass index (BMI) and waist circumference (WC). Principal component analysis was used to identify lifestyle-related behavior patterns. Multiple linear regression models were used to estimate the association between behavior patterns, BMI, and WC. Results Six lifestyle-related behavior patterns were identified: pattern 1: consuming iced tea and soft drinks ≥2 times/week, having a television (TV) in the bedroom, watching TV ≥2 h/day, and consuming <2 portions of fruits/day; pattern 2: parents and children remaining physically inactive during leisure time; pattern 3: consuming ≤1 portion of vegetables and milk/day; pattern 4: having parents with excess weight; pattern 5: consum...
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Papers by Helena Nogueira