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In the backdrop of the global obesity pandemic, recognized as a notable risk factor for coronavirus disease 2019 (COVID-19) complications, the study aims to explore clinical and epidemiological attributes of hospitalized COVID-19 patients throughout 2021 in Brazil. Focused on four distinct age cohorts, the investigation scrutinizes parameters such as intensive care unit (ICU) admission frequency, invasive mechanical ventilation (IMV) usage, and in-hospital mortality among individuals with and without obesity. Using a comprehensive cross-sectional study methodology, encompassing adult COVID-19 cases, data sourced from the Influenza Epidemiological Surveillance Information System comprises 329 206 hospitalized patients. Of these individuals, 26.3% were affected by obesity. Analysis reveals elevated rates of ICU admissions, increased dependence on IMV, and heightened in-hospital mortality among the individuals with obesity across all age groups (p < .001). Logistic regression, adjusting for confounding variables, underscores a progressively rising odds ratio for mortality in younger age brackets: 1.2 (95%CI 1.1-1.3) for those under 50 years, 1.1 (95%CI 1.0-1.2) for the 50-59 age group, and 1.1 (95%CI 1.0-1.2) for the 60-69 age group. Conversely, no significant mortality difference is observed for patients over 70 years (OR: 0.972, 95%CI 0.9-1.1). In summary, hospitalized COVID-19 patients with obesity, particularly in younger age groups, exhibit elevated rates of ICU admission, IMV requirement, and in-hospital mortality compared with the control group. Notably, the 'obesity paradox' is not evident among hospitalized COVID-19 patients in 2021., (© 2024 World Obesity Federation.)

Background: Anthropometric indicators of obesity have been associated with blood pressure in adolescents. However, the accuracy of anthropometric indicators of obesity for screening for high blood pressure (HBP) in adolescents is not known. Thus, the aim of the present study was to summarize the set of evidence regarding the predictive ability of anthropometric indicators of obesity to identify HBP in adolescents., Methods: Searches were performed in five databases: MEDLINE, Web of Knowledge, Scopus, Scientific Electronic online (SciELO) and SportDiscus. The inclusion criteria for studies were: adolescents aged 10-19 years or mean age included in this range, observational and intervention studies, studies that proposed cutoff points for anthropometric indicators of obesity, and studies in English, Portuguese and Spanish. The methodological quality of studies was assessed using the QUADAS-2 instrument., Results: Ten studies met the inclusion criteria and had their information summarized. Based on the information described in these studies, the anthropometric indicators body mass index (BMI), waist circumference (WC), waist-to-height-ratio (WHtR), triceps skinfold thickness, body adiposity index, C index, body mass, waist-to-arm span ratio, arm fat area, average arm perimeter, fat percentage and arm span were likely to be used in high blood pressure (HBP) screening among adolescents. However, only one study showed acceptable values (moderate to high precision) in relation to the accuracy measurements of described cutoffs., Conclusion: Caution is suggested in the use of anthropometric indicators of obesity for HBP screening in adolescents, in which a greater number of studies with accurate diagnostic tools are necessary., Competing Interests: The authors declare there are no competing interests., (©2022 Lima Borges et al.)

Background: Good sleep quality is an essential component for growth, development, and physical and mental health of the individual, in addition to being a positive indicator of health and well-being. The objective of this study was to estimate the prevalence of poor sleep quality and to identify the association of poor sleep quality with sociodemographic factors, lifestyle, weight status, and associated aerobic fitness in adolescents., Methods: This study included 1110 students aged 14-19 years from city of São José/SC, Brazil. Sleep quality of the subjects was assessed using a questionnaire and classified as adequate and low. Independent variables were gender, age, monthly household income, maternal education, school shift, global physical activity, proper diet, screen time, sleeping hours of full week, sleeping hours of weekdays, sleeping hours of weekends, weight status, and aerobic fitness. Binary logistic regression was used to estimate odds ratios and confidence intervals of 95%., Results: Prevalence of poor sleep quality was 60.4%. More likely to have poor sleep quality were identified in female students (OR 1.68, 95% CI 1.11-2.55), whose mothers had higher levels of education (OR 1.44, 95% CI 1.20-1.73) and low aerobic fitness (OR 1.80, 95% CI 1.02-3.19)., Conclusion: Adolescents who were most likely to report poor sleep quality were female, those whose mothers had a higher educational level and had low aerobic fitness. Students with sedentary risk behavior were less likely of reporting poor sleep quality.

Background and aims: Few population-based studies have studied whether muscle strength (MS) levels influence the relationship between cardiometabolic markers with excess body weight. We investigate the possible moderator role of MS in the relationship between overweight and obesity with cardiometabolic markers. Methods: Cross-sectional analysis using data from two studies in Florianópolis, Brazil (EpiFloripa Adult Cohort Study, n = 862, 39.3 ± 11.4 years; EpiFloripa Aging Cohort Study, n = 1,197, 69.7 ± 7.1 years). MS was assessed by handgrip strength. Body mass index (BMI) was classified as overweight or obesity (BMI 25.0–29.9 or ≥30.0 kg/m2, respectively). Cardiometabolic markers included systolic (SBP) and diastolic blood pressure (DBP), C-reactive protein (CRP), lipids, glucose markers, and carotid intima-media thickness (CIMT). Linear regression models stratified by age groups (adults: <60 years; older adults: ≥60 years) and adjusted for confounders were used. Results: Compared to those with a normal BMI, overweight and obesity were related to higher SBP, DBP, lnCRP, ln triglycerides, fasting glucose (FG), and glicated hemoglobin (HbA1c), and inversely associated with HDL-C among adults and older adults (p value <.05 for all). Additionally, BMI was positively associated with LDL-C and CIMT only among adults (p value <.05). Among adults and older adults, elevated MS attenuated the adverse relationship between excess body weight with FG and HbA1c. Conclusion: Higher MS might help adults and older adults with overweight or obesity reduce their cardiovascular risk by keeping their FG and HbA1c at the same levels of those with a normal BMI. [ABSTRACT FROM AUTHOR]

Secondary cardiovascular disease is the main cause of mortality in congenital heart disease (CHD) patients. The cardiovascular risk could be widely prevented with adherence to a healthy lifestyle; however, clusters of lifestyle behaviors related to atherosclerosis risk factors in children and adolescents with CHD remain unclear. We aimed to describe the clusters of lifestyle behaviors of children and adolescents with CHD and to evaluate their association with atherosclerosis risk factors. We conducted a cross-sectional study on 227 children and adolescents with CHD (median age:10.02 [IQR:7.08–13.02] years). Dietary intake, physical activity (PA), and sedentary behavior (SB) were evaluated. Clusters of lifestyle behaviors were determined using a two-step cluster analysis. Atherosclerosis risk factors evaluated include body fat mass, central obesity, blood pressure, lipid parameters, glucose, C-reactive protein, and carotid intima-media thickness (cIMT). Multiple logistic regressions were used. The "unhealthy: high SB + low PA" cluster was associated with elevated body fat mass, central obesity, and elevated cIMT. Furthermore, the "unhealthy: low PA + unhealthy eating habits" cluster was associated with elevated body fat mass, central obesity, and elevated glucose. The unhealthier lifestyle behavior clusters were associated with atherosclerosis risk factors in children and adolescents with CHD. Multidisciplinary strategies to promote healthy behaviors are needed to prevent cardiovascular disease in later life. [ABSTRACT FROM AUTHOR]

Background: The importance of muscular fitness (MF) in the performance of activities of daily living is unequivocal. Additionally, emerging evidence has shown MF can reduce cardiometabolic risk in children and adolescents. Objectives: The purpose of this study was to examine and summarize the evidence regarding the relationship between MF phenotypes (i.e., maximum muscular strength/power, muscular endurance, and maximum muscular strength/power/endurance) and cardiometabolic variables (obesity, blood pressure, lipids, glucose homeostasis, inflammatory markers, and clustered cardiometabolic variables) in children and adolescents. Design: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered with PROSPERO, number CRD42020179273. Data Sources: A systematic review was performed on five databases (PubMed, EMBASE, SciELO, Scopus, and Web of Knowledge) from database inception to May 2020, with complementary searches in reference lists. Eligibility Criteria for Selecting Studies: Eligibility criteria included (1) a study sample of youth aged ≤ 19 years, (2) an assessment of MF with individual or clustered cardiometabolic variables derived from adjusted models (regardless of test/measurement adopted or direction of reported association), and (3) a report of the association between both, using observational studies. Only original articles published in peer-reviewed journals in English, Portuguese, and Spanish languages were considered. The quality of the included studies was assessed by using the National Heart, Lung, and Blood Institute checklist. The percentage of results reporting a statistically significant inverse association between each MF phenotype and cardiometabolic variables was calculated. Results: Of the 23,686 articles initially identified, 96 were included (77 cross-sectional and 19 longitudinal), with data from children and adolescents from 35 countries. The score for the quality of evidence ranged from 0.33 to 0.92 (1.00 maximum). MF assessed by maximum muscular strength/power was inversely associated with lower obesity (64/113 total results (56.6%)) and reduction in clustered cardiometabolic risk (28/48 total results (58.3%)). When assessed by muscular endurance, an inverse association with obesity (30/44 total results (68.1%)) and cardiometabolic risk (5/8 total results (62.5%)) was identified. Most of the results for the relationship between MF phenotypes with blood pressure, lipids, glucose homeostasis, and inflammatory markers indicated a paucity of evidence for these interrelationships (percentage of results below 50.0%). Conclusion: MF assessed by maximum muscular strength/power or muscular endurance is potentially associated with lower obesity and lower risk related to clustered cardiometabolic variables in children and adolescents. There is limited support for an inverse association between MF with blood pressure, lipids, glucose homeostasis biomarkers, and inflammatory markers in children and adolescents. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the independent and joint associations among muscle strength (MS) and obesity with blood pressure, atherosclerosis, and laboratory markers. This was a cross-sectional study comprising a representative sample of 642 adults (men: 44.9%, 39.9 ± 11.2 years; women: 55.1%, 39.3 ± 11.1 years) from Florianópolis, Brazil. MS was assessed by handgrip strength. Obesity was defined as a Body Mass Index (BMI) ≥30.0 kg/m² and a waist circumference ≥80.0 cm in women and ≥90.0 cm in men. Clinical variables included systolic (SBP) and diastolic blood pressure (DBP), C-reactive protein (CRP), lipids, glucose metabolism markers and carotid intima-media thickness (IMT). Linear regression models stratified by sex and adjusted for confounders were used. Higher MS levels were related to lower CRP (up to 0.59 times lower), triglycerides (up to 0.33 times lower), HOMA-IR (up to 0.35 times lower), and higher HDL cholesterol (up to 5.2 mg/dL) levels among men. Among women, higher MS levels were related to lower SBP and DBP (up to −10.2 mmHg), CRP (up to 0.56 times lower), HOMA-IR (up to 0.27 times lower) and IMT (up to −4.8 × 10−2 mm). In addition, MS was inversely related to triglycerides and HOMA-IR among obese men, inversely related to CRP among obese men and women, and inversely associated to DBP only among obese women. This population-based study corroborates findings from clinical studies suggesting that even among individuals with obesity, higher MS might help adults to reduce cardiometabolic risk. Muscle strength levels were directly associated with better prognosis in relation to cardiometabolic variables in individuals with or without abdominal obesity. Among men with abdominal obesity, to have higher values of muscle strength were associated with lower values of diastolic blood pressure, C-reactive protein, triglycerides, cholesterol and HOMA-IR. Higher muscle strength levels were inversely associated with C-reactive protein among women with abdominal obesity; Higher muscle strength might help adults to reduce cardiometabolic risk. [ABSTRACT FROM AUTHOR]

Introduction: The increase in excess body fat and the decrease in the number of hours of sleep per day are health problems affecting the pediatric population. Objective: To estimate the combined prevalence of overweight and insufficient sleep/day in adolescents, and the association with sociodemographic characteristics, physical activity and sedentary behavior. Methods: A cross-sectional study of school-based, was conducted with 1.132 participants from 14 to 19 years old in São José, Brazil. Body fat was assessed by body mass index (BMI) and classified by the Z-score, while the total hours of sleep/day was reported by adolescents. Sociodemographic data, physical activity and sedentary behavior were collected by self-administered questionnaire. Results: The simultaneous prevalence of overweight and insufficient sleep/day was 17.5%. The factors associated with this condition were to meet the recommendations of the practice of physical activity per week, participate in gym class twice/week and period greater/equal to four hours/day in front of the screen. Conclusion: Guidelines in the school environment in relation to health problems posed by excess weight and the amount of insufficient hours sleep can be present when recommendations on physical activity and sedentary behavior are given to students. [ABSTRACT FROM AUTHOR]

Introduction: An increase in excess body fat and a decrease in the number of hours of sleep per day are health problems affecting the paediatric population. Objective: To estimate the combined prevalence of overweight and insufficient sleep/day in adolescents, and the association with sociodemographic characteristics, physical activity and sedentary behaviour. Methods: A cross-sectional school-based study was conducted with 1,132 participants from 14 to 19 years old in São José, Santa Catarina, Brazil. Body fat was assessed by body mass index (BMI) and classified by the Z-score, while adolescents reported the total hours of sleep/day. Sociodemographic data, physical activity and sedentary behaviour were collected by self-filled questionnaire. Results: The simultaneous prevalence of overweight and insufficient sleep/day was 17.5%. The factors associated with this condition were to meet the recommendations of the practice of physical activity per week, participate in gym class twice/week and period greater/equal to four hours/day in front of the screen. Conclusion: Guidelines in the school environment in relation to health problems posed by weight excess and the amount of insufficient hours sleep can be present when recommendations on physical activity and sedentary behaviour are given to students. [ABSTRACT FROM AUTHOR]

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