Influências familiares e determinantes precoces na ocorrência da obesidade e do risco cardiovascular em crianças

• Autor(a) principal: Moreira, Adriana Cotote
• Data de Publicação: 2010
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: LOCUS Repositório Institucional da UFV
• Texto Completo: http://locus.ufv.br/handle/123456789/2735
• topic: Risco cardiovascular; Crianças; Obesidade; Antecedentes familiares; Determinantes precoces; Cardiovascular risk; Children; Obesity; Family background; Early determinants; CNPQ::CIENCIAS DA SAUDE::NUTRICAO

Analytical cross hybrid studies with retrospective components were conducted in order to verify the effect of early risk factors and family background of obesity and hypertension on the development of cardiovascular risk factors in children. In the first stage, anthropometric evaluation in 90.6% of students aged 6 -10 from the municipal schools in Nova Era/ Minas Gerais (1.025 total) was conducted using the Body Mass Index (BMI)/age as indicator, considering the anthropometric reference standard of the World Health Organization/2007 (WHO). All children classified as obese were invited to participate. For each obese child, two euthrophic ones of the same sex, age and school were selected. Biological parents were invited to take part as well. In the studies that investigated the influence of the nutritional status and blood pressure levels of mothers and fathers in the nutritional status and blood pressure (BP) of children (Articles 1 and 2), only children with complete information on BP and nutritional status of their biological parents participated in the analysis. In the study that investigated the influence of birth weight and current nutritional status on cardiovascular risk factors (Article 3), only children with information on birth weight participated in the analysis. Children with birth weight higher 4,000 grams were excluded too. The variables analyzed for children were: birth weight, current weight and height, waist circumference (WC), percent body fat (%BF), blood pressure, total and fractions of serum cholesterol levels (HDL, LDL, VLDL, triglycerides) glucose and C-reactive protein (CRP). The mother and father variables were: BP, weight, height, WC and %BF. The BP of children, fathers and mothers were assessed and classified according to the recommendations of the V Brazilian Guidelines on Hypertension (2006). It was noticed increased BP in children, percentile value corresponding to the classification of prehypertension and increased BP in mothers and fathers. Moreover, value of systolic blood pressure (SBP) or diastolic blood pressure (DBP), corresponding to the limitrophe classification of BP for adults. The nutritional status of children was notably related to the nutritional state of their parents. The average BMI, % BF and WC were statistically superior in children of overweight parents, excess in BF and with central obesity. I was found that body fatness indicators were significantly correlated to elevated levels of BP in children: DBP was correlated with BMI, % BF and WC. Furthermore, BP of children was associated with the BP of fathers, but did not establish any relation with the BP of mothers. It was observed a weak relation between low birth weight and cardiovascular risk and the weight at birth was correlated only with the DBP. In addition, it was observed that the current nutritional status correlated with DBP, WC, BF%, glucose, triglycerides, LDL, VLDL and CRP. The study presented statistically higher average in the BMI, WC, BF%, DBP, TG, VLDL and CRP of the group of children with low birth weight and current obesity and also in those with birth weight equals or higher 2,500 and higher 4,000g and current obesity, suggesting a higher increase in weight in the first years of life as an significant predictor of cardiovascular risk. As a result, the studies suggest that obesity and hypertension in children are respectively related to the excess in weight of mothers and fathers and with the fathers BP. Interventions to reduce cardiovascular events had better prioritize measures aiming the whole family, instead of actions focused only on the individual. It draws the attention to the importance of implementing policies for motherly and child health and the vital role of the Family Health strategy.