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AIMS: To evaluate, through anthropometric and biochemical parameters, the impact of an overweight management strategy implemented in an outpatient clinic for childhood obesity in a public hospital.METHODS: Retrospective analysis of a cohort of 206 children and adolescents with a diagnosis of obesity or overweight, aged between 5 and 17 years, attended between 2010 and 2014 with an average period of three months during one year. The strategy evaluated consisted of counseling, with guidelines aimed at reducing sedentary activity time and increased physical activity and nutritional guidelines for healthier food choices. Were evaluated anthropometric parameters (body mass index, z-escore of body mass index by age, waist circumference, hip circumference and waist hip ratio) and biochemistry (fasting glucose, fasting insulinemia, homeostasis model assessment, total cholesterol (CT), high density lipoprotein (HDL-c), low density lipoprotein (LDL-c), triclycerides (TG) at the baseline, at 6 and 12 months of follow-up. Statistical analyzes were performed in the IBM SPSS Statistics 22.0, using the Generalized Estimating Equations model.RESULTS: In 12 months, there was a significant reduction in BMI, Z score of BMI/age, percentage of individuals with BMI/age z score ≥ +2, WHR, percentage of individuals with WC > p90 and HC (p<0,001). Serum glycemia and insulin levels did not show significant reduction, only a trend, as did TC, LDL-c and TG, but HDL-c levels had a significant increase (p=0.035).CONCLUSIONS: This strategy of management of childhood and adolescent overweight, based on counseling, made it possible to reduce significantly the levels of overweight, although the biochemical parameters were not reduced in the same proportion., OBJETIVOS: Avaliar, através de parâmetros antropométricos e bioquímicos, o impacto de uma estratégia de manejo do excesso de peso implantada em um ambulatório de obesidade infanto-juvenil de um hospital público.MÉTODOS: Análise retrospectiva de uma coorte, realizada a partir de fichas de 206 crianças e adolescentes com diagnóstico de obesidade ou sobrepeso, com idade entre 5 a 17 anos, atendidos entre 2010 e 2014 com periodicidade média de três meses durante um ano. A estratégia avaliada consistiu em aconselhamento, com orientações visando redução do tempo de atividade sedentária e aumento de atividade física e orientações nutricionais para escolhas alimentares mais saudáveis. Foram avaliados parâmetros antropométricos (índice de massa corporal (IMC), escore z de IMC por idade, circunferências da cintura (CC) e do quadril (CQ), razão cintura quadril (RCQ)) e bioquímicos (glicemia de jejum, insulinemia de jejum, índice do Homeostasis Model Assessment, colesterol total (CT), lipoproteína de alta densidade (HDL-c), lipoproteína de baixa densidade (LDL-c), triglicerídeos (TG) no início, aos 6 e aos 12 meses de acompanhamento. As análises estatísticas foram realizadas no programa IBM SPSS Statistics 22.0, com aplicação do modelo de Equações de Estimativas Generalizadas.RESULTADOS: Em 12 meses, houve redução significativa do IMC, do escore z do IMC/idade, do percentual de indivíduos com escore z de IMC / idade ≥ +2, da CC, do percentual de indivíduos com CC > p90 e da RCQ (p<0,001). Os níveis séricos de glicemia e insulina não apresentaram redução significativa, apenas uma tendência, assim como os de CT, LDL-c e TG, porém os níveis de HDL-c tiveram um aumento significativo (p=0,035).CONCLUSÕES: Esta estratégia de manejo do excesso de peso infanto-juvenil, baseada em aconselhamento, possibilitou redução significativa dos níveis de excesso de peso, embora os parâmetros bioquímicos não tenham sido reduzidos na mesma proporção.

Aims: To compare the Subjective Global Nutritional Assessment (SGNA) and the Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) protocols with anthropometric measurements at admission, and associate them to length of stay in hospitalized children. Methods: Cross-sectional study with patients from four to 8.9 years admitted to a pediatric hospital in Porto Alegre, Rio Grande do Sul, Brazil. The sample was selected by convenience, and data collection occurred between June and October 2014. Patients in the Intensive Care Unit and those unable to feed orally were not included. We collected general and socioeconomic information and applied STRONGkids and SGNA protocols at admission. Clinical and anthropometric data were retrieved from electronic medical records. Results: We evaluated 317 patients with a mean age of 76.1±17.5 months, most of them admitted for surgery (21.5%). According to anthropometric measurements, 5% of patients were malnourished, 74.1% had normal weight and 20.8% were overweight. There was a statistically significant association between malnutrition classified by anthropometric measurements and moderate and severe malnutrition defined by SGNA (p<0.001). There was also a significant association between overweight, normal weight and malnutrition classified by anthropometric measurements and low, medium and high nutritional risk, respectively (p<0.001). There was a statistically significant agreement, although very weak, between STRONGkids and anthropometric measurements (kappa=0.148; p=0.001). Conclusions: All protocols were associated (though in low intensity) to length of hospital stay. In addition, STRONGkids showed greater agreement, although still weak, with anthropometric measurements when compared to the SGNA. Further studies are needed to verify the agreement of these protocols with other objective methods of nutritional assessment.