Sample Of Brazilian Adolescents Research Articles

Associations of sedentary behaviors and physical activity with social isolation in 100,839 school students: The Brazilian Scholar Health Survey

ObjectiveTo examine the relationship between physical activity, sedentary behaviors, and social isolation in a representative sample of Brazilian adolescents. MethodCross sectional analyses using data from the Brazilian Scholar Health Survey conducted in 2015. The sample included 100,839 adolescents (mean age: 14.3 y, 51.4% Female) from 3040 schools. Information about social isolation (number of close friends and perceived loneliness), physical activity (International Physical Activity Questionnaire) and sedentary behaviors (total sitting time and TV viewing) were self-reported. Chronological age, race and type of city (state capital or other) were co-variables. Logistic regression models were used to analyze the data (results are presented as odds ratios (OR) with 95% confidence intervals). ResultsPhysical activity was associated with lower odds of both social isolation indicators in boys, and with lower likelihood of having few friends in girls. Greater sitting time was associated with higher likelihood of social isolation, as was low (<1 h/d) [boys: OR: 1.54 (95% CI: 1.33 to 1.77); girls: OR: 1.31 (95% CI: 1.17 to 1.48] and high TV viewing (≥8 h/d) [boys: OR: 1.75 (95% CI: 1.47 to 2.09)]; girls: OR: 1.58 (95% CI: 1.37 to 1.82)]. More than 300 min/week of physical activity was sufficient to eliminate the association of high TV viewing and high sitting time with markers of social isolation in boys. ConclusionPhysical activity is associated with a lower prevalence of social isolation, especially among boys. Both high and low amounts of TV viewing increase the likelihood of social isolation. Physical activity reduced the association between TV viewing and sitting with social isolation among boys.

OR20-1 Increasing Values of Cardiometabolic Risk Markers Are Associated with Severity of Obesity in Adolescents: Findings from the ERICA Study

Overweight and obesity in adolescents have exponentially increased in the last decades and are considered a primary driver of other chronic diseases, such as diabetes and hypertension. Cardiometabolic risk factors, if not early managed, tend to persist in adult life, and some studies suggest different prevalences according to obesity category. This association among young people, however, is still unclear. The aim of this study was to evaluate the association of severity of obesity and known cardiometabolic risk factors in a representative sample of Brazilian adolescents from ERICA (Study of Cardiovascular Risk in Adolescents), a multicenter, school-based cross-sectional study composed of 75,000 students. For this analysis, we used data from students with overweight or obesity according to the IOTF reference values for body mass index: overweight ≥ 25kg/m²; class I obesity ≥ 30kg/m²; class II ≥ 35kg/m²; class III ≥ 40kg/m². Prevalences of abnormal cardiometabolic risk factors according to the severity of obesity were calculated for overall sample and stratified by sex and age groups (12-14 or 15-17 years). Adjusted Wald’s test for trends and Poisson regression models were used. From the 8,708 adolescents with excess weight, 71.6% were classified with overweight, 23.2% with class I obesity, 4.1% with class II and 1.2% with class III. As severity of obesity increased, there was an increase in the prevalence of higher levels of blood pressure, total and LDL-cholesterol, triglycerides, glycated hemoglobin, fasting glucose, insulin and metabolic syndrome (p≤0.05). Prevalence of low HDL-cholesterol levels was inversely proportional to increase in severity of obesity (p≤0.01). Increasing severity of obesity was associated with higher prevalence of all cardiometabolic risk factors in both age groups, except for fasting glucose in 15-17 years adolescents. After adjustment for sex, age, skin color and socioeconomic status, individuals with class III obesity had the highest prevalence of all the evaluated cardiometabolic variables, such as high levels of blood pressure [odds ratio (OR) compared to overweight = 2.4; 95%CI 1.5 - 3.8), triglyceride (OR = 2.99; 95%CI 1.8 - 4.9), LDL-cholesterol (OR = 2.5; 95%CI 1.2 – 5.3), glycated hemoglobin (OR = 2.0; 95%CI 1.3 - 3.2) and insulin (OR = 8.3; 95%CI 6.3 – 10.8). Metabolic syndrome in class III obese adolescents, when compared to overweight and class I obese, was 2 and 9 times more frequent, respectively. Our study involving Brazilian youth shows a positive association between severity of obesity and prevalence of cardiometabolic risk factors, indicating the need to further stratify them in this population. Investigating the association between severity of obesity and cardiometabolic risk factors can help us to identify the individuals at higher risk groups and develop public health strategies against obesity related outcomes early in life. Support: CAPES

Clustering of Excess Body Weight-Related Behaviors in a Sample of Brazilian Adolescents

The aim of the study was to identify the existence of clusters in multiple lifestyle behaviors, including consumption of fruits/vegetables, sugary products/soft drinks, physical activity and sedentary behavior. The association between identified clusters and excess body weight in a sample of adolescents from Dourados, Brazil, was examined. This is a cross-sectional school-based study involving 578 participants aged 12–18 of both sexes. Anthropometric measurements were performed and a questionnaire was applied with structured questions to collect data. Excess body weight was identified through body mass index. Cluster analysis was performed to identify sex-specific clusters of multiple lifestyle behaviors. Analysis of covariance and logistic regression were used to analyze associations between clusters and excess body weight. Six clusters were identified in both sexes. Girls and boys in the cluster characterized by greater time spent in sedentary behavior were 53% (OR = 1.53 [1.06–2.26]) and 63% (OR = 1.63 [1.12–2.35]) more likely to present excess body weight compared to their peers in the reference cluster. In the case of adolescents in the cluster characterized by high consumption of sugary products/soft drinks, girls were 47% more likely to be overweight (OR = 1.47 [1.05–2.13]) and boys were 51% more likely (OR = 1.51 [1.05–2.16]). High consumption of fruits/vegetables, low consumption of sugary products/soft drinks and less sedentary behavior was considered the most effective combination for the maintenance of a healthy weight.

Disordered eating behaviors and energy and nutrient intake in a regional sample of Brazilian adolescents from public schools.

To estimate the prevalence of disordered eating behaviors and the association with energy and nutrient intake and nutritional status in adolescents. A school-based cross-sectional study was performed involving a probabilistic sample of 487 teenagers (aged 15-19years) from public schools in the Metropolitan area of Rio de Janeiro, Brazil. The Eating Attitude Test and the Bulimic Investigatory Test Edinburgh questionnaires were applied to identify abnormal eating patterns and unusual dietary patterns, respectively. Nutritional status was defined by sex- and age-specific body mass index cutoffs. Energy and nutrient intake were assessed by a 3-day food record. The association between variables was assessed by the prevalence ratio and 95% confidence intervals, Pearson's Chi-square test, and linear regression. The prevalence of abnormal eating patterns was 7.4% and that of unusual dietary patterns was 18.9%. Vitamin C intake was higher among girls with abnormal dietary patterns, with a consequent lower frequency of vitamin C deficiency when compared to those with normal dietary patterns. Calcium intake was lower in boys with unusual dietary pattern than in those without this behavior. Excess weight was associated with the presence of unusual dietary pattern in girls (PR: 2.4, 95% CI 1.6-3.5). The prevalence of disordered eating behaviors was high, mainly in those who were overweight. It was associated with lower calcium intake in boys and with higher Vitamin C intake in girls. Level V, descriptive studies.

Associations of ultra-processed food and drink products with asthma and wheezing among Brazilian adolescents.

Although both consumptions of ultra-processed products and asthma are common during adolescence, the epidemiological evidence in regarding their association is unclear. We investigated the associations of ultra-processed products consumption with asthma and wheezing in a representative sample of Brazilian adolescents. We used data from a representative sample of 109104 Brazilian adolescents enrolled in the National Survey of School Health, 2012. The consumption of ultra-processed products was based on the weekly consumption (0-2, 3-4, ≥5d/wk) of sweet biscuits, salty biscuits, ultra-processed meats, sweets/candies, soft drinks, and packaged snacks over the previous 7days. We also calculated an ultra-processed consumption score by adding partial scores corresponding to weekly frequency intake of each ultra-processed product. The ultra-processed consumption score ranged from 0 to 42, the higher score, the higher the intake of these products. The presence of wheezing in the previous 12months and asthma at any time in the past was self-reported. The adjusted odds ratios of asthma comparing the extreme categories ranged from 1.08 (95% CI 1.03-1.13) for sweets/candies to 1.30 (1.21-1.40) for ultra-processed meats. Similar magnitude of associations was found for wheezing outcome. The ultra-processed consumption score was positively associated with the presence of asthma and wheezing in a dose-response manner. The adjusted OR of asthma and wheezing comparing highest to lowest quintile of ultra-processed consumption score was 1.27 (95% CI 1.15-1.41) and 1.42 (1.35-1.50), respectively. The consumption of ultra-processed products was positively associated with the presence of asthma and wheezing in adolescents.

Are school and home environmental characteristics associated with oral health-related quality of life in Brazilian adolescents and young adults?

The aim of this study was to test the association of contextual school and home environmental characteristics and individual factors with oral health-related quality of life (OHRQoL) in a representative sample of Brazilian adolescents and young adults. Individual-level data from 3854 fifteen- to nineteen-year-olds who participated in the Brazilian Oral Health Survey were pooled with contextual city-level data. The dependent variable was the frequency of impacts of oral disorders on daily performances (OIDP extent), as a measure of OHRQoL. Contextual school and home environmental characteristics were categorized into three equal groups according to tertiles of the contextual variable's scores (low, moderate and high). Individual demographic, socioeconomic and oral clinical measures were the covariates. The association between contextual and individual characteristics and OIDP extent was estimated using multilevel Poisson regression models. The mean of OIDP extent was 0.9 (standard error 0.1). Adolescents and young adults living in the cities with high levels of lack of security at school (RR 1.33; 95% CI=1.02-1.74), moderate levels of bullying at school (RR 1.56; 95% CI=1.20-2.03) and moderate levels of low maternal schooling (RR 1.43; 95% CI=1.06-1.92) had a higher mean OIDP extent. Male sex, higher age, skin colour, poor individual socioeconomic status and worse oral clinical measures were also associated with higher mean of OIDP extent. Poor school and home environmental characteristics were independently associated with poor OHRQoL in individuals aged between 15 and 19years. Our findings suggest the place where they study and the maternal level of education are meaningful aspects for their oral health.

Validity and reliability of the quality of masticatory function questionnaire applied in Brazilian adolescents.

Purpose proper chewing and swallowing functions have great importance in general health, since it potentially affects food's digestion and the subject's nutritional status. The aim was to assess the validity and reliability of the self-applied Quality of Masticatory Function Questionnaire (QMFQ) in a convenience (non-referred) sample of Brazilian adolescents divided into three groups: control (n=57), dental caries (n=51) and malocclusion (n=54). Methods caries and malocclusion were evaluated using DMF-S index (number of decayed, missing and filled primary and permanent surfaces) and Index of Orthodontic Treatment Need, respectively. The QMFQ comprises 26 items regarding frequency and intensity of chewing problems with five domains: Food-Mastication, Habits, Meat, Fruits and Vegetables. Data were submitted to descriptive statistics, Kolmogorov-Smirnov and Chi-square tests. Psychometric evaluation included measures of reliability (internal consistency - Cronbach's alpha and matrix of correlation) and discriminant validity (Kruskal-Wallis/Dunn post-test). Results the instrument showed satisfactory internal consistency, with significant positive correlations between the domains scores except between Habits and Vegetables. Total scale Cronbach's alpha coefficient was 0.87 and the coefficient did not increase significantly with the removal of each domain. Significant differences were found between controls and caries group in Food-Mastication, Meat and Fruits scores. Caries group also showed higher median values in Food-Mastication and Fruits than the malocclusion group. Conclusion the Quality of Masticatory Function Questionnaire showed acceptable properties regarding internal consistency, reliability, and discriminant validity in evaluating the impact of caries on the perception of the masticatory function quality of Brazilian adolescents.

Insegurança alimentar entre adolescentes brasileiros: um estudo de validação da Escala Curta de Insegurança Alimentar

Objetivo Os objetivos do trabalho foram avaliar a validade interna e a capacidade preditiva da escala de segurança alimentar de seis itens aplicada a adolescentes. Métodos Foi um estudo transversal com amostra representativa de adolescentes brasileiros (N=14.690), realizado em escolas públicas e privadas nas 26 capitais de estados brasileiros e no Distrito Federal por meio de questionário online. Resultados A maior parte dos respondentes era do sexo feminino (53,2%), com idade média de 14,4 anos, sendo 72,7% de escolas públicas. O comportamento da escala, observado pelo modelo de Rasch, foi melhor sem o item cinco, apresentando valores ótimos de Infit e nível de severidade crescente entre os itens. O alfa de Cronbach foi 0,77, e as análises do funcionamento diferencial dos itens mostraram comportamento dos itens semelhante entre os subgrupos avaliados. A análise fatorial mostrou a unidimensionalidade do instrumento. Conclusão Foi proposta a retirada do item cinco e novos pontos de corte para a escala curta de segurança alimentar. A escala curta de segurança alimentar é válida e confiável para mensurar insegurança alimentar domiciliar entre adolescentes brasileiros.

Prevalence of dyslipidemia in adolescents: Comparison between definitions

IntroductionThe indiscriminate use of different diagnostic criteria for the definition of dyslipidemia may result in inaccurate interpretations, which could compromise diagnosis and therefore the therapeutic and prophylactic actions to be taken. ObjectiveTo analyze possible differences in prevalence rates of dyslipidemia in adolescents based on three diagnostic definitions. MethodsA cross-sectional study was conducted of a representative sample of Brazilian adolescents between 11 and 16 years of age. Blood samples were collected from 1000 students (423 boys and 577 girls) to determine fasting total cholesterol (TC), HDL and LDL cholesterol, and triglycerides (TG). The prevalence of dyslipidemia was established according to three definitions: those of the National Cholesterol Education Program (NCEP), the Brazilian Society of Cardiology (BSC), and the National Health and Nutrition Examination Survey (NHANES). ResultsSignificant differences (p<0.01) were found between the diagnostic criteria for TC (BSC 38.3%; NCEP 11.2%; NHANES 4.8%), HDL cholesterol (BSC 30.0%; NCEP 15.8% NHANES 18.4%), LDL cholesterol (BSC and NCEP 10.8% and NHANES 5.9%), and TG (BSC and NCEP 4.7% and NHANES 1.3%). The overall prevalence of dyslipidemia was 61% (BSC), 28.6% (NCEP) and 24.2% (NHANES). Agreement rates varied significantly (kappa 0.15–0.90). ConclusionsAlthough a high prevalence of dyslipidemia was observed in this study regardless of the diagnostic criteria used, the wide variation in rates highlights the need to establish a single definition with appropriate discriminatory power for adolescents.

Prevalence of dyslipidemia in adolescents: Comparison between definitions

IntroductionThe indiscriminate use of different diagnostic criteria for the definition of dyslipidemia may result in inaccurate interpretations, which could compromise diagnosis and therefore the therapeutic and prophylactic actions to be taken. ObjectiveTo analyze possible differences in prevalence rates of dyslipidemia in adolescents based on three diagnostic definitions. MethodsA cross-sectional study was conducted of a representative sample of Brazilian adolescents between 11 and 16 years of age. Blood samples were collected from 1000 students (423 boys and 577 girls) to determine fasting total cholesterol (TC), HDL and LDL cholesterol, and triglycerides (TG). The prevalence of dyslipidemia was established according to three definitions: those of the National Cholesterol Education Program (NCEP), the Brazilian Society of Cardiology (BSC), and the National Health and Nutrition Examination Survey (NHANES). ResultsSignificant differences (p<0.01) were found between the diagnostic criteria for TC (BSC 38.3%; NCEP 11.2%; NHANES 4.8%), HDL cholesterol (BSC 30.0%; NCEP 15.8% NHANES 18.4%), LDL cholesterol (BSC and NCEP 10.8% and NHANES 5.9%), and TG (BSC and NCEP 4.7% and NHANES 1.3%). The overall prevalence of dyslipidemia was 61% (BSC), 28.6% (NCEP) and 24.2% (NHANES). Agreement rates varied significantly (kappa 0.15–0.90). ConclusionsAlthough a high prevalence of dyslipidemia was observed in this study regardless of the diagnostic criteria used, the wide variation in rates highlights the need to establish a single definition with appropriate discriminatory power for adolescents.

Respiratory muscle strength of Brazilian adolescents: obtained and predicted values

ResumoObjetivos: Comparar os valores encontrados para as pressões respiratórias máximas de uma amostra de adolescentes brasileiros com os valores preditos por Wilson et al e Domènech-Clar et al. Método: Foram avaliados 156 adolescentes (84 meninos) entre 12 e 17 anos. As pressões respiratórias máximas foram avaliadas por meio de um manovacuômetro digital com os adolescentes sentados e utilizando um clipe nasal. As avaliações das pressões inspiratória e expiratória máximas foram realizadas a partir do volume residual e da capacidade pulmonartotal, respectivamente. A comparação dos valores das pressões respiratórias máximas obtidos no atual estudo com os preditos pelas equações propostas por Wilson et al e Domènech-Clar et al, foi realizada pelo teste t de Student pareado. Para verificar a associação entre estes valores, foi utilizado o teste de correlação de Pearson. Resultados: A média da pressão inspiratória máxima foi de 74,66 ± 22,95 cm H2O e de 103,52 ± 25,67 cm H2O para meninas e meninos, respectivamente. A média da pressão expiratória máxima foi de 86,23 ± 25,92 cm H2O e de 120,08 ± 27,37 cm H2O para meninas e meninos, respectivamente. O svalores obtidos não diferiram e também não se correlacionaram significativamente com os preditos através das equações propostas por Wilson et al., e Domènech-Clar et al. Conclusões: As equações propostas por Wilson et al. e Domènech-Clar et al., não foram capazes de predizer os valores das pressões respiratórias máximas na população estudada, indicando a necessidade de se usar na prática clínica valores de referência advindos de uma população saudável de mesma etnia.

Confirmatory Factor Analysis of the Generalized Self-Efficacy Scale in Brazil and Portugal

This study aims to evaluate the construct validity, internal consistency and cross-cultural invariance of the Generalized Self-Efficacy Scale-Portuguese version (GSE) in a Brazilian and Portuguese sample. The GSE is composed of 10 items, designed to parsimoniously and comprehensively assess self-efficacy beliefs to deal with a wide range of stress-inducing situations. The construct validity (factorial, convergent and discriminant) and internal consistency of the instrument were established within a sample of 304 Portuguese adolescents (study 1) and a sample of 477 Brazilian adolescents (study 2). Then, the invariance of the GSE was tested in a sample of Brazilian adolescents (study 3), using Multigroup Confirmatory Factor Analysis (MGCFA). In the first two studies, the construct validity of the GSE was demonstrated in its three components and the reliability of the scales was confirmed based on satisfactory levels of internal consistency. In the third study, the cross-cultural invariance of the instrument was established. This work adds to previous research on generalized self-efficacy instruments, with good psychometric qualities. Moreover, comparisons can now be made with confidence using this instrument among adolescent samples from Portugal and Brazil.

Association between binge drinking, type of friends and gender: A cross-sectional study among Brazilian adolescents

BackgroundHazardous drinking among adolescents is a major public health concern. The purpose of this study was to examine the prevalence of binge drinking/alcohol consumption and its association with different types of friendship networks, gender and socioeconomic status among students in Belo Horizonte, Minas Gerais, Brazil.MethodsWe conducted a cross-sectional study on a representative random sample of 891 adolescents (41% male, aged 15–19 years) from public and private schools in 2009–2010. Information on friendship networks and binge drinking was collected using two validated self-administered questionnaires: the Integrated Questionnaire for the Measurement of Social Capital and the first 3 items in the Alcohol Use Disorders Identification Test (AUDIT C). We used the area-based Social Vulnerability Index (SVI), mother and father’s educational background, and the type of school to assess socioeconomic status. The chi-squared test was used to examine the associations between sample characteristics or the type of friends and binge drinking (p-values <0.05 were considered statistically significant). Ordinal logistic regression was used to estimate the association between binge drinking and the independent variables.ResultsA total of 321 (36%) adolescents reported binge drinking (5 or more drinks in one occasion), and among them, 233 (26.2%) adolescents reported binge drinking less than monthly to monthly, and 88 (9.9%) weekly to daily. Binge drinking was associated with being male (OR = 1.52, 95% CI 1.01–2.28) and with living in a low vulnerability area (having the best housing conditions, schooling, income, jobs, legal assistance and health) (OR = 1.66, 95% CI 1.05–2.62). Students who reported that their closest friends were from school (as opposed to friends from church) had an increased risk of binge drinking (OR = 3.55, 95% CI 1.91–5.87). In analyses stratified by gender, the association was significant only among the female students.ConclusionsThe prevalence of binge drinking was high in this sample of Brazilian adolescents, and gender, low social vulnerability and friendship network were associated with binge drinking.

Maternal drinking behavior and Fetal Alcohol Spectrum Disorders in adolescents with criminal behavior in southern Brazil

Prenatal alcohol exposure can have serious and permanent adverse effects. The developing brain is the most vulnerable organ to the insults of prenatal alcohol exposure. A behavioral phenotype of prenatal alcohol exposure including conduct disorders is also described. This study on a sample of Brazilian adolescents convicted for criminal behavior aimed to evaluate possible clinical features of Fetal Alcohol Syndrome (FAS). These were compared to a control group of school adolescents, as well as tested for other environmental risk factors for antisocial behavior. A sample of 262 institutionalized male adolescents due to criminal behavior and 154 male students aged between 13 and 21 years comprised the study population. Maternal use of alcohol was admitted by 48.8% of the mothers of institutionalized adolescents and by 39.9% of the school students. In this sample of adolescents we could not identify individual cases with a clear diagnosis of FAS, but signs suggestive of FASD were more common in the institutionalized adolescents. Social factors like domestic and family violence were frequent in the risk group, this also being associated to maternal drinking during pregnancy. The inference is that in our sample, criminal behavior is more related to complex interactions between environmental and social issues including prenatal alcohol exposure.

Prevalence and Correlates of Gambling Problems Among a Nationally Representative Sample of Brazilian Adolescents

The objectives of the study are: (a) to provide the first prevalence estimates of pathological gambling among Brazilian adolescents using an age-specific instrument in a nationally representative sample; (b) to investigate the extent to which adolescents participate in gambling activities in a developing country; and (c) to correlate different levels of gambling behavior with demographic variables. Multistage cluster sampling selected 3,007 individuals over 14years of age from Brazilian household population. A total of 661 participants were between 14 and 17years old. The Lie/Bet Questionnaire and the DSM-IV-MR-J were used for assessing problem and pathological gambling. 2.8% scored positive on the screening questionnaire, while 1.6% were classified as problem and pathological gamblers. Factors associated with problem and pathological gambling were male sex, not currently studying and considering religion as not important. Less than 4months elapsed between the age of regular gambling involvement and the first gambling problem. Prevalence rates were quite similar from recent studies which used nationally representative samples. The association of problem and pathological gambling with male sex, school drop-out and low religiosity supports the Problem Behavior Theory. The fast progression to problem gambling adds evidence that adolescents may be more vulnerable to the effects of gambling.

Medida Interpessoal de Psicopatia (IM-P): estudo preliminar no contexto brasileiro

The direct observation of interpersonal behaviors is an important resource in the description and diagnosis of the psychopathic personality. The Interpersonal Measure of Psychopathy (IM-P) is a psychometric instrument comprised of 21 items, designed to be applied in association with other instruments that also evaluate psychopaths. It focuses specifically on interpersonal and non-verbal behaviors that become evident during the interaction between the interviewer and individuals with psychopathic characteristics. To describe preliminary results obtained in the assessment of interpersonal behaviors of psychopathic individuals using the IM-P, including instrument translation/adaptation and inter-rater reliability results, in a sample of Brazilian adolescents. This was a cross-sectional, descriptive, correlation study conducted with a sample of 20 institutionalized male adolescents from the metropolitan area of Porto Alegre, state of Rio Grande do Sul, southern Brazil. Following instrument translation, interviewer training, and a pilot study conducted using a semi-structured interview, the IM-P was scored by three independent raters. The statistical results obtained using Kendall's coefficient of concordance revealed a high and satisfactory inter-rater agreement for IM-P total scores (W = 0.84; p < 0.001). Some items showed conflicting results and were therefore discussed and evaluated separately. The psychometric properties of the Brazilian Portuguese version of the IM-P, as assessed in this preliminary study, showed consistent inter-rater concordance, suggesting instrument reliability. Some study limitations are discussed, as are some relevant aspects that should be taken into consideration in future research involving the IM-P.

Prevalence and Associated Factors of Osgood-Schlatter Syndrome in a Population-Based Sample of Brazilian Adolescents

Background: Osgood-Schlatter (OS) syndrome is a disease of the musculoskeletal system often observed during the bone growth phase in adolescents. Hypothesis/Purpose: Demographic and anthropometric factors and those linked to the practice of sports may be related to the prevalence of OS. The aim of the present study was to describe the epidemiologic profile and associated factors of individuals with OS syndrome in a population-based sample of Brazilian adolescents. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A cross-sectional study was conducted with 956 adolescent students (474 boys, 482 girls) from 2008 to 2009 enrolled in the school system of Natal, Brazil. The age ranged between 12 and 15 years (13.7 ± 1.04 years). Tests were performed to assess the anthropometric and clinical aspects related to OS. To confirm the diagnosis of OS syndrome, the participant had to fulfill all the following clinical criteria: pain with direct pressure on the tibial apophysis; aforementioned pain before, during, and after physical activities; enlargement or prominence of the tibial apophysis; pain with resisted knee extension; and pain from jumping. Results: The prevalence of OS in the sample was 9.8% (11.0% of boys and 8.3% of girls; boys, 13.5 ± 1.07 years; girls, 13.6 ± 1.01 years). The results showed that 74.6% of the students suffered from muscle shortening. Multivariate analysis using logistic regression showed that the factors associated with the presence of OS were the regular practice of sport activity (odds ratio, 1.94; 95% confidence interval, 1.22-3.10) and the shortening of the rectus femoris muscle (odds ratio, 7.15; 95% confidence interval, 2.86-17.86). Conclusions: The regular practice of sports in the pubertal phase and the shortening of the rectus femoris muscle were the main factors associated to the presence of OS syndrome in the students.

Characteristics of family nucleus as correlates of regular participation in sports among adolescents

To estimate the relationship between family nucleus and sport practice among adolescents. A school-based cross-sectional study carried out with 1,752 Brazilian adolescents (812 male and 940 female), aged 11-17 years. Characteristics of the family nucleus (parental education, socioeconomic status and number of siblings) and sport practice (≥240 min/week) were assessed by questionnaires. Adjusted prevalence ratios were estimated using Poisson regression models. The overall prevalence of sport practice was 14.8% (boys 21.2% and girls 9.4%, P = 0.001). Higher socioeconomic status, number of siblings and parents' educational level were associated with more sport practice. Despite the low engagement, family nucleus plays an essential role in the sport practice of our sample of Brazilian adolescents.

Índice de massa corporal e circunferência da cintura como marcadores de hipertensão arterial em adolescentes

To evaluate the sensitivity and specificity of anthropometric measurements of body fat in a sample of Brazilian adolescents for the prediction of hypertension. The arterial blood pressure was measured on two visits in a sample of 456 students aged 12 to 17 years, from public and private schools of the Fonseca neighborhood, in Niterói, between 2003 and 2004. A subject was defined as hypertensive if he/she had systolic and diastolic pressures above the 95th percentile for sex, age and height. A questionnaire was applied and Body Mass Index (BMI) and waist circumference (WC) measurements were made. A statistically significant correlation was observed between hypertension and the cutoff points considered unfavorable, both for BMI and WC. The greatest association was with the cutoff point proposed for the Brazilian population. As to the BMI sensitivity used for American Black or White populations or for the Brazilian population, we found 52.4% to 57.1% and 52.4%, respectively. And BMI specificity was 69.3%, 70.0% and 80.88%, respectively. The sensitivity found in our sample, relative to the cutoff points for WC proposed for all American ethnic groups, was also low (45.0%) and specificity was a little higher (77.6% and 74.5%, respectively). Existing American WC measurements showed low sensitivity and specificity for hypertension in our population. As to BMI, the available cutoff points also showed a low level of sensitivity. There is a need to establish body fat cutoff points that can provide a better prediction of cardiovascular risk.

Expression of Depressive Symptoms in a Nonclinical Brazilian Adolescent Sample

This study aimed to detect the prevalence of depressive symptomatology and its expression in a nonclinical Brazilian adolescent student sample. A sample of students from private and public schools (n = 1555, aged 13 to 17 years) answered the Beck Depression Inventory (BDI). We performed factor analysis of the BDI as an indicator of the expression of depressive symptomatology. The following cut-off scores defined nonclinical subgroups: "nondepressed," BDI < 15; "dysphoria," BDI 16 to 20; and "depressed," BDI > 20. We used discriminant analysis to test whether these subgroups could be separated by the depression-specific and nonspecific items. The point prevalence of depression was 7.6%, according to the BDI cut-off of 20. Girls had higher scores than boys in several items. Scores increased with age. Students from public schools had higher scores than did private school students. Factor analysis showed 2 common factors for the total sample and for each sex: the cognitive affective dimension and the somatic nonspecific dimension. In the adolescents showing clinical depression, items related to self-depreciation, sense of failure, guilty feelings, self-dislike, suicidal wishes, and distortion of body image were common components of BDI factors. Discriminant analysis showed that the BDI highly discriminates depressive symptomatology in adolescent students and also measures specific aspects of depression. The BDI is useful as a measure of specific aspects of depression in nonclinical adolescent samples; it was able to detect depression in approximately 7% of the surveyed population. The expression of depressive symptoms in a Brazilian adolescent population is compatible with international studies in this age group. Detecting depressive symptoms in a school population is a critical preventive strategy; to avoid damage to the learning process, it should be followed with further referral to treatment when needed.