DOI: 10.1590/1413-81232017222.

17522015 627

Overweight among adolescents and nutritional status

REVIEW
of their parents: a systematic review

Niedja Maria da Silva Lima 1

Vanessa S Leal 1
Juliana Souza Oliveira 1
Maria Izabel Siqueira de Andrade 1
Fernanda Cristina de Lima Pinto Tavares 1
Rsia Cristina Egito de Menezes 2
Catarine Santos da Silva 1
Pedro Israel Cabral de Lira 1

Abstract The article seeks to investigate the as-

sociation between overweight in adolescents and
the nutritional state of the parents and identify
possible determinants. The search was carried out
in the Pubmed, Lilacs, Scielo databases and Vir-
tual Health Library (BVS), were searched regard-
ing the period from 2004 to 2014. The descriptors
were: Adolescent, Risk factors, Obesity, Par-
ents and Overweight. Of the 366 articles, only
07 met al.l the eligibility criteria. Higher preva-
lence of overweight in adolescents was noted in
studies conducted in Brazil and Greece, while the
prevalence of obesity was higher in studies con-
ducted in United States. Higher overweight prev-
alence in male adolescents was verified. All studies
showed that the presence of overweight or obesity
in the father or the mother increases the risk of
adolescents developing overweight, and this risk
is even greater when both parents are obese. The
strong association between overweight in adoles-
cents and nutritional status of the parents found
in the selected studies is related to many factors,
thus the presence of a risk factor, such as genetic
1
Centro de Cincias predisposition, can be ameliorated by a protective
da Sade, Universidade factor, such as healthy eating habits.
Federal de Pernambuco. R. Key words Adolescent, Risk factors, Obesity, Par-
Alto de Reservatrio, Bela
Vista. 55608-680 Vitria ents and Overweight
de Santo Anto PE Brasil.
niedjanutricionista@
gmail.com
2
Universidade Federal de
Alagoas. Macei AL Brasil.
628
Lima NMS et al.

Introduction Methods

Adolescence represents a period of the life cycle This study involves a systematic review of the
that is marked by intense biological and psycho- literature based on the following question that
social changes. Obesity among adolescents is a uses the PECO strategy10: What is the associa-
major public health problem that has been on the tion between overweight in adolescents and the
rise in recent years1. parents nutritional status, when compared with
Behavioral changes that have occurred in re- children of eutrophic individuals?. The revision
cent decades, including reduced levels of phys- was based on the PRISMA directive: Preferred
ical activity and increases in the consumption Reporting Items for Systematic Reviews11.
of high calorie foods, have driven an epidemio- The bibliographic review was carried out
logical transition, characterized by a drop in the between November 2014 and January 2015, us-
prevalence of infectious diseases and an increase ing the following databases: Publisher Medline
in the prevalence of chronic non-communicable (Pubmed), Literatura Latino-Americana e do
diseases, among them obesity, which is currently Caribe em Cincias da Sade (Lilacs), Scientific
at pandemic levels2. Electronic Library Online (Scielo) and Biblioteca
A global study using systematic analysis Virtual de Sade (BVS). For the search strategy
showed the prevalence of overweight in chil- the following key terms were combined using the
dren and adolescents in developing countries to Boolean operators OR and AND: Overweight,
be 12.9% in boys and 13.4% in girls3. While in obesity, risk factors, adolescent and par-
developed countries, the figures are even high- ents. For the search on Pubmed, the key terms
er with 23.8% of boys and 22.6% of girls with were identified using Medical Subject Head-
overweight or obesity3. In Brazil, data from the ings (Mesh), published by the U.S. National Li-
Study of Household Budgets (POF Pesquisa de brary of Medicine (http://www.nlm.nih.gov/
Oramentos Familiares) from 2008-2009 showed mesh/), and the following search terms were
the prevalence of overweight in adolescents to be used: (((overweight[MeSH Terms] OR obe-
21.7% for males and 19.4% for females, numbers sity [MeSH Terms]) AND risk factors[MeSH
that are worrying given the serious problems that Terms]) AND adolescent[MeSH Terms]) AND
are associated with excess adiposity4. parents[MeSH Terms]. For the searches car-
The early development of obesity, in infan- ried out on Lilacs, Scielo and BVS, the terms
cy or adolescence, is a strong predictor of the were drawn from the key terms at Descritores
persistence of this infirmity in adult life and a em Cincia da Sade (DeCS), available at the
risk factor for the development of other chronic Biblioteca Virtual em Sade portal (http://decs.
non-communicable diseases such as cardiovas- bvs.br), and the following search terms were
cular disease, dyslipidemia, arterial hypertension, used, respectively: obesity [subject key term] and
type 2 diabetes and some types of neoplasms5. adolescent [subject key term] and parents [sub-
There are a number of factors associated with ject key term], (overweight) OR (obesity) AND
the development of overweight in adolescence, (risk factors) AND (adolescent) AND (parents)
among them: parental factors; inappropriate eat- and (tw:(overweight)) OR (tw:(obesity)) AND
ing habits; physical inactivity; screen time; rela- (tw:(risk factors)) AND ((tw:(adolescent)) AND
tionships with peers; socioeconomic levels; the (tw:(parents)).
social context in which the individual is brought The inclusion criteria that were used were:
up; maternal schooling and parents nutritional original studies involving humans, with a repre-
status6,7. sentative and random sample selection, in which
Studies have shown a strong association be- the nutritional status of adolescents was evaluat-
tween parents overweight and adiposity in ad- ed in line with the curves proposed by the World
olescents. This association also involves genetic Health Organization (WHO)12 or by the Centers
factors, since children of obese parents have a for Disease Control and Prevention (CDC)13or
considerably greater risk of becoming obese and the International Obesity Task Force (IOTF)14
of adopting inadequate behaviors such as poor and the nutritional status of the parents was
dietary habits that are passed down through gen- measured using Body Mass Index (BMI)15; with
erations7-9. Thus, this study seeks to verify the as- an association between excess weight in adoles-
sociation between overweight among adolescents cents and overweight/obesity in parents, using
and the nutritional status of their parents, in or- multivariate statistical analysis; written in Portu-
der to identify possible determining factors. guese, English or Spanish and published in the
 629

Cincia & Sade Coletiva, 22(2):627-636, 2017

last ten years (between January 2004 and Decem-
ber 2014).

Identification
Articles selected
The selection of articles was carried out by as a result of search
two researchers working independently, and in- strategy
volved three stages: reading of the title, reading of N = 366
the abstract and reading of the complete article. Duplicate articles
After reading the title and abstract, the full text excluded
was read in order to identify those which fulfilled N = 192
the inclusion criteria, as per the pre-established
Articles excluded after
protocol. reading title
The kappa agreement index was calculated N = 103

Triage
and was found to be 0.85, which points to a high
level of agreement between the researchers16. Any Articles selected after
reading title
disagreements were resolved by consensus be- N = 71
tween the two readers. Once the articles had been
selected, the data was extracted, following the Articles excluded after
reading abstract
protocol that had been defined in advance by the N = 34
authors, then put into a table in Microsoft Office
Excel 2007.
The articles were evaluated for quality using Articles selected after
reading abstract
the STROBE check-list, translated by Malta et N = 37
al.17, containing 22 items relating to the essential
Eligibility

points that should be described in observation-

al studies. Each item was given a score from 0 Articles excluded
to 1 point, and any article that scored 50% (11 for not meeting all
points) of the overall points was considered to be eligibility criteria
(e.g. sample selection
of good quality. and statistical analysis)
N = 30

Results
Included

Articles selected
366 articles were initially identified, including for the systematic
review
154 on Pubmed, 8 on Lilacs, 2 on Scielo and 202 N = 07
on BVS. Of the articles found on BVS, only 10
were not indexed in the other databases, so 192
were excluded from the original number. The
titles and abstracts were evaluated, resulting in
the exclusion of 137 articles that did not meet Figure 1. Flow diagram of the process of identifying
the criteria established previously. After reading and selecting the articles including in the systematic
through the remaining 37 articles, seven were revision about the association between overweight
found to meet the eligibility criteria and were se- in adolescence and parents nutritional status, 2004
lected by both researchers (Figure 1). 2014.
The main characteristics of each of the seven
studies are shown in Chart 1, in decreasing or- Source: Moher et al.20.

der of the score they obtained using an analysis

of methodological quality. The average score ob-
tained using the STROBE protocol was 17, with
a maximum of 19.38,18 and a minimum of 1519
(Chart 1). studies18,21, while all the others are cross-sectional
The majority of the studies were carried studies8,19,22-24. The studies included members of
out in the United States21,22, Greece18,19 and Bra- both sexes in similar proportions, with the ex-
zil8,23 and all were published in the period be- ception of one which was carried out in Iran and
tween 2004 and 20138,18,19,21-24. The sample sizes involved only female adolescents (Chart 1)25.
ranged from 91423 to 957122 individuals and, of The objectives and statistical analyses of the
the studies selected, two are prospective cohort selected studies are presented in Chart 2. The
630
Lima NMS et al.

Chart 1. Characteristics and scores of the quality of studies about the association between overweight in
adolescence and parents nutritional status, selected for the systematic review.
Population Characteristics
Reference Location, year Type of study Score
(n) of the population
Bernardo et Florianpolis, Cross-cutting 2,826 Age range = 7 to 14 years. 48% 19.3
al.8 Brazil, 2012 M; 52% F.
Veltsista et Greece, 2010 Prospective Cohort 7,219 Age = 7 years 19.3
al.18 51.8% M; 48.1% F.
2,826 Age = 18 years.
45.4% M; 54.6% F.
Kowaleski- Ohio, United Prospective Cohort 1759 Age range = 16 to 21 years. 17.4
Jones et al.21 States, 2009 52.2% M; 47.8% F.
Maddah et Rasht, Iran, 2010 Prospective Cohort 2,577 Age range = 12 to 17 years. 17
al.24 100% F.

Liu et al.22 United States, 2013 Prospective Cohort 9,571 Age range = 6 to 17 years. 15.4
50.6% M; 49.4% F.
Marins et Rio de Janeiro, Prospective Cohort 914 Age range = 6 to 14 years. 15.1
al.23 Brazil, 2004 Prospective Cohort 50.8% M; 49.2% F.
Birbilis et tica; Etlia- Cross-cutting 2.294 Age range = 9 a 13 years. 15
al.19 Acarnnia; 49.7% M; 50.3% F.
Heraclio;
Tessalnica -
Greece, 2013
M: male sex; F: female sex.

multivariate analysis that was most commonly were found to be greater prevalence of overweight
used to check for an association between nutri- in male adolescents (Chart 3)8,18,19,21-23.
tional status of adolescents and their parents and Perinatal, behavioral, biological and socio-
to calculate the risk of this event was logistical economic factors were significantly associated
regression18,22-24. The dependent variable in the with a greater risk of excess weight in adoles-
studies was overweight and/or obesity in adoles- cents and these include: excess of pre-gestational
cents, and the independent variable was excess weight; smoking during pregnancy; rapid weight
adiposity in parents. In addition, other inde- gain during childhood8; skipping meals24; male
pendent variables were analyzed such as: family sex8,18,19,21-23; overweight in parents8,18,19,21-24; black
income, level of schooling of parents, diet, the parents21; living in low income areas24; low lev-
practice of physical activity, sedentary lifestyle, el of schooling of parnets8,21,23; and lower family
location of residence, among other socioeco- income21,22.
nomic and demographic variables (Chart 2). All the studies showed that the presence of
Chart 3 shows the principle results and meth- overweight or obesity in the father or mother in-
odological limitations of the selected studies. creases the risk of adolescents developing excess
The prevalence of obesity and overweight var- adiposity8,18,19,21-24 and that this risk is still great-
ied according to the geographic region in which er when both parents are overweight8,18,22. In the
the study was developed. A greater prevalence of prospective cohort study carried out in Greece,
overweight was found in the studies carried out in the adolescents were found to have a five-fold
Brazil8,23 and in Greece18,19, while the research car- greater risk of being obese when both parents
ried out in the United States found the prevalence were obese, when compared with children of eu-
of obesity to be greater21,23. The lowest prevalence trophic parents (Chart 3)18.
of obesity was found in a prospective cohort in The main methodological limitations of the
Greece18. With regard to frequency by sex, there studies cited were: use of self-referred anthropo-
 631

Cincia & Sade Coletiva, 22(2):627-636, 2017

Chart 2. Objective and statistical analysis of studies selected for the systematic revision.

Reference Objective Statistical Analysis

Bernardo et al. 8
To measure the association between parents Poissons Regression.
NS, sociodemographic and dietary variables DV: Overweight/obesity in schools;
with overweight/obesity in schools. IV: Parents NS and demographic and
dietary factors; CI 95%.
Veltsista et al.18 To determine the prevalence and monitoring Multivariate logistical regression.
of overweight and obesity in a representative DV: Overweight/obesity in adolescence
sample of Greek youths and to relate with IV: Parents NS, location of home,
childhood and parental factors. education levels of parents and practice of
PA. CI 95%.
Kowaleski-Jones To check for an association between three Multivariate analysis.
et al.21 measures of maternal BMI and overweight in DV: Overweight in adolescents. IV:
adolescence. Maternal BMI

Maddah et al.24 To check the prevalence of overweight/ Logistical regression.

obesity among female school children by DV: overweight in adolescents
location of home, mothers socioeconomic IV: overweight/ obesity of parents; BW,
and education levels in Rasht; to explore socio-economic factors and PA. CI 95%.
the contributions played by certain lifestyle
factors in the family context.
Liu et al.22 To analyze the similarities between BMI and Logistical binary and multinomial
body weight among parents and children regression.
DV: obesity in adolescents; IV:
obesity in parents. Mode adjusted
for sociodemographic factors and
socioeconomic variables.
Marins et al.23 To investigate the relationship between NS Logistical regression.
of parents and overweight in children and Univariate analysis (association between
adolescents who reside in Rio de Janeiro, overweight in children and adolescents
Brazil with socioeconomic and demographic
variables).
Birbilis et al.19 To identify the association between Multivariate regression.
overweight and/or obesity in school children DV: overweight/obesity in adolescence
with parents BMI, perinatal, socioeconomic IV: NS of parents, demographic and
and demographic factors perinatal factors. Adjusted OR. 95% CI.
OR= odds ratio; CI = Confidence Interval; NS: Nutritional status; DV: Dependent Variable; IV: Independent Variable; BMI: Body
Mass Index; PA: Physical activity; BW: Birthweight.

metric data8,18,19,21,22,24 and the inability to estab- energy balance, whereby the individual ingests
lish a causality relationship (Chart 3)8,19. more energy than he or she expends through
organic processes25. It is a risk factor for the de-
velopment of Chronic Non-Communicable Dis-
Discussion eases (CNCDs), including cardiovascular disease
which is the principle cause of mortality globally.
Obesity is a chronic disease with multifaceted In Brazil, approximately 30% of deaths are at-
causes that is characterized by an excess of ad- tributed to heart-related illness27.
iposity on the body, that has a negative impact The high prevalence of overweight found in
on health26. It is linked to biological, genetic and the studies of Brazilian adolescents may be relat-
environmental factors, and is caused by a positive ed to the nutritional transition which the coun-
632
Lima NMS et al.

Chart 3. Principle results and methodological limitations of the studies selected for the systematic revision.
Reference Principle Results Methodological
Limitations
Bernardo Overweight in adolescents: 25.4% M: 18.7% F. Self-reported weight
et al.8 OR and CI 95% - father overweight: 1.53 (1.13, 2.07); OR and and height of parents.
CI 95% - mother overweight: 1.41 (0.99, 2.01); OR and CI 95% - Reverse causality.
father and mother overweight : 1.83 (1.27, 2.65).
Veltsista 7 year old children: Self-reported weight
et al.18 Overweight: 16.1% M; 19.2% F. Obesity: 6.2% M; 5.8% F. and height.
18 year old adolescents:
Overweight: 19.1% M; 7.9% F. Overweight: 3.6% M; 1.0% F.
OR and CI 95% - father or mother overweight: 3.34 (1.79, 6.24);
OR and CI 95% - father and mother overweight: 5.03 (2.70, 9.38).
In the transition from childhood to adolescence, the prevalence of
overweight increased among boys and reduced among girls.
Kowaleski-Jones Overweight among adolescents: 17% M; 13% F. Self-reported weight
et al.21 OR and CI 95% - mother overweight: and height.
1.16 (1.11, 1.20)
Maddah Overweight among adolescents: 18.6%. Self-reported weight
et al.24 Obesity among adolescents: 5.9%. and height of parents.
OR and CI 95% - father obese: 2.0 (1.25, 3.36);
OR and CI 95% - mother obese: 2.1 (1.31, 3.42).
Liu Overweight among adolescents: 16.2% M; 14.9% F. Self-reported weight
et al.22 Obesity among adolescents: 20.6% M; 14.8% F. and height.
OR and CI 95% father obese: 2.1 (1.6, 2.8); 22% - 23% of
OR and CI 95% mother obese: 1.9 (1.5, 2.4); children were
OR and CI 95% father and mother obese: 3.2 (2.5, 4.2). excluded, which
affected the age of
the sample and may
result in sample bias.
Marins Overweight among adolescents: 26.9% M; 20.7% F. Not reported
et al.23 Obesity among adolescents: 9.7% M; 6.7% F.
OR and CI 95% - father overweight: 1.0 (0.7, 1.40); OR and CI 95%
- mother overweight: 1.4 (1.04, 1.93).
Birbilis Overweight among adolescents: 31.3% M; 29.7% F. Reverse causality.
et al.19 Obesity among adolescents: 13.7% M; 9,5% F. Self-reported weight
OR and CI 95% - father obese: 2.25 (1.45, 3.48); and height of parents.
OR and CI 95% - mother obese: 2.14 (1.28, 3.60).
OR= odds ratio; CI = Confidence Interval; M: male sex; F: female sex.

trys population has passed through. According In the Greek studies18,19, elevated levels of
to Gaino et al.28, in the last 30 years, there has overweight were found that can also be attribut-
been a significant increase in the consumption ed to changes in dietary habits and in the practice
of industrialized foods, with increases of: 317.6% of physical activity, arising from socioeconomic
in the consumption of prepared food products; changes that have occurred in recent decades19.
584.6% in the consumption of guarana flavored Among the articles chosen for the present sys-
fizzy drinks; and 966.6% of yoghurts. These in- tematic revision, the greatest prevalence of obe-
creases are cause for concern since they are as- sity was among American adolescents. Liu et al.22
sociated with a concomitant increase in the inci- and Kowaleski-Jones et al.21 carried out studies
dence of obesity in the Brazilian population. of adolescents in the United States and observed
 633

Cincia & Sade Coletiva, 22(2):627-636, 2017

that socioeconomic variables demonstrated the were found to have a 2.54% greater risk of being
greatest association with excess weight in adoles- obese. Lower levels of schooling among parents,
cents, since those with greater family income and lower income and living in low-income areas
lower levels of maternal schooling had a greater were positively associated with excess weight in
prevalence of overweight and obesity. According adolescents. These variables are inter-related,
to Frederick et al.29, the prevalence of obesity in since low levels of paternal and maternal school-
American adolescents has, in recent years, de- ing reduce the chance of finding well paid jobs,
creased amongst the population with the highest leading to lower family incomes which can influ-
socioeconomic levels while it has gradually in- ence where people live.
creased among those in the lowest income brack- Among the several factors that are related
et. This may be related to low levels of physical to overweight and obesity in adolescence in this
activity, due to a lack of spaces that might allow systematic revision, parents nutritional status
for the practice of physical exercise near to their was found to have a strong influence7,33. Power et
homes, and also to food errors, since healthy al.s34 longitudinal study of Britons born in 1958
foods such as fruits and vegetables are more cost- showed an inter-generational transmission of
ly than fast food and may not be available to pur- adiposity. In this birth cohort study, an associa-
chase near to where adolescents live. tion was found between high BMI of parents and
In this revision, male adolescents showed children across three generations.
greater prevalence of overweight, when com- The significant association between over-
pared with their female counterparts. This find- weight in adolescents and overweight or obesity
ing is consistent with those from other studies in in their parents, when compared with the chil-
the literature. In the National Survey of School dren of eutrophic parents, can be explained, at
Health (Pesquisa Nacional de Sade do Escolar least in part, by behavioral factors. A 2012 study
- PeNSe), which was carried out in schools in carried out by Morton et al.35 showed that fam-
Brazilian state capital cities, a greater prevalence ilies that have transformational behaviors had
of overweight was found among boys (24%) health food consumption levels and greater levels
in the 11 to 19 age range, when compared with of physical activity among adolescents. The level
girls (22.1%) of the same age30. Similar results of physical activity of adolescents appears to be
were reported in a longitudinal study of Amer- directly related to the practice of physical activity
ican children and adolescents, among whom the by their parents, as confirmed by Cheng et al.36
prevalence of obesity was 23.5% among boys and in a study of adolescents aged between 14 and 19
17.8% among girls in the 8th year of school and in Brazil, indicating that having parents who are
with an average age of 14.1 years31. One of the sedentary can be a determining factor leading to
factors that may explain the greater frequency of intra-family overweight.
overweight among boys is that adolescent girls The food habits of previous generations are
tend to monitor their weight more and are more also related to childrens nutritional status. Alia
aware of their body images and therefore of their et al.37 found that the consumption of fruits and
weights. In this way, although both sexes face vegetables by parents was related to lower weight
similar environmental risk factors, boys show a among adolescent children, showing that one of
greater tendency towards overweight and obesity. the strategies for reducing the prevalence of excess
In the studies selected, perinatal factors such weight in individuals in this age range would be to
as excess weight during pregnancy, maternal reeducate parents and children about food habits.
smoking and accelerated growth during child- Genetic factors have a significant impact on
hood increased the risk of adolescents display- the nutritional status of parents and children,
ing overweight or obesity. In a literature review, however more research is required on the rele-
Godfrey et al.32 (2010), confirmed that children vant mechanisms involved. A study carried out
of obese mothers, independently of their birth- in Japan found evidence that points to paternal
weight, showed a greater probability of having transition of obesity induced by a diet rich in fats,
excess weight and consequently a greater risk which can be passed through genomes and is re-
of developing CNCDs. Skipping meals was re- lated to the genes Peg3 and Igf238.
lated to overweight/obesity among adolescents. The conclusion that can thus be drawn is that
Terres et al.5 carried out a cross-sectional, popu- the significant association between overweight
lation-based study of adolescents in Pelotas, Rio in adolescents and parents nutritional status, re-
Grande do Sul state and reported similar findings ported in the selected studies, is related to several
since adolescents who reported skipping meals factors. In this way, the presence of a risk factor
634
Lima NMS et al.

such as genetic predisposition for example, can er when both parents are obese. The percentage
be counter-weighted by a protective factor such contribution of environmental and genetic fac-
as health food habits. tors in this associated is not defined in the liter-
Regarding methodological shortcomings of ature, although it is known that both have a role
the selected articles, the majority of studies re- to play. The selected studies show that several fac-
fer to the use of self-reported data on weight and tors in addition to parents weight are related to
height, however anthropometric measures show overweight/obesity in adolescence, with the most
high levels of agreement with standard mea- important being lower family income, lower level
sures39. Studies such as the Surveillance of Chron- of mothers schooling and male sex.
ic Illnesses by Telephone Interview (VIGITEL This findings point to the need for pub-
- Vigilncia de Doenas crnicas por Inqurito lic policies focused on the prevention and/or
Telefnico)40, have used self-reported weight and treatment of overweight/obesity in adolescence.
height data, which simplifies the work and reduc- These policies need to consider biological and
es costs. Another limitation was that it was not socioeconomic differences and must also target
possible to establish a causal relationship, howev- parents if they are to be most effective.
er this is inherent to cross-sectional studies. In addition, studies are needed that evaluate
To summarize, the studies shows that ado- in isolation each risk factor involved in develop-
lescents whose parents were overweight have a ing overweight in adolescence given that there is
greater risk of being overweight or obese when a tendency for this nutritional disorder to contin-
compared with eutrophic peers. This risk is great- ue to adulthood.

Collaborations

All authors participated in the making of the

article and, read and approved the final version.
NMS Lima participated in the design and delin-
eation of the study, data collection, execution of
methodological procedure, analysis and inter-
pretation of data and writing of the manuscript;
VS Leal and JS Oliveira participated in the study
design, interpretation of the data, reading and
approval of the final version. MIS Andrade par-
ticipated in the data collection, execution of the
methodological procedure and interpretation of
the data. FCTL Pinto, RCE Menezes, CS Silva and
PIC Lira participated in the critical analysis read-
ing, review and approval of the final version.
 635

Cincia & Sade Coletiva, 22(2):627-636, 2017

References

1. Tassitano R, Tenrio M, Hallal P. Systematic review 10. Brasil. Ministrio da Sade (MS). Secretaria de Cin-
on obesity in Brazilian adolescents.Brazilian Journal cia, Tecnologia e Insumos Estratgicos. Departamento
of Kinanthropometry and Human Performance 2009; de Cincia e Tecnologia. Diretrizes metodolgicas: Ela-
11(4):449-456. borao de Reviso Sistemtica e Metanlise de estudos
2. Popkin BM. Nutritional patterns and transitions. Pop- observacionais comparativos sobre fatores de risco e prog-
ulation and Development.Nutr Rev1993; 19(1):138- nstico. Braslia: MS; 2014.
157. 11. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche
3. Ng M, Fleming T, Robinson M, Thomson B, Graetz PC, Ioannidis JP, Clarke M Devereaux PJ, Kleijnen J,
N, Margono C, Mullany EC, Biryukov S, Abbafati C, Moher D. The PRISMA statement for reporting sys-
Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, Al- tematic reviews and meta-analyses of studies that eval-
Buhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guz- uate healthcare interventions: explanation and elabo-
man NA, Ammar W, Anwari P, Banerjee A, Barquera S, ration. BMJ 2009; 339:b2700.
Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nona- 12. De Onis M, Onyango AW, Borghi E, Siyam A, Nishida
to IC, Chang JC, Chowdhury R, Courville KJ, Criqui C, Siekmann J. Development of a WHO growth ref-
MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis erence for school-aged children and adolescents. Bull
A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, World Health Organ 2007; 85(9):660-667.
Esteghamati A, Farzadfar F, Fay DF, Feigin VL, Flax- 13. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Fle-
man A, Forouzanfar MH, Goto A, Green MA, Gupta R, gal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF,
Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmo- Johnson CL. CDC growth charts: United States. Adv
eller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Data 2000; (314):1-27.
Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys 14. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Estab-
M, Jonas JB, Kabagambe EK, Khalifa SE, Kengne AP, lishing a standard definition for child overweight and
Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge obesity worldwide: international survey. BMJ 2000;
JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li 320(7244):1240-1243.
Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma 15. World Health Organization (WHO). Physical status:
J, Mainoo NK, Mensah GA, Merriman TR, Mokdad the use and interpretation of anthropometry. Geneva:
AH, Moschandreas J, Naghavi M, Naheed A, Nand D, WHO; 1995. Technical Report Series, 854.
Narayan KM, Nelson EL, Neuhouser ML, Nisar MI, 16. Landis JR, Koch GG. The measurement of observ-
Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, er agreement for categorical data. Biometrics 1997;
Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, 33(1):159-174.
Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg 17. Malta M, Cardoso LO, Bastos FI, Magnanini MM, Silva
NJ, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande CM.STROBE initiative:guidelines on reporting obser-
L, Toyoshima H, van de Vijver S, Vasankari TJ, Veer- vational studies.Rev Saude Publica 2010; 44(3):559-565
man JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, 18. VeltsistaA,KanakaC, GikaA,LekeaV, RomaE, Bak-
Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, oulaC. Tracking of Overweight and Obesity in Greek
Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Youth. Obes Facts 2010; 3(3):166-172.
Y, Zhou M, Zhu S, Lopez AD, Murray CJ, Gakidou E. 19. Birbilis M, Moschonis G, Mougios V, Manios Y, Healthy
Global, regional, and national prevalence of overweight Growth Study group. Obesity in adolescence is associ-
andobesity in children and adults during 1980-2013: ated with perinatal risk factors, parental BMI and so-
a systematic analysis for the Global Burden of Disease ciodemographic characteristics. Eur J Clin Nutr 2013;
Study 2013. Lancet 2014; 384(9945):766-781. 67(1):115-121.
4. Instituto Brasileiro de Geografia e Estatstica (IBGE). 20. Moher D, Liberati A, Tetzlaff J, Altman DG, Altman
Pesquisa de oramentos familiares 2008-2009: antropo- DG; PRISMA Group. Preferred reporting items for
metria e anlise do estado nutricional de crianas e ado- systematic reviews and meta-analyses: The PRISMA
lescentes no Brasil. Rio de Janeiro: IBGE; 2010. statement. PLoS Med 2009; 6(7):e1000097.
5. Terres NG, Pinheiro RT, Horta BL, Pinheiro KAT, Horta 21. Kowaleski-Jones L, Brown BB, Fan JX, Smith KR, Zick
LL. Prevalncia e fatores associados ao sobrepeso e CD. Are You What Your Mother Weighs? Evaluating
obesidades em adolescentes. Rev Saude Publica 2006; the Impact of Maternal Weight Trajectories on Youth
40(4):627-633. Overweight. Matern Child Health J 2010; 14(5):680-
6. Vasconcellos MB, Anjos LA, Vasconcellos MTL. Estado 686.
nutricional e tempo de tela de escolares da Rede Pbli- 22. Liu Y, Chen H, Liang L, Wang Y. Parent-Child Resem-
ca de Ensino Fundamental de Niteri, Rio de Janeiro, blance in Weight Status and Its Correlates in the United
Brasil.Cad Saude Publica2013; 29(4):713-722. States. PLoS ONE 2013; 8(6):e65361.
7. Frutuoso MFP, Bovi TG, Gambardella AMD. Adiposi- 23. Marins VMR, Almeida RMVR, Pereira RA, Barros
dade em adolescentes e obesidade materna. Rev. Nutr. MBA. The relationship between parental nutritional
2011; 24(1):5-15. status and overweight children/adolescents in Rio de
8. Bernardo CO, Vasconcelos FA. Association of parents Janeiro, Brazil. Public Health 2004; 118(1):43-49.
nutritional status, and sociodemographic and dietary 24. Maddah M, Nikooyeh B. Obesity among Iranian Ado-
factors with overweight/obesity in schoolchildren 7 to lescent Girls: Location of Residence and Parental Obe-
14 years old. Cad Saude Publica 2012; 28(2):291-304. sity.J Health Popul Nutr 2010; 28(1):61-66.
9. Pontes LM, Amorim RJ, Lira PIC. Prevalncia e fatores 25. Kumanyika SK. Minisymposium on obesity: overview
associados ao excesso de peso em adolescentes da rede and some strategic considerations. Annu Rev Public
pblica de ensino de Joo Pessoa, Paraba. Rev AMRIGS Health 2001; 22:293-308.
2013; 57(2):105-111.
636
Lima NMS et al.

26. World Health Organization (WHO). Obesity: prevent-

ing and managing the global epidemic: report of a WHO
Consultation. Geneva: WHO; 2000. WHO Technical
Report Series 894.
27. Brasil. Ministrio da Sade (MS). Secretaria Executiva.
Datasus. Informaes de sade. Estatsticas vitais. [aces-
sado 2015 abr 24]. Disponvel em: www2.datasus.gov.
br/DATASUS/index.php?area=0205
28. Gaino NM, Amancio RD, Oetterer M, Silva MV. Dis-
ponibilidade domiciliar de alimentos industrializados
no Brasil. Higiene Alimentar 2012; 26(206/207):55-63.
29. Frederick CB, Snellman K, Putnam RD. Increasing so-
cioeconomic disparities in adolescent obesity. PNAS
2014; 111(4):1338-1342.
30. Arajo C, Toral N, Silva ACF, Velsquez-Melendez G,
Dias AJR. Estado nutricional dos adolescentes e sua
relao com variveis sociodemogrficas: Pesquisa Na-
cional de Sade do Escolar (PeNSE), 2009. Cien Saude
Colet 2010; 15(2):3077-3084.
31. Cunningham SA, Kramer MR, Narayan KMV. Inci-
dence of Childhood Obesity in the United States. N
Engl J Med 2014; 370(5):403-411.
32. Godfrey KM, Gluckman PD, Hanson MA. Develop-
mental origins of metabolic disease: life course and
intergenerational perspectives. Trends Endocrinol Me-
tabol 2010; 21(4):p199-205.
33. Ramos AMPP, Barros Filho AA. Prevalncia da obesi-
dade em adolescentes de Bragana Paulista e sua re-
lao com a obesidade dos pais. Arq Bras Endocrinol
Metab 2003;47(6):663-668.
34. Power C, Pouliou T, Li L, Cooper R, Hyppnen E. Pa-
rental and offspring adiposity associations: Insights
from the 1958 British birth cohort. Ann Hum Biol 2011;
38(4):390-399.
35. Morton KL, Wilson AH, Perlmutter LS, Beauchamp
MR. Family leadership styles and adolescent dietary
and physical activity behaviors: a cross-sectional study.
Int J Behav Nutr Phys Act 2012; 9(1):48.
36. Cheng LA, Mendona G, Farias Jnior JC. Physical ac-
tivity in adolescents: analysis of the social influence of
parents and friends. J Pediatr 2014; 90(1):35-41.
37. Alia KA, Wilson DK, St. George SM, Schneider E,
Kitzman-Ulrich H. Effects of Parenting Style and Par-
ent-Related Weight and Diet on Adolescent Weight Sta-
tus.J Pediatr Psychol 2013; 38(3):321-329.
38. Morita S, Horii T, Kimura M, Arai Y, Kamei Y, Ogawa Y,
et al.. Paternal Allele Influences High Fat Diet-Induced
Obesity. PLoS ONE 2014; 9(1):e85477.
39. Neto GAM, Polito MD, Lira VA. Fidedignidade entre
peso e estatura reportados e medidos e a influncia do
histrico de atividade fsica em indivduos que procu-
ram a prtica supervisionada de exerccios. Rev Bras
Med Esporte 2005; 11(2):141-145
40. Brasil. Ministrio da Sade (MS). Secretaria de Vigiln-
cia em Sade (Vigitel). Brasil 2006: vigilncia de fatores
de risco e proteo para doenas crnicas por inqurito
telefnico. Braslia: MS; 2007.

Article submitted 08/09/2015

Approved 11/01/2016
Final version submitted 13/01/2016