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The aim of the present study was to verify whether the amount of sleep duration, screen time, and physical activity moderate the relationship between FTO rs9939609 polymorphism and waist circumference (WC) in children and adolescents. This is a cross-sectional study conducted with 1338 children and adolescents, aged between 6 and 17 years. Lifestyle habits were assessed through self-reported questionnaire. WC was measured on the narrowest part of the trunk between the last rib and the iliac crest. FTO rs9939609 polymorphism was genotyped by real time polymerase chain reaction. The PROCESS macro for the SPSS was used for moderation analyses, through multiple linear regression models. Results indicated significant interactions were found between sleep duration and screen time X FTO rs9939609, showing that these lifestyle behaviours are moderators in the relationship between a genetic predisposition for obesity and higher WC. For physical activity, there was no significant interaction. Therefore, sleeping more than 564 min a day (i.e. 9.4 h) and spending no more than 233 min in front of screen may counteract the genetic predisposition to obesity in children and adolescents.

Dietary factors play a role in modulating chronic inflammation and in the development of CVD. We aimed to investigate the association between the dietary inflammatory index (DII) and cardiometabolic risk factors among adolescents. A total of 31 684 Brazilian adolescents (aged 12-17 years) from the Study of Cardiovascular Risks in Adolescents (ERICA) were included. Dietary intake was assessed using a 24-h dietary recall. The energy-adjusted dietary inflammatory index (E-DII) score was calculated based on data for twenty-five available nutrients. The anthropometric profile, blood pressure, lipid profile, glucose, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and glycated Hb were measured. Poisson regression models were used to examine the associations between sex-specific quartiles of the E-DII and cardiometabolic risk factors. In the energy-adjusted models, when comparing a high pro-inflammatory diet (quartile 4) with an anti-inflammatory diet (quartile 1), there was a positive association with high HOMA-IR among boys (prevalence ratios (PR)Q4 = 1·37, 95 % CI: 1·04, 1·79); and with high fasting glucose (PRQ4 = 1·96, 95 % CI: 1·02, 3·78), high TAG (PRQ4 = 1·92, 95 % CI: 1·06, 3·46), low HDL-cholesterol (PRQ4 = 1·16, 95 % CI: 1·02, 1·32) and high LDL-cholesterol (PRQ4 = 1·93, 95 % CI: 1·12, 3·33) among girls. Additionally, a moderately pro-inflammatory diet was positively associated with high HOMA-IR (PRQ2 = 1·14, 95 % CI: 1·02, 1·29) among girls and high total cholesterol (PRQ3 = 1·56, 95 % CI: 1·20, 2·01) among boys. In conclusion, this study provides new evidence on the association between inflammatory diets with cardiometabolic risk factors among adolescents.

Objective We investigated the association of IRX3 SNP rs3751723 with anthropometric characteristics related to adiposity and potential relationships with FTO SNP rs9939609 in a population of Brazilian children and adolescents. Methods A total of 871 children and adolescents between 7 and 17 years of age were recruited. Adiposity measurements and biochemical parameters were assessed. The variants were genotyped by real-time PCR. Analysis of multiple linear regression, multiple logistic regression, and generalised multifactor dimensionality reduction (GMDR) adjusted for sex, age and ethnicity were applied to test the polymorphisms association with obesity-related phenotypes and the interaction between them. Results The analyses showed that IRX3 was associated with obesity and fat percentage (BF%). An association of FTO rs9939609 with body mass index (BMI) Z-Score and with waist circumference (WC) was detected. The odds ratios (OR) showed that IRX3 rs3751723 was associated with risk of obesity in additive model (p = 0.017), recessive model (p = 0.016) and with high BF% in all models. FTO rs9939609 was associated with risk of obesity in additive model (p = 0.031), recessive (p = 0.033) and with altered WC in all models. GMDR-based predictive models for the risk of obesity, altered WC and high BF% adjusted by age, ethnicity and sex suggested no interaction of the two loci. Conclusions The genetic variants rs3751723 and rs9939609 have an influence on the characteristics of adiposity; however, the effects of IRX3 and FTO investigated polymorphisms are independent in relation to adiposity parameters.

The fat mass and obesity-associated gene (FTO) has been extensively reported in the literature related to nutritional status, but there has been limited description of the genetic contribution to obesity risk during childhood and adolescence, especially in Latin Americans. This study aims to associate the rs9939609 polymorphism, of the FTO gene, with changes in nutritional status in Brazilian schoolchildren followed for 3 years. A longitudinal study was conducted with 355 schoolchildren, aged 7–15 years in 2011/2012 and subsequently re-evaluated in 2014/2015. Nutritional (obesity) status was classified by identifying those exceeding recommended thresholds for waist circumference (WC), waist-to-height ratio (WHtR), body mass index (BMI), and body fat percentage (BF%). The rs9939609 polymorphism was genotyped by a real-time polymerase chain reaction. Relative risk (RR with 95% confidence interval) of obesity status by FTO gene polymorphism was calculated by Poisson regression. The risk group was determined for genotypes with the allele A polymorphism, and regression models were adjusted for age, sex, height, ethnicity, and geographical location. Considering the longitudinal changes in status over the 3-year follow-up, the RR of developing a WC exceeding the threshold recommended (WC >75th age and sex-standardized percentile), or remaining with this condition, was higher in children with AT/AA genotype. For WC, the RR was 1.66 (1.07; 2.58) in crude analysis and 1.17 (1.01; 1.35) following adjustment for age (years), gender, ethnicity, and geographical location. The comparative risk of abdominal obesity, assessed by WHtR (not recommended threshold ≥0.50), was 53% and 8%, respectively, higher in AT/AA compared to TT genotype. Conclusion: This is one of the first longitudinal investigations to show a significant association between the A allele of the rs9939609 polymorphism and individuals with higher than recommended WC and WHtR measures in Brazilian children and adolescents.

Objective The goal of this study was to analyze whether the relationship between the rs9939609 polymorphism of the fat mass and obesity-associated gene (FTO) with nutritional status is moderated by the ponderal index (PI) at birth in children and adolescents. Methods A cross-sectional study evaluated 382 schoolchildren aged 6-17 years. Anthropometric variables such as waist circumference (WC), body mass index (BMI) and body fat percentage (BF%) were used to assess nutritional status. Weight and height at birth were used for the PI calculation, which was divided into tertiles (lower, middle and upper). To compare the continuous variables between genotypes of the rs9939609 polymorphism, a recessive model (TT/AT vs. AA) and covariance analysis (ANCOVA) were used. Results The AA genotype of the rs9939609 polymorphism was associated with higher WC in schoolchildren born with lower PI (β = 4.40; p = .048). However, for BF%, the genotype association was found in the upper PI tertile (β = 7.35; p = .040). Conclusion The relationship between WC and BF% with rs9939609 polymorphism (FTO) seems to be moderated by PI at birth. This is an important insight, since the data for intrauterine growth, genetic factors and the presence of obesity in children and adolescents are still contradictory.

Obesity is an important risk factor associated with non-communicable cardiometabolic diseases. Previous studies have indicated that children and adolescents with a predisposed genetic risk for obesity could benefit from an active lifestyle, but there are no studies investigating whether physical fitness moderates the association of genetics and obesity. The aim of this study was to verify the moderating role of physical fitness in the relationship between genetic risk score (GRS) and body mass index (BMI) in children and adolescents. This cross-sectional study was carried out with 1471 children and adolescents, aged between 6 and 17 years from Santa Cruz do Sul, Brazil. Weight and height were assessed to determine BMI. Physical fitness components (cardiorespiratory fitness [CRF], lower limb strength [LLS], upper limb strength, and abdominal strength) were evaluated. The GRS was based on previously associated obesity single-nucleotide polymorphism rs9939609 (FTO), rs6548238 (TMEM18), and rs16835198 (FNDC5). Moderation analyses were tested using linear regression models, and the interactions were represented by physical fitness components X GRS (categorical variable). All analyses were adjusted for skin color/ethnicity, sex, and sexual maturation. Significant interactions for CRF (P = 0.041), LLS (P = 0.041), and abdominal strength (P = 0.046) X 5 and 6 risk alleles with BMI were found only in adolescents. In addition, there was evidence that fitness components attenuated the high genetic predisposition to high BMI. Physical fitness components are moderators in the relationship between GRS and BMI in adolescents. These findings highlight the need for interventions targeting to improve this aspect, which is an important health indicator in all ages.

Objectives: Lifestyle, obesity, and eating habits are emerging as determinants for the instability of telomeres. The increase in childhood and adolescent obesity and the association of biochemical profiles and dietary components with telomere length (TL) makes it an important issue in nutritional research. The aim of the present study was to investigate TL and its association with ethnic background, adiposity, clinical and biochemical parameters, and dietary patterns among Brazilian children and adolescents. Methods: A cross-sectional study encompassing 981 children and adolescents between 7 and 17 y of age was performed. Dietary intake habits, anthropometry, and clinical data were collected. TL analysis was performed by quantitative polymerase chain reaction. Results: Children presented significantly longer TL than adolescents (P = 0.046). Participants who self-declared as black, mulatto, or brown (P < 0.001) also showed longer TL than those who were white. Regarding biochemical parameters, individuals with altered glucose levels had shorter TL than normoglycemic participants in the total sample (P = 0.014). Such difference remained statistically significant in adolescents (P = 0.019). Participants who reported eating fruits and vegetables regularly had longer TL than those who did not (P < 0.001). Conclusion: The results suggested that both biochemical parameters and the intake of antioxidant-rich food, such as fruits and vegetables, are associated with the stability of telomere biology among young Brazilians.

Objectives Evaluate the influence of the genetic variant rs9939609 of the FTO gene on anthropometric characteristics and whether parental obesity is related to children and adolescents being overweight. Methods A total of 2,364 children and adolescents between 6 and 17 years old were genotyped and the lipid profile, plasma glucose level, and anthropometric characteristics were measured to assess adiposity. Results The AA genotype (risk) was associated with higher body mass index (BMI Z-score; p = 0.006), waist circumference (WC; p = 0.001), and triglycerides (p = 0.033). The association of the participants’ adiposity characteristics with the parents’ BMI and FTO genotypes showed an association of the BMI Z-score when either the mother or father was overweight or obese (p = 0.028 and p = 0.029). In the overweight or obese father/eutrophic mother, we also observe an association of FTO rs9939609 with WC (p = 0.039). The effect of these variables on the risk of obesity was also tested: overweight or obese mother (OR = 1.82, p = 0.041), overweight and obese parents (OR = 3.09, p < 0.0001), and FTO rs9939609 AA genotype (OR = 2.08, p = 0.0004) were associated. With regard to altered WC and high body fat percentage (BF%), either overweight or obese parents (OR = 2.39, p < 0.0001; OR = 1.92, p < 0.002) showed an association. The FTO rs9939609 AA genotype (OR = 1.99, p = 0.0002) was associated with altered WC. Conclusions The results show that parental weight also contributes to obesity and may interact with the FTO genetic make-up.

The prevalence of childhood obesity has increased worldwide. Although it is considered a polygenic inheritance disease, little is known about its susceptibility when the additive effect is considered. The aim of this study is to investigate whether the genetic risk score (GRS) based on previously associated obesity polymorphisms (SNP) rs9939609 (fat mass and obesity-associated (FTO)), rs6548238 (transmembrane protein 18 (TMEM18)) and rs16835198 (fibronectin type III domain containing 5 (FNDC5)) could serve as a predictor for anthropometric characteristics in a sample of Brazilian children and adolescents. This is a cross-sectional study with 1471 children and adolescents aged 6–17 years. BMI, waist circumference (WC) and percentage of body fat and metabolic parameters were verified. In all, three SNP were genotyped by TaqMan™ allelic discrimination. The metabolic and anthropometric parameters were compared between the genotypes, and the unweighted and weighted GRS (GRS and wGRS, respectively) were created to test the additive effect of these genetic polymorphisms on anthropometric parameters. The prevalence of overweight plus obesity was 41 %. Significant associations were identified forFTOrs9939609,TMEM18rs6548238 andFNDC5rs16835198 and for GRS and wGRS with anthropometric phenotypes. The higher score of wGRS was associated with obesity (OR: 2·65, 95 % CI 1·40, 5·04,P=0·003) and with greater WC (OR: 2·91, 95 % CI 1·57, 5·40,P=0·001). Our results suggest that these genetic variants contribute to obesity susceptibility in children and adolescents and reinforce the idea that the additive effect may be useful to elucidate the genetic component of obesity.

Objective: Verify the association between metabolic risk profile in students with different levels of cardiorespiratory fitness and body mass index, as well as the nutritional status of their parents. Methods: A cross-sectional study comprising 1.254 schoolchildren aged between seven and 17 years. The metabolic risk profile was calculated by summing the standardized values of high density lipoproteins and low density lipoproteins, triglycerides, glucose and systolic blood pressure. The parents’ nutritional status was evaluated by self-reported weight and height data, for body mass index calculating. The body mass index of schoolchildren was classified as underweight/normal weight and overweight/obesity. The cardiorespiratory fitness was assessed by 9-minute running/walk test, being categorized as fit (good levels) and unfit (low levels). Data were analyzed using prevalence ratio values (PR). Results: The data indicates a higher occurrence of developing metabolic risk in schoolchildren whose mother is obese (PR: 1.50; 95% CI: 1.01, 2.23), and even higher for those whose father and mother are obese (PR: 2, 79, 95% CI: 1.41; 5.51). Students who have low levels of cardiorespiratory fitness and overweight/obesity have higher occurrence of presenting metabolic risk profile (PR: 5.25; 95% CI: 3.31; 8.16). Conclusion: the occurrence of developing metabolic risk in schoolchildren increase when they have low levels of cardiorespiratory fitness and overweight/obesity, and the presence of parental obesity. Resumo: Objetivo: Verificar se há associação entre o perfil de risco metabólico em escolares com diferentes níveis de aptidão cardiorrespiratória e índice de massa corporal, bem como com o perfil nutricional de seus pais. Métodos: Estudo transversal constituído por 1.254 escolares com idade entre sete e 17 anos. O perfil de risco metabólico foi calculado por meio da soma dos valores estandardizados de lipoproteína de alta densidade e lipoproteína de baixa densidade, triglicerídeos, glicose e pressão arterial sistólica. O perfil nutricional dos pais foi avaliado pelos dados autorreferidos de peso e estatura, calculando-se posteriormente o índice de massa corporal. O índice de massa corporal do escolar foi classificado em baixo peso/peso normal e sobrepeso/obesidade. A aptidão cardiorrespiratória foi avaliada através do teste de corrida/caminhada de 9 minutos, sendo categorizada em apto (bons níveis) e inapto (baixos níveis). Os dados foram analisados através dos valores de razão de prevalência (RP). Resultados: Os dados apontam maior ocorrência de desenvolvimento de risco metabólico em escolares que apresentam mãe com obesidade (RP: 1,50; IC 95%: 1,01; 2,23) e, maior ainda, em escolares que possuem pai e mãe obesos (RP: 2,79; IC 95%: 1,41; 5,51). Escolares que apresentam baixos níveis de aptidão cardiorrespiratória e sobrepeso/obesidade possuem maior ocorrência de perfil metabólico de risco (RP: 5,25; IC 95%: 3,31; 8,16). Conclusões: a ocorrência de desenvolvimento de risco metabólico em escolares aumentam quando estes apresentam baixos níveis de aptidão cardiorrespiratória e sobrepeso/obesidade, assim como na presença de obesidade dos pais. Keywords: School, Cardiorespiratory fitness, Body mass index, Parents, Palavras-chave: Escolares, Aptidão cardiorrespiratória, Índice de massa corporal, Pais

Activation of adipose tissue inflammation is associated with obesity caused by lipid accumulation in adipocytes. Through this activation, proinflammatory cytokines, such as Interleukin-6 (IL-6) and C-reactive protein (CRP) seem to influence metabolic disorders. The present study evaluated whether polymorphisms in the CRP (rs1205) and IL-6 (rs1800795, rs2069845) genes are associated with the development of metabolic disorders in children and adolescents. A cross-sectional study was performed, consisting of 470 students from the municipality of Santa Cruz do Sul, Brazil, aged 7-17 years. Body mass index (BMI) was classified according to overweight and obesity. Genotyping was performed by real-time Polymerase Chain Reaction(PCR). Anthropometric characteristics, biochemical markers, immunological markers and blood pressure were assessed. Descriptive statistics, chi-square and logistic regression were used for the analyses. No association was detected between the rs1800795 polymorphism and the assessed variables. Individuals with the risk genotype in the rs1205 gene were associated with the risk of developing hypercholesterolemia (OR 2.79; CI 1.40, 5.57; p = 0.003). Carriers of the risk genotype in the rs2069845 gene are associated with the risk of developing obesity (OR 3.07; CI 1.08, 8.72; p = 0.03). The polymorphism rs2069845 was associated with obesity and rs1205 was associated with the risk of developing hypercholesterolemia in Brazilian schoolchildren. A ativação da inflamação do tecido adiposo está relacionada com a obesidade, causada pelo acúmulo de lipídios nos adipócitos. Através dessa ativação, citocinas pró-inflamatórias como Interleucina-6 (IL-6) e Proteína C-Reativa (CRP) parecem influenciar as desordens metabólicas. O presente estudo avaliou se polimorfis mos nos genes da CRP (rs1205) e da IL-6(rs1800795 rs2069845) estão relacionados com o desenvolvimento de alterações metabólicas em crianças e adolescentes. Estudo transversal, foi feito com 470 escolares do município de Santa Cruz do Sul, Brasil, com idades entre 7 a 17 anos. O índice de massa corporal (IMC) foi classificado de acordo com sobrepeso e obesidade. A genotipagem foi realizada através da Reação em Cadeia de Polimerase (PCR) em tempo real. Características antropométricas, indicadores bioquímicos, marcadores imunológicos e a pressão arterial foram avaliados. Estatísticas descritivas, qui-quadrado e regressão logística foram utilizadas para as análises. Nenhuma associação foi detectada entre o polimorfismo rs1800795 e as variáveis avaliadas. Indivíduos com o genótipo de risco no gene rs1205 foram associados ao risco de desenvolver hipercolesterolemia (OR = 2,79; IC: 1,40, 5,57; p = 0,003). Portadores do genótipo de risco no gene rs2069845 estão associados com o risco de desenvolver obesidade (OR = 3,07; IC: 1,08, 8,72; p = 0,03). O polimorfismo rs2069845 foi relacionado com obesidade e o rs1205 associado ao risco de desen volver hipercolesterolemia em escolares brasileiros.

Justificativa e Objetivo: Polimorfismos no gene relacionado à massa gorda e obesidade - FTO (fat mass and obesity associated) têm sido associados com obesidade pelos seus efeitos na homeostase de energia do indivíduo. Assim, busca-se verificar se escolares portadores do alelo de risco para obesidade (A), do polimorfismo rs9939609, do gene FTO, respondem diferentemente a um programa de intervenção com exercício físico e orientação nutricional, em comparação aos escolares que não possuem este alelo, com relação ao Índice de Massa Corporal (IMC). Métodos: estudo quase experimental, realizado com 46 escolares, distribuídos, igualmente, em grupos experimental e controle, da zona rural do município de Santa Cruz do Sul-RS. A variante A/T, do polimorfismo rs9939609 do gene FTO, foi genotipada utilizando-se o sistemaTaqManTM, em equipamento automatizado StepOne Plus. O programa interdisciplinar teve duração de 4 meses, sendo realizado 3 vezes por semana, no turno contrário ao das aulas. A duração de cada foi de 1 hora e 30 minutos. Resultados: no grupo experimental, um escolar com genótipo TT que apresentava sobrepeso, passou a ter IMC normal após o programa. Para os genótipos AT + AA, os escolares mantiveram a classificação (obesidade), sendo que um escolar que apresentava sobrepeso, passou a apresentar obesidade, após o término da intervenção. A análise dos valores de IMC, antes e após a intervenção, revelou que não houve diferença significativa, tanto no grupo experimental (p=0,088), quanto no controle (p=0,964). Conclusão: independente do genótipo, os escolares responderam de forma semelhante ao programa interdisciplinar com exercícios físicos e orientação nutricional.

FUNDAMENTO: A obesidade tem sido identificada como importante fator de risco no desenvolvimento de doencas cardiovasculares, porem outros fatores exercem influencia, combinados ou nao a obesidade, e devem ser considerados na estratificacao de risco cardiovascular em pediatria. OBJETIVO: Analisar a associacao entre medidas antropometricas e fatores de risco cardiovascular, investigar os determinantes para as mudancas da pressao arterial (PA) e propor uma equacao de predicao para circunferencia de cintura (CC) em criancas e adolescentes. METODOS: Foram avaliadas 1.950 criancas e adolescentes, com idade entre 7-18 anos. Foi investigada a gordura visceral pela CC e a relacao cintura-quadril, PA e indice de massa corporal (IMC). Em uma subamostra selecionada aleatoriamente desses voluntarios (n = 578), foram medidos o colesterol total, a glicemia e os triglicerideos. RESULTADOS: A CC se correlacionou positivamente com o IMC (r = 0,85; p < 0,001) e a PA (PAS r = 0,45 e PAD = 0,37; p < 0,001). A glicemia e os triglicerideos apresentaram correlacao fraca com a CC (r = 0,110; p = 0,008 e r = 0,201; p < 0,001, respectivamente). O colesterol total nao se correlacionou com nenhuma variavel. Idade, IMC e CC foram preditores significativos nos modelos de regressao para PA (p < 0,001). Propoe-se uma equacao de predicao da CC para criancas e adolescentes: meninos: y = 17,243 + 0,316 (altura em cm); meninas: y = 25,197 + 0,256 (altura em cm). CONCLUSAO: A CC esta associada com fatores de risco cardiovascular e apresenta-se como fator preditor de risco para hipertensao em criancas e adolescentes. A equacao de predicao para CC proposta em nosso estudo deve ser testada em futuros trabalhos.

Introdução: O Pacto pela Saúde, parceria das três esferas do governo, teve como intuito promover a melhoria dos serviços ofertados à população. Neste contexto, se enquadrava a reorganização dos Centros de Atenção Psicossocial, os quais tiveram novas metas de cobertura populacional. Objetivos: Identificar a cobertura de assistência dos Centros de Atenção Psicossocial nos estados brasileiros, a partir do site do Ministério da Saúde entre 2010 e 2012. Materiais e Métodos: Trata-se de um estudo ecológico do tipo transversal retrospectivo, cujas unidades de análises foram todos os estados brasileiros no período de 2010 a 2012. Buscou-se investigar a cobertura estadual dos Centros de Atenção Psicossocial, tendo como fonte a base de dados do DATASUS. A análise foi realizada por meio da comparação de indicadores lançados pelo Ministério da Saúde e os resultados apresentados no site do DATASUS. Resultados: Observou-se que a cobertura dos Centros de Atenção Psicossocial no período estudado, ficou com uma média considerada boa a muito boa. Conclusão: De um modo geral, pode-se dizer que grande parte dos estados obteve um aumento da cobertura durante o período estudado, revelando desta maneira, que os Centros de Atenção Psicossocial estão sendo mais divulgados e procurados pela população. Alcançar a meta de cobertura ideal no país pode representar a vitória de grande parte da população brasileira.