Obesity in adolescence-from etiological variability to interventional efficacy in the school context

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Introduction: Our paper concern two fundamental pillars to face obesity in adolescence- nutrition education and the phenomenon of human variability, namely in the biological and behavior dimension. Objectives: Assessment of the impact of an innovate school-based nutrition education program (OBESIDATA); the multivariate study of the anthropometric profile and physical activity pattern of adolescents in Portugal; comparison between energy consumption and their energy needs; Evaluation of the accuracy of four commonly used basal metabolic rate prediction equations. Results: After a two weeks period of open interactive digital platform, 85.8% of students increased their nutritional knowledge; the overall prevalence of overweight and obesity in adolescents was 16.5% and 5.9%, respectively; just 38% of participants reported a level of physical activity in line with WHO recommendations; the RMR mean differences of six identified anthropometrics clusters vary from 1349 Kcalories to 1955 Kcalories; the mean reported energy intake was lower than the estimated energy requirements; from all predictive equations estimating energy requirements the relative accuracy, using indirect calorimetric evaluations, is just about 17%. Conclusions: School-based nutrition using technology may provide a practical, attractive and cost- effective strategy to improve nutrition knowledge and eating behaviors; the adolescent’s prevalence of overweight/obesity remains relatively high and physical activity was clear below the WHO recommendations; at average level adolescents REI seems to be lower than their EER, but REI reveals a great individual variability; the accuracy of RMR using predictive equations may have limited applicability; a new paradigma to prevent obesity is coming where genetic will have soon a practical central role.1,2