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Vol. 29. Issue 2.
Pages 148-156 (July - December 2011)
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Vol. 29. Issue 2.
Pages 148-156 (July - December 2011)
Artigo original
Open Access
Análise comparativa de métodos de abordagem da obesidade infantil
Comparative analysis of methods to address childhood obesity
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Maria Ana Carvalhoa,
Corresponding author
mariaanacarvalho@gmail.com

Autor para correspondência.
, Isabel do Carmob, João Bredac, Ana Isabel Ritod
a Faculdade de Medicina, Universidade de Lisboa, Lisboa. Universidade Atlântica, Oeiras, Portugal
b Faculdade Medicina, Universidade de Lisboa. Presidente do Conselho Científico da Plataforma Contra a Obesidade, Lisboa, Portugal
c Programa de nutrição, actividade fisica e obesidade da Organização Mundial da Saúde – Europa, Copenhaga, Dinamarca
d Instituto Nacional de Saúde e Dr. Ricardo Jorge I.P., Lisboa. Universidade Atlântica, Oeiras, Portugal
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Article information
Resumo
Introdução

A obesidade infantil constitui, na actualidade, um dos mais sérios desafios de saúde pública, tendo atingindo níveis epidémicos em vários países do Mundo. A obesidade na infância e adolescência aumenta a probabilidade de obesidade na idade adulta assim como está associada a uma série de efeitos adversos em termos da saúde e do bem-estar das crianças e dos adolescentes. Como tal, a sua prevenção e o seu tratamento tornam-se prioritários.

Objectivo

Não estando definido um modelo único padrão no tratamento da obesidade infantil, pretende-se identificar e valorizar neste artigo os elementos essenciais da abordagem desta doença.

Material e métodos

Foram analisados maioritariamente estudos aleatorizados controlados que enfatizam importantes desenvolvimentos ao nível das intervenções no âmbito da alimentação, da actividade física, da mudança comportamental, do ambiente familiar e da participação da comunidade.

Conclusão

Concluiu-se que as intervenções em ambiente familiar de base comportamental que incorporam modificações ao nível da alimentação e da actividade física parecem ser as mais efectivas no controlo do peso corporal. As intervenções de base comunitária, apesar de ainda serem escassas, parecem assumir um eixo estratégico no combate a esta doença.

Palavras-chave:
Adolescentes
Crianças
Excesso de peso
Obesidade
Tratamento
Abstract
Introduction

Childhood obesity represents one of the most serious public health challenges, as it has reached epidemic levels in several countries around the world. Obese children and adolescents are more likely to be obese in adulthood. In addition, childhood and adolescent obesity has adverse psychological, social and health consequences in childhood and later in life. Thus, the prevention, early identification and treatment of this disease should be a priority for the health sector.

Objective

Since there hasn’t been determined one single intervention model that can address and tackle childhood obesity, the aim of this review is to identify the key elements frequently used in the most common approaches to address childhood obesity.

Material and methods

The review included mostly randomised controlled trials which have been used to emphasise important developments and contributions of intervention programs concerning diet, physical activity and behaviour modification and also in family and community based programmes.

Conclusion

The conclusion was that the interventions used within the childhood obesity approach should be family based and should essentially lie upon behaviour modification regarding diet and physical activity. Interventions targeting a variety of population groups can have potent effects on reducing overweight prevalence and reverse trends particularly the one that takes action at community level.

Keywords:
Adolescents
Children
Obesity
Overweight
Treatment
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Bibliografia
[1.]
M. Dehghan, N. Akhtar-Danesh, A.T. Merchant.
Childhood obesity, prevalence and prevention.
Nutrition Journal, 4 (2005),
[2.]
W.P. James.
The challenge of childhood obesity.
Int J Pediatr Obes, 1 (2006), pp. 7-10
[3.]
T. Lobstein, M.L. Frelut.
Prevalence of overweight among children in Europe.
Obes Rev, 4 (2003), pp. 195-200
[4.]
R.C. Whitaker, J.A. Wright, M.S. Pepe, K.D. Seidel, W.D. Dietz.
Predicting obesity in young adulthood from childhood and parental obesity.
New Engl J Med, 337 (1997), pp. 869-873
[5.]
S. Sun Guo, Wei Wu, W.C. Chumlea, A.F. Roche.
Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence.
Am J Clin Nutr, 76 (2002), pp. 653-658
[6.]
The challenge of obesity in the WHO European Region and the strategies for response. [Internet],
[7.]
W.H. Dietz.
Health consequences of obesity in youth: childhood predictors of adult disease.
Pediatrics, 101 (1998), pp. 518-525
[8.]
A. Rito, E. Paixão, M.A. Carvalho, C. Ramos.
Childhood Obesity Surveillance Initiative: COSI Portugal 2008.
Instituto Nacional de Saúde Doutor Ricardo Jorge, Direcção-Geral da Saúde, Ministério da Saúde, (2011),
[9.]
T. Lobstein, N. Rigby, R. Leach.
EU Platform on Diet Physical Activity and Health: EU Platform Briefing Paper. [Internet].
International Obesity Task Force, European Association for the Study of Obesity, (2005),
[10.]
C.L. Ogden, M.D. Carroll, K.M. Flegal.
High body mass index for age among US children and adolescents, 2003–2006.
JAMA, 299 (2008), pp. 2401-2405
[11.]
S.E. Barlow, W.H. Dietz.
Obesity evaluation and treatment: Expert Committee recommendations.
Pediatrics, 102 (1998), pp. E29
[12.]
I. Carmo, O. Santos, J. Camolas, J. Vieira.
Obesidade em Portugal e no mundo.
Faculdade de Medicina da Universidade de Lisboa, (2008),
[13.]
T. Lobstein, L. Baur, R. Uauy.
IASO International Obesity Task Force Obesity in children and young people: a crisis in public health.
[14.]
Y. Wang, T. Lobstein.
Worldwide trends in childhood overweight and obesity.
Int J Pediatr Obes, 1 (2006), pp. 11-25
[15.]
R.J. Kuczmarski, C.L. Ogden, L.M. Grummer-Strawn, K.M. Flegal, S.S. Guo, R. Wei, et al.
CDC Growth Charts: United States.
Advance Data, 8 (2000), pp. 1-27
[16.]
T. Cole, M.C. Bellizzi, K.M. Flegal, W.H. Dietz.
Establishing a standard definition for child overweight and obesity worldwide: international survey.
BMJ, 320 (2000), pp. 1240-1243
[17.]
A. Guerra.
As curvas de crescimento da Organização Mundial de Saúde.
Acta Pediátrica Portuguesa, 40 (2009), pp. XLI-XLV
[18.]
WHO.
Department of Nutrition for Health and Development. WHO child growth standards.
WHO, (2006),
[19.]
Ministério da Saúde, Direcção-Geral da Saúde.
Consultas de vigilância de saúde infantil e juvenil: actualização das curvas de crescimento.
DGS, (2006),
[20.]
W.H. Dietz, T.N. Robinson.
Overweight children and adolescents.
New Engl J Med, 352 (2005), pp. 2100-2109
[21.]
S.E. Barlow.
Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report.
Pediatrics, 120 (2007), pp. S164-S192
[22.]
S.R. Daniels, D.K. Arnett, R.H. Eckel, S.S. Gidding, L.L. Hayman, S. Kumanyika, et al.
Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment.
Circulation, 111 (2005), pp. 1999-2012
[23.]
B.A. Spear, S.E. Barlow, C. Ervin, D.S. Ludwig, B.E. Saelens, E. Karen, et al.
Recommendations for treatment of child and adolescent overweight and obesity.
Pediatrics, 120 (2007), pp. S254-S288
[24.]
C.E. Collins, J. Warren, M. Neve, P. McCoy, B.J. Stokes.
Measuring effectiveness of dietetic interventions in child obesity: a systematic review of randomized trials.
Arch Pediatr Adolesc Med, 160 (2006), pp. 906-922
[25.]
L.J. Gibson, J. Peto, J.M. Warren, I. dos Santos Silva.
Lack of evidence on diets for obesity for children: a systematic review.
Int J Epidemiol, 35 (2006), pp. 1544-1552
[26.]
National Academy of Sciences Institute of Medicine.
Food and Nutrition Board. Dietary Reference Intakes (DRIs).
National Academy of Sciences, (2002),
[27.]
M. Golan, S. Crow.
Targeting parents exclusively in the treatment of childhood obesity: long-term results.
Obes Res, 12 (2004), pp. 357-361
[28.]
S.B. Sondike, N. Copperman, M.S. Jacobson.
Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factors in overweight adolescents.
J Pediatr, 142 (2003), pp. 253-258
[29.]
M.F. Rolland-Cachera, H. Thibault, J.C. Souberbielle, D. Soulie, P. Carbonel, M. Deheeger, et al.
Massive obesity in adolescents: dietary interventions and behaviours associated with weight regain at 2 y follow-up.
Int J Obesity, 28 (2004), pp. 514-519
[30.]
K. Foster-Powell, S.H. Holt, J.C. Brand-Miller.
International table of glycemic index and glycemic load values: 2002.
Am J Clin Nutr, 76 (2002), pp. 5-56
[31.]
H.A. Sampaio, B.Y. Silva, M.O. Sabry, P.C. Almeida.
Índice glicêmico e carga glicêmica de dietas consumidas por indivíduos obesos.
Rev. Nutr, 20 (2007), pp. 621-624
[32.]
L.E. Spieth, J.D. Harnish, C.M. Lenders, L.B. Raezer, M.A. Pereira, S.J. Hangen, et al.
A low–glycemic index diet in the treatment of pediatric obesity.
Arch Pediatr Adolesc Med, 154 (2000), pp. 947-951
[33.]
C.B. Ebbeling, M.M. Leidig, K.B. Sinclair, J.P. Hangen, D.S. Ludwig.
A reduced-glycemic load diet in the treatment of adolescent obesity.
Arch Pediatr Adolesc Med, 157 (2003), pp. 773-779
[34.]
American Dietetic Association. The traffic light diet and treating childhood overweight [Internet] [consultado 26 Ago 2009] Disponível em: http://www.adaevidencelibrary.com/evidence.cfm?evidence_summary_id=250033.
[35.]
L.H. Epstein, A. Valoski, R.R. Wing, J. McCurley.
Ten-year follow-up of behavioral, family-based treatment for obese children.
JAMA, 264 (1990), pp. 2519-2523
[36.]
L.H. Epstein, R.A. Paluch, C.C. Gordy, J. Dorn.
Decreasing sedentary behaviors in treating pediatric obesity.
Arch Pediatr Adolesc Med, 154 (2000), pp. 220-226
[37.]
L.H. Epstein, R.A. Paluch, H.A. Raynor.
Sex differences in obese children and siblings in family-based obesity treatment.
Obes Res, 9 (2001), pp. 746-753
[38.]
G.S. Goldfield, L.H. Epstein, C.K. Kilanowski, R.A. Paluch, B. Kogut-Bossler.
Cost-effectiveness of group and mixed family-based treatment for childhood obesity.
Int J Obes Relat Metab Disord, 25 (2001), pp. 1843-1849
[39.]
U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. 2008 physical activity guidelines for Americans. [Internet] [consultado 20 Mai 2010]. Disponível em: http://www.health.gov/paguidelines/pdf/paguide.pdf.
[40.]
Public Health Agency of Canada.
Canadian Society for Exercise Physiology. Canada's physical activity guide for youth.
Public Health Agency of Canada, (2002),
[41.]
Australian Government.
Department of Health and Ageing. Australia's physical activity recommendations for 5–12 year old.
Australian Government, (2004),
[42.]
Australian Government.
Department of Health and Ageing. Australia's physical activity recommendations for 12–18 year old.
Australian Government, (2004),
[43.]
B. Gutin, P. Barbeau, S. Owens, C.R. Lemmon, M. Bauman, J. Allison, et al.
Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents.
Am J Clin Nutr, 75 (2002), pp. 818-826
[44.]
G.D. Foster, A.P. Makris, B.A. Bailer.
Behavioral treatment of obesity.
Am J Clin Nutr, 82 (2005), pp. 230S-235S
[45.]
T.N. Robinson.
Behavioural treatment of childhood and adolescent obesity.
Int J Obes Relat Metab Disord, 23 (1999), pp. S52-S57
[46.]
C.B. Ebbeling, D.B. Pawlak, D.S. Ludwig.
Childhood obesity: public-health crisis, common sense cure.
[47.]
M. Golan, A. Weizman, A. Apter, M. Fainaru.
Parents as the exclusive agents of change in the treatment of childhood obesity.
Am J Clin Nutr, 67 (1998), pp. 1130-1135
[48.]
M. Golan, V. Kaufman, D.R. Shahar.
Childhood obesity treatment: targeting parents exclusively v. parents and children.
Br J Nutr, 95 (2006), pp. 1008-1015
[49.]
B.H. Wrotniak, L.H. Epstein, R.A. Paluch, J.N. Roemmich.
Parent weight change as a predictor of child weight change in family-based behavioral obesity treatment.
Arch Pediatr Adolesc Med, 158 (2004), pp. 342-347
[50.]
M. Romon, A. Lommez, M. Tafflet, A. Basdevant, J.M. Oppert, J.L. Bresson, et al.
Downward trends in the prevalence of childhood overweight in the setting of 12-year school- and community-based programmes.
Public Health Nutr, 12 (2009), pp. 1735-1742
[51.]
WHO.
Regional Office for Europe. European Chart on Counteracting Obesity.
WHO, (2006),
[52.]
M.A. Carvalho, A. Rito, J. Breda.
Avaliação do impacto do projecto Obesidade Zero ao nível do estado nutricional das crianças [resumo]. Endocrinologia.
Diabetes & Obesidade, 4 (2010), pp. 264
[53.]
Sociedad Española para el Estudio de la Obesidad.
Recomendaciones nutricionales basadas en la evidencia para la prevención y el tratamiento del sobrepeso y la obesidade en adultos: Consenso FESNAD-SEEDO.
Revista Española de Obesidad, 9 (2011), pp. 4-78
Copyright © 2011. Sociedade Portuguesa de Cardiologia
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