Abstract Background Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in Brazil. Objective To provide population-based data on prevalence and factors associated with CVD risk factors. Methods Individuals aged ≥20 years from two editions of the cross-sectional Health Survey of São Paulo focusing on Nutrition (ISA-Nutrition), performed in Sao Paulo city in 2008 (n=590) and 2015 (n=610), were evaluated for: obesity, central obesity, waist/height ratio, high blood pressure (HBP), dyslipidemia, diabetes, and number of CVD risk factors ≥3. Prevalence was estimated according to complex survey procedures. Factors associated with cardiovascular risk factors were assessed using logistic regression, with statistical significance of p<0.05. Results Obesity and older age were associated with higher odds of all cardiovascular risk factors investigated, except for dyslipidemia. HBP was positively associated with being Black/Brown and negatively associated with being physicaly active in leisure time. Women were more likely to have increased adiposity indicators and three or more cardiovascular risk factors than men. Those with higher education had lower chances of having diabetes, HBP and dyslipidemia, and those with higher income had higher chances of having three or more risk factors. Former smokers had higher odds of diabetes, obesity, and high waist/height ratio, and smokers had higher odds of high non-HDL cholesterol levels. From 2008 to 2015, there was an increase (p<0.001) in the prevalence of diabetes (6.9% to 17.3%), HBP (31.9% to 41.8%), dyslipidemia (51.3% to 67.6%), and number of CVD risk factors ≥3 (18.9% to 34.1%). Conclusion This study shows increasing prevalence of CVD risk factors in adult population in Sao Paulo and may support the definition of target groups and priority actions on CVD prevention and treatment.

Resumo Objetivo: Estimar a prevalência de consumo de café da manhã e descrever os alimentos e nutrientes consumidos nessa refeição e durante todo o dia por adolescentes brasileiros. Método: Foram avaliados 7.276 adolescentes entre 10-19 anos no Inquérito Nacional de Alimentação 2008-2009, um estudo transversal de base populacional. As informações dos indivíduos foram coletadas nos domicílios. Os dados alimentares foram obtidos por dois registros alimentares. O café da manhã foi definido como a primeira refeição do dia entre 6h e 9h59. As diferenças entre os consumidores de café da manhã, consumidores ocasionais e aqueles que não tomam café da manhã foram testadas por meio do teste de qui-quadrado ou teste F para análise de regressão. Resultados: O café da manhã foi consumido por 93% dos adolescentes e seu consumo foi associado à idade, renda, região geográfica e área residencial. Os alimentos mais frequentemente consumidos foram pão branco, café, manteiga/margarina, biscoitos e bolachas refinados e leite integral. A ingestão média diária de energia total, açúcar e cálcio foi maior entre os consumidores ocasionais e aqueles que não tomam café da manhã. Aqueles que tomam café da manhã apresentam maior ingestão de vitaminas B12, C e D. O café da manhã contribuiu mais para a ingestão total de cálcio, fósforo, tiamina, riboflavina e vitaminas A, B6 e D (17%-32%), gordura trans e sódio (cerca de 30%) e menos para a ingestão de ácido fólico, vitamina C, ferro, zinco e fibras (8%-12%) e energia (16%). Conclusões: Apesar de a prevalência de consumo de café da manhã entre os adolescentes brasileiros ter sido alta, a qualidade nutricional dessa refeição está abaixo do ideal, destaca a necessidade de apoio aos adolescentes e suas famílias para possibilitar a escolha de alimentos mais densos em nutrientes.

Abstract Objective: To estimate the prevalence of breakfast consumption and describe the foods and nutrients consumed at this meal and throughout the day by Brazilian adolescents. Method: A total of 7276 adolescents aged 10-19 years were evaluated in the Brazilian National Dietary Survey 2008-9, a population-based cross-sectional study. Individuals' information was collected at home. Dietary data were obtained by two food records. Breakfast was defined as the first eating occasion of the day that occurred between 6 and 9:59 am. Differences between breakfast consumers, occasional consumers, and skippers were tested through Pearson's chi-squared test or F-test of regression analysis. Results: Breakfast was consumed by 93% of adolescents and it was associated with age, income, geographic region and household area. The most frequently consumed foods at breakfast were white bread, coffee, butter/margarine, refined cookies and crackers, and whole milk. The mean daily intakes of total energy, sugar, and calcium were higher among occasional consumers and skippers. Breakfast consumers had higher intake of vitamins B12, C, and D. Breakfast contributed more to total intake of calcium, phosphorus, thiamin, riboflavin, and vitamins A, B6, and D (17-32%), trans fat and sodium (about 30%) and less to folate, vitamin C, iron, zinc, and fiber (8-12%) and energy intake (16%). Conclusions: Although the prevalence of breakfast consumption among Brazilian adolescents was high, the overall nutritional quality of this meal is suboptimal, highlighting the need to support adolescents and their families to make more nutrient-dense food choices.

OBJETIVO: Comparar as mudanças da aptidão cardiorrespiratória em avaliações a cada 10 anos a partir de 1978/1980, de acordo com o estado nutricional e o sexo de escolares do município de Ilhabela, Brasil. MÉTODOS: O estudo faz parte do Projeto Misto-Longitudinal de Crescimento, Desenvolvimento e Aptidão Física de Ilhabela. Participaram do estudo 1.291 escolares de ambos os sexos, de 10 e 11 anos de idade. Os períodos analisados foram 1978/1980, 1988/1990, 1998/2000 e 2008/2010. As variáveis analisadas foram peso corporal, estatura e aptidão cardiorrespiratória (VO2máx - L.min-1 e mL.kg-1.min-1) realizada por um protocolo progressivo submáximo em um ciclo ergômetro. Os indivíduos foram classificados em eutróficos e excesso de peso mediante as curvas propostas pela Organização Mundial da Saúde de índice de massa corporal para idade e sexo. Para comparar os períodos, foi utilizado a ANOVA com três fatores, seguida pelo método Bonferroni. RESULTADOS: A quantidade de eutróficos (61%) foi maior do que a de excesso de peso. Houve diminuição significativa da aptidão cardiorrespiratória em ambos os sexos. Entre os escolares meninos e as meninas eutróficas houve diminuição de 22% e 26%, respectivamente. Nos escolares com excesso de peso, os meninos diminuíram em 12,7%, e as meninas, em 18%. CONCLUSÃO: Em uma análise de 30 anos, com avaliações a cada 10 anos a partir de 1978/1980, houve uma diminuição significante da aptidão cardiorrespiratória em escolares de ambos os sexos, que não pode ser explicada pelo estado nutricional. A queda da aptidão cardiorrespiratória foi maior nos escolares eutróficos do que nos obesos.

OBJECTIVE: To compare the changes in cardiorespiratory fitness in evaluations performed every ten years since 1978/1980, according to the nutritional status and gender of students in the city of Ilhabela, Brazil. METHODS: The study is part of the Mixed Longitudinal Project on Growth, Development and Physical Fitness of Ilhabela. The study included 1,291 students of both genders, aged 10 to 11 years old. The study periods were: 1978/1980, 1988/1990, 1998/2000, and 2008/2010. The variables analyzed were: body weight, height, and cardiorespiratory fitness (VO2max -L.min-1 and mL.kg-1.min-1) performed using a submaximal progressive protocol on a cycle ergometer. Individuals were classified as normal weight and overweight according to curves proposed by the World Health Organization of body mass index for age and gender. Analysis of variance (ANOVA) with three factors followed by the Bonferroni method were used to compare the periods. RESULTS: The number of normal weight individuals (61%) was higher than that of overweight. There was a significant decrease in cardiorespiratory fitness in both genders. Among the schoolchildren with normal weight, there was a decrease of 22% in males and 26% in females. In overweight schoolchildren, males showed a decrease of 12.7% and females, of 18%. CONCLUSION: During a 30-year analysis with reviews every ten years from 1978/1980, there was a significant decrease in cardiorespiratory fitness in schoolchildren of both genders, which cannot be explained by the nutritional status. The decline in cardiorespiratory fitness was greater in individuals with normal weight than in overweight individuals.

OBJETIVO: Avaliar a densidade mineral óssea (DMO) e relacioná-la com a ingestão alimentar e composição corporal de adolescentes modelos de passarela. MÉTODOS: Estudo transversal avaliando 33 modelos e 33 não modelos de 15 a 18 anos pareadas por idade e índice de massa corporal (IMC). A densidade mineral óssea da coluna (L1-L4) foi avaliada por meio da técnica da absorciometria de feixe duplo de energia (Lunar® DPX Alpha), e a composição corporal, pela técnica de pletismografia. A ingestão alimentar foi avaliada por meio do registro alimentar de 3 dias. RESULTADOS: A média de idade das adolescentes foi de 16,75±1,04 anos, sendo que 24% apresentaram IMC abaixo dos valores ideais para a idade. Não houve diferença de DMO entre modelos (1,108±0,080 g/cm2) e não modelos (1,096±0,102 g/cm2) (p > 0,05), sendo identificada uma porcentagem de 6% de baixa DMO para a idade. Observou-se que a média de ingestão de energia foi menor entre as modelos em comparação às adolescentes não modelos (1.480,93±582,95 versus 1.973,00±557,63 kcal) (p > 0,05) e que a maioria das adolescentes de ambos os grupos apresentou consumo inadequado de micronutrientes, ressaltando-se a baixa ingestão de cálcio. Verificou-se correlação significativa da DMO apenas com a massa magra (kg) (modelos r = 0,362 e não modelos r = 0,618; p < 0,05). CONCLUSÃO: Apesar de não ter sido encontrada associação entre a DMO, o IMC e a ingestão de nutrientes importantes no processo de mineralização óssea, as inadequações na ingestão alimentar podem influenciar negativamente a aquisição de massa óssea, que se encontra potencializada neste estágio de vida.

OBJECTIVE: To evaluate the bone mineral density (BMD) and to relate it to the food intake and body composition of adolescent runway models. METHODS: Cross-sectional study evaluating 33 models and 33 non-models aged from 15 to 18 years, paired by age and body mass index (BMI). BMD of spine (L1-L4) was evaluated using the dual-energy X-ray absorptiometry technique (Lunar® DPX Alpha), and body composition was assessed by means of plethysmography. Food intake was evaluated by a 3-day-food record. RESULTS: The subjects mean age was 16.75±1.04 years, and 24% had BMI below ideal value for their age. BMD values (g/cm2) were similar between models (1.108±0.080) and non-models (1.096±0.102) (p > 0.05), and 6% of the participants had low BMD for age. We found that the mean energy intake was lower among models as compared to non-models (1,480.93±582.95 vs. 1,973.00±557.63 kcal) (p < 0.05) and that most of the adolescents in both groups presented an inadequate consumption of micronutrients, with emphasis to the low calcium intakes. There was only significant correlation between BMD and lean body mass (kg) (r = 0.362 for models and r = 0.618 for non-models) (p < 0.05). CONCLUSION: Although no association was found between BMD, BMI, and intake of nutrients which are important for the bone mineralization process, inadequacies of food intake have an adverse influence on the acquisition of bone mass, which is more effective at this stage of life.

O objetivo do presente estudo foi avaliar as alterações promovidas, por intervenção multidisciplinar, nas concentrações plasmáticas de grelina e leptina, adiposidade visceral e prevalência de esteatose hepática não alcoólica (NAFLD), em adolescentes obesos. Foram avaliados 28 adolescentes obesos, 16 meninas (IMC 34,58 ± 3,86kg/m²) e 12 meninos (IMC 37,08 ± 3,17kg/m²), com idade entre 15 e 19 anos, quanto à concentração de leptina, grelina, insulina, assim como a adiposidade visceral e o diagnóstico de NAFLD pelo método de ultra-sonografia. Os resultados demonstraram redução significante na concentração circulante de grelina e leptina e na adiposidade visceral (p < 0,01). Houve ainda redução percentual na prevalência de NAFLD, sendo este um resultado relevante, visto que esta doença pode progredir para cirrose, tanto em crianças quanto em adolescentes obesos. Este tipo de tratamento demonstrou ser eficiente na melhora do perfil metabólico e hormonal, contribuindo para o controle da obesidade e suas co-morbidades em adolescentes obesos.

The aim of this study was to assess the changes promoted by a multidisciplinary therapy in ghrelin and leptin concentrations, visceral adiposity and non-alcoholic fat liver disease-NAFLD, in obese adolescents. A total of 28 obese adolescents, 16 girls (BMI 34.58 ± 3,86 wt/ht²) and 12 boys (BMI 37.08 ± 3.17 wt/ht²), aged between 15 and 19 years old, was evaluated to leptin, ghrelin and insulin concentrations, visceral adiposity and NAFLD through ultrasonography. The results showed a significant decrease in ghrelin, leptin concentrations and visceral adiposity (p < 0.01). Moreover, a decrease in the NAFLD prevalence was observed. It is an important result, since this disease can progress to cirrhosis, not only in children but also in obese adolescents. This kind of treatment can be efficient to improve metabolic and hormonal profile, as well as, to control obesity and related co-morbidities in obese adolescents.

El objetivo del presente trabajo ha sido evaluar las alteraciones promovidas por la intervención multidisciplinar, en las concentra- ciones plasmáticas de grelina y leptina, adiposidad visceral y prevalencia de esteatosis hepática no alcohólica - NAFLD, en adolescentes obesos. 28 adolescentes obesos, 16 chicas (IMC 34,58 ± 3,86 kg/m²) y 12 chicos (IMC 37,08 ± 3,17 kg/m²), con edades entre 15 y 19 años, fueron evaluados respecto a la concentración de leptina, grelina, insulina, así como a la adiposidad visceral y el diagnóstico de NAFLD por el método de ultrasonografía. Los resultados demostraron una reducción significante en la concentra- ción circulante de grelina y leptina y en la adiposidad visceral (p < 0,01). Hubo aún una reducción porcentual en la prevalencia de NAFLD, siendo este un resultado relevante, ya que esta enfermedad puede progresar hasta la cirrosis, tanto en niños como en adolescentes obesos. Este tipo de tratamiento demostró ser eficiente en la mejora del perfil metabólico y hormonal, contribuyendo para el control de la obesidad y su comorbilidad en adolescentes obesos.

Several studies have indicated that depressive states may lead to hypokinesia with diminished metabolic rate and energy use. Hypokinesia associated with certain eating behaviors may lead to an unfavorable energy balance that can contribute to the emergence and prevalence of obesity among children and adults. The purpose of the present study was to examine the possibility of reducing depression inventory scores in female adolescents with third-degree obesity while testing the effectiveness of different exercise programs in reducing anxiety and depression scores. The sample consisted of 40 female subjects (mean age 16 ± 1.56 years) divided into 4 groups (aerobic training, anaerobic training, leisure activities, and control). Subjects had a body mass index of 95% or more in relation to the 50th percentile. The aerobic program consisted of three ergometric bicycle sessions per week over a 3-month period (12 weeks) and the activities were prescribed after determining the anaerobic ventilatory threshold (VO2 threshold). Anaerobic training was based on the Wingate anaerobic power test. The leisure program consisted of a varied range of activities (games, exercises, etc.). A nutritionist interviewed the members of these two groups and the control group every week in order to adapt them to the nutritional guidelines proposed for the study. The study showed that all three programs (aerobic exercise, anaerobic exercise and leisure activities) were effective in reducing body mass. However, we found a significant reduction when analyzing the depression scores only for aerobic exercise (18.9 ± 9.33 to 10.6 ± 9.56 or 43.9%) but no significant alterations for anaerobic exercise (11.36 ± 5.23 to 9.63 ± 4.78 or 15.22%) and leisure (17.28 ± 7.55 to 15.07 ± 7.54 or 12.78%), thus indicating that in principle this type of activity could be included to improve emotional well-being of obese adolescent girls.

O objetivo deste trabalho foi caracterizar o stress em crianças de 1ª a 4ª série, de uma escola pública do município de São Paulo e ainda comparar a presença ou ausência do stress com o respectivo desempenho escolar, das crianças. 342 crianças foram avaliadas pela Escala de Stress Infantil (ESI). O desempenho escolar das crianças foi obtido a partir da média de conceitos (A, B, C, D e E) fornecidos pelos professores, em sete disciplinas. E, para fins de tratamento estatístico, o desempenho escolar passou a se configurar nos seguintes critérios: forte (A), médio (B) e fraco (C). Os resultados não apontaram diferenças estatisticamente significativas. Porém, os dados mostraram que 30,1% das crianças apresentaram stress e, das crianças estressadas, 38,2% apresentaram desempenho fraco.

The objective of this article was to evaluate stress in children (1tst to 4th grade ) at a public school in São Paulo city and also to study the correlation between the presence or absence of stress and the children's school performance. 342 children were evaluated through the ESI (Escala de Stress Infantil) and their school performance was assessed on the basis of the average grade (A, B, C, D or E) given by their teachers in seven different subjects. For statistical purposes, the average school performance grades were defined as: A-strong; B-medium; C-weak. The results did not show differences that were statistically significant. However, they showed that 30,1% of the children had stress symptons and 38,2% of the children who had stress had also weak school performance.

We evaluated spine bone mineral density (BMD) in Brazilian children with juvenile systemic lupus erythematosus (JSLE) in order to detect potential predictors of reduction in bone mass. A cross-sectional study of BMD at the lumbar spine level (L2-L4) was conducted on 16 female JSLE patients aged 6-17 years. Thirty-two age-matched healthy girls were used as control. BMD at the lumbar spine was measured by dual-energy X-ray absorptiometry. Weight, height and pubertal Tanner stage were determined in patients and controls. Disease duration, mean daily steroid doses, mean cumulative steroid doses and JSLE activity measured by the systemic lupus erythematosus disease activity index (SLEDAI) were determined for all JSLE patients based on their medical charts. All parameters were used as potential determinant factors for bone loss. Lumbar BMD tended to be lower in the JSLE patients, however, this difference was not statistically significant (P = 0.10). No significant correlation was observed in JSLE girls between BMD and age, height, Tanner stage, disease duration, corticosteroid use or disease activity. We found a weak correlation between BMD and weight (r = 0.672). In the JSLE group we found no significant parameters to correlate with reduced bone mass. Disease activity and mean cumulative steroid doses were not related to BMD values. We did not observe reduced bone mass in female JSLE.

Uso de bollos fortificados con hierro bis-glicinato quelado en la prevención de anemia por deficiencia de hierro en preescolares. La efectividad del pan fortificado con hierro bis-glicinato quelado para el control de deficiencia de hierro y la anemia ferropriva en infantes fue evaluada en 89 niños preescolares procedentes de familias de bajo nivel socio-económico, que asistían a hogares de día de la municipalidad del Estado de Sao Paulo, Brazil. La intervención duró 6 meses durante los cuales los niños del estudio recibieron dos bollos fortificados con 2 mg de hierro del quelado cada uno. Después de 6 meses de intervención, se observó una disminución significativa en la prevalencia de anemia ferropriva de 62 a 22%. Hubo una mejoría en los niveles de hemoglobina de 1.1 g/dL en el grupo total, y en aquellos niños que al principio mostraban valores <11 g/dL el aumento medio en hemoglobina fue de 1.42 g/dL. Los valores medios de ferritina en plasma aumentaron de 11.34 a 20.2 my g/L, y todos los niños con depauperación de hierro normalizaron sus niveles de ferritina plasmática. Al final de la intervención se demostró un aumento significativo en el valor de "z" para peso/talla. Se concluye que el consumo de los bollos fortificados con 2 mg de hierro del bis- glicinato quelado por unidad es altamente efectivo en el control de , la deficiencia de hierro y la anemia ferropriva.

The effectiveness of bread fortified with iron bis- glycinate chelate for the control of iron deficiency and iron deficiency anemia was evaluated in 89 preschool children from families of low socioeconomic level attending 2 day nurseries of the Sao Paulo City Council. During the intervention's time of 6 months the children received besides their usual center's diet, a daily supplement of two sweet rolls fortified with 2 mg each of iron from the chelate for a total daily iron intake of 4 mg. After six months of intervention there was a significant decrease in the prevalence of iron deficiency anemia from 62 to 22%. There was a mean hemoglobin improvement of 1.1 g/dL, and in children with initial hemoglobin levels < 11 g/dL the mean increase in hemoglobin was 1.42 g/dL. The total mean plasma ferritin values increased from 11.34 to 20.2 mu g/L, and in those children originally iron depleted the ferritin values normalized. A significant increase in the "z" score for weight/height was also observed. We concluded that the use of sweet rolls fortified with 2 mg of iron from the bis-glycinate chelate is highly effective for the control of iron deficiency and iron deficiency anemia in young children.

OBJETIVO: verificar se a desnutrição pregressa, além de causar déficit na estatura de meninas também poderia estar causando uma limitação funcional à capacidade de realização de exercício máximo e submáximo em bicicleta ergométrica. CASUÍSTICA: 24 meninas, 12 eutróficas de idade (média ± DP) 9,13 ± 0,79 anos; peso 27,64 ± 3,64 kg; e altura 131,31 ± 6,04 cm; e 12 com desnutrição pregressa; idade 9,75 ± 1,10 anos; peso 25,16 ± 2,33 kg; e altura 125,06 ± 3,90 cm. METODOLOGIA: Avaliação clínica e teste ergoespirométrico em bicicleta ergométrica, a partir do qual foram obtidas as variáveis metabólicas e cardiorrespiratórias analisadas. Protocolo de teste: 2 minutos iniciais a 25 watts, seguidos de incrementos de 15 watts a cada 2 minutos, até a exaustão. RESULTADOS: Testes de esforço máximo: não foram observadas diferenças entre o grupo de meninas eutróficas (E) e o grupo de meninas com desnutrição pregressa (D) para nenhuma das variáveis analisadas: VO2max l/min., VO2max ml/min/kg, VEmax , R, FCmax, %FCmax prev e Watts max. Teste de esforço submáximo: foram observadas diferenças entre os grupos para as seguintes variáveis: VO2 l/min LA, % VO2max , FC LA, % FCmax LA, VE LA, % VEmax LA. Não foram encontradas diferenças entre os grupos para: VO2 ml/min/kg LA e Watts LA. CONCLUSÃO: O restabelecimento da relação peso para estatura em meninas com desnutrição pregressa, considerado como critério de eutrofia, é válido também para indicar ausência de limitação funcional da capacidade de realização de exercício.

OBJECTIVE: The metabolic and cardiovascular responses of eutrophic girls and girls who underwent early undernutrition, were examined during physical exercise, in order to verify whether previous undernutrition could, in addition to cause a deficit in the children's height, and limit their functional capability to perform a maximal and submaximal exercise in an ergometric bicycle. SUBJECTS: Our sample was composed of 24 girls, of which 12 were eutrophic, with 9.13 ± 0.79 years (mean ± s.d.), 27.64 ± 3.64 kg of body weight, and 131.31 ± 6.04 cm in height. The 12 early undernourished girls were 9.75 ± 1.1 years old, 25.16 ± 2.33 kg, and 125.06 ± 3.9 cm high. MEASUREMENTS: The method included clinical evaluation and ergo-spirometric test on an ergometric bicycle, from which all the metabolic and cardiac-respiratory variables were obtained and analyzed. The test protocol was an initial two minutes period with 25 watts, followed by increments of 15 watts every two minutes, until exhaustion. RESULTS: Analysis of the results of the test of maximal effort did not reveal significant differences between eutrophic (E) and early undernourished (UN) girls in any of the variables: VO2max expressed in l/min (E = 1.11 ± 0.25; UN = 1.02 ± 0.19); VO2max expressed in ml/min/kg (E = 40.23 ± 6.98; UN = 40.53 ± 6.32), VEmax (E = 40.61 ± 8.79; UN = 38.25 ± 8.95), R (E = 1.13 ± 0.07; UN = 1.13 ± 0.05), HRmax (E = 195.33 ± 9.13; UN = 193.85 ± 11.18), previous % HRmax (E = 92.87 ± 4.33; UN = 92.80 ± 4.87), and maximum watts (E = 90.00 ± 20.56; UN = 91.25 ± 11.33). Analysis of the results obtained in test of submaximal effort, reflected by the intensity of effort in the anaerobic threshold (AT), showed differences between the groups in the following variables: VO2max expressed in l/min. (E = 0.77 ± 0.14; UN = 0.62 ± 0.13), % of VO2max (E = 70.07 ± 7.52; UN = 61.21 ± 9.83), HR (E = 166.58 ± 14.25; UN = 146.33 ± 17.40), % HRmax (E = 85.31 ±6.41; UN = 75.50 ± 7.73), VE (E = 24.18 ± 5.81; UN = 17.69 ± 4.30), % VEmax (E = 59.64 ± 8.45; UN = 46.95 ± 10.59). No differences were found for VO2max, expressed in l/min/kg (E = 28.06 ± 4.87; UN = 24.81 ± 5.31) and watts (E = 51.25 ± 17.47; UN = 45.00 ± 9.77). CONCLUSION: The reestablishment of the ratio weight/height in early undernourished girls is also useful to indicate lack of limitation of functional capability to perform physical exercises.

A análise de performance psicomotora de crianças institucionalizadas é de fundamental importância no planejamento de atividades educativas. Estudos anteriores têm mostrado prejuízos desta função em crianças de creches. OBJETIVO. Comparar o desempenho no teste de triagem de Denver em crianças de 2 a 6 anos de idade, de creches conveniadas com a Prefeitura de São Paulo, antes e após seis meses de intervenção nutricional com suplemento alimentar enriquecido com ferro. MÉTODO. Foram analisadas 130 crianças de 2 a 6 anos de idade, em três creches municipais de São Paulo, aplicando-se o teste de Denver, por psicólogas treinadas, comparando-se os resultados de acordo com o sexo, faixa etária e estado nutricional, antes e após período de suplementação alimentar. RESULTADOS. A maior parte das crianças teve desempenho normal, tanto na primeira aplicação (70,80%), como na segunda (80,80%), sem modificação do estado nutricional. Na comparação dos resultados, 76,92% não modificaram o desempenho e 18,46% melhoraram significativamente. Em relação ao sexo, não foram encontradas diferenças significantes, enquanto que, para a faixa etária, houve melhora significante entre as crianças de 4 a 6 anos. CONCLUSÕES. Além do aspecto nutricional, fatores como prontidão para aprendizagem, organização familiar e orientação psicopedagógica das creches devem estar favorecendo o desenvolvimento, mesmo considerando-se o baixo nível socioeconômico da população estudada.

Psychomotor and development analysis must be emphasized when studying institutionalized children. Many previous investigations have been showing deleterious effects of day care centers over developmental performance in children. OBJECTIVE. This study is aimed at comparing the performance in the Development Screening Test (Denver) in children attending day care centers, before and after nutritional intervention with an energetic supplement enriched with iron. METHOD. 130 children from 2 to 6 years old, attending three municipal day care centers, were evaluated by means of the application of the Denver test, by trained psychologists, comparing the collected data according to sex and age group, before and after six months intervention with iron enriched protein energetic supplement. RESULTS. Most of the children had normal performance, both in first application (70.80%), and in the second one (80.80%). When comparing these results, 76.92% of the children had not altered their performance and 18.46% improved it substantially. As to sex, no significant differences were found and as to age group, there was significant improvement among children aged 4 to 6 years of age. CONCLUSIONS. Besides the nutritional aspects, factors such as learning readiness, family organization, and psychopedagogic orientation to the day care centers, must have fostered development, even if the low socioeconomic level of the studied population is considered.

Foram estudadas as características intelectuais de 65 crianças obesas, de 8 a 13 anos e 11 meses, comparativamente às de 35 crianças eutróficas, através da Escala de Inteligência Wechsler para Crianças. Os dois grupos foram pareados de acordo com a faixa etária, série escolar e nível socioeconômico. O grupo de obesos foi composto por pacientes atendidos pelo Departamento de Pediatria da Universidade Federal São Paulo, e o grupo-controle, por crianças pertencentes a escolas públicas. O grupo de eutróficos apresentou significantemente melhor desempenho no teste de inteligência do que o grupo de obesos (Quociente de inteligência -QI médio - 91 x 85; p < 0,05). Crianças eutróficas revelaram maior amplitude de interesses e capacidade de adaptação social e, melhor velocidade e destreza. Houve correlação positiva entre o nível de renda, a relação peso/estatura e o QI. Apesar de todos os resultados médios de QI apresentarem dados consistentemente favoráveis aos eutróficos, não se pode afirmar total superioridade desse grupo em virtude da ampla gama de fatores emocionais intervenientes no processo de inteligência, não controlados pelo estudo.

The intellectual characteristics of 65 obese children and adolescents (weight for height <FONT FACE=Symbol>³</FONT>140% ), aged 8 to 13 years and 11 months, were compared to those of 35 eutrophic children and adolescents (weight for height between 90 and 110%; and stature for age > 95%) of the same age group, utilizing the Wechsler Intelligence Scale for Children - WISC. Children and adolescents of the two groups were paired according to age groups, schooling level and socioeconomic condition. The obese group was composed of new patients assisted at the Department of Pediatrics of the Federal University of S. Paulo (Escola Paulista de Medicina), Brazil. The control group was made up of children from public primary schools, from the same geographical area as those studied. The eutrophic group presented significantly better performance in the intelligence test (Intelligence Quotient - IQ) than the obese group (average IQ - 91 x 85; p < 0.05). Eutrophic children and adolescents revealed a wider range of interests, better capacity for social adaptability as well as greater speed and dexterity. Although weak, there was a positive correlation between income level, weight/stature relation (W/S) and IQ. There was no correlation between IQ and level of schooling. The eutrophic boys from higher income levels showed better perceptual and spacial organizing ability and a wider range of interests than those from the lower income groups. In spite of the fact that all the average IQ results presented consistently favored the eutrophic in relation to the obese, it is not possible to confirm one group's superiority over the other, due to the wide range of intervenient factors involved in the intelligence process.

Foram estudadas as características intelectuais de 65 crianças obesas, de 8 a 13 anos e 11 meses, comparativamente às de 35 crianças eutróficas, através da Escala de Inteligência Wechsler para Crianças. Os dois grupos foram pareados de acordo com a faixa etária, série escolar e nível socioeconômico. O grupo de obesos foi composto por pacientes atendidos pelo Departamento de Pediatria da Universidade Federal São Paulo, e o grupo-controle, por crianças pertencentes a escolas públicas. O grupo de eutróficos apresentou significantemente melhor desempenho no teste de inteligência do que o grupo de obesos (Quociente de inteligência -QI médio - 91 x 85; p < 0,05). Crianças eutróficas revelaram maior amplitude de interesses e capacidade de adaptação social e, melhor velocidade e destreza. Houve correlação positiva entre o nível de renda, a relação peso/estatura e o QI. Apesar de todos os resultados médios de QI apresentarem dados consistentemente favoráveis aos eutróficos, não se pode afirmar total superioridade desse grupo em virtude da ampla gama de fatores emocionais intervenientes no processo de inteligência, não controlados pelo estudo.

The intellectual characteristics of 65 obese children and adolescents (weight for height <FONT FACE=Symbol>³</FONT>140% ), aged 8 to 13 years and 11 months, were compared to those of 35 eutrophic children and adolescents (weight for height between 90 and 110%; and stature for age > 95%) of the same age group, utilizing the Wechsler Intelligence Scale for Children - WISC. Children and adolescents of the two groups were paired according to age groups, schooling level and socioeconomic condition. The obese group was composed of new patients assisted at the Department of Pediatrics of the Federal University of S. Paulo (Escola Paulista de Medicina), Brazil. The control group was made up of children from public primary schools, from the same geographical area as those studied. The eutrophic group presented significantly better performance in the intelligence test (Intelligence Quotient - IQ) than the obese group (average IQ - 91 x 85; p < 0.05). Eutrophic children and adolescents revealed a wider range of interests, better capacity for social adaptability as well as greater speed and dexterity. Although weak, there was a positive correlation between income level, weight/stature relation (W/S) and IQ. There was no correlation between IQ and level of schooling. The eutrophic boys from higher income levels showed better perceptual and spacial organizing ability and a wider range of interests than those from the lower income groups. In spite of the fact that all the average IQ results presented consistently favored the eutrophic in relation to the obese, it is not possible to confirm one group's superiority over the other, due to the wide range of intervenient factors involved in the intelligence process.