Sociodemographic, anthropometric and dietary determinants of dyslipidemia in preschoolers

Nobre, Luciana N.; Lamounier, Joel A.; Franceschini, Sylvia do C.C.

doi:10.1016/j.jpedp.2013.02.006

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Abstract

Objective

To investigate the determinants of dyslipidemia in preschoolers.

Methods

A total of 227 preschoolers residing in an urban area of the city of Diamantina, Minas Gerais, Brazil were evaluated at age 5 years, using a cross-sectional design. Dietary intake from a food frequency questionnaire, anthropometric/biochemical parameters, and socioeconomic/behavioral information from a questionnaire were evaluated. ‘Mixed diet’, ‘snack’, and ‘unhealthy’ dietary patterns were identified using principal component analysis. The determinants of dyslipidemia were examined using Poisson regression analysis.

Results

The prevalence of dyslipidemia in this study was 65.19%. Preschoolers who less frequently consumed foods in the ‘mixed diet’ dietary pattern had a higher risk of high concentrations of low-density lipoprotein cholesterol (PR = 2.30; p = 0.004) when compared with those with more frequent consumption of the ‘mixed diet’ dietary pattern. Preschoolers whose mothers had lower levels of education presented a lower risk of high concentrations of low-density lipoprotein cholesterol (PR = 0.43; p = 0.003), and preschoolers who were overweight/obese presented with greater risk of high concentrations of low-density lipoprotein cholesterol (PR = 2.23; p = 0.003).

Conclusion

The determinants of dyslipidemia identified in this study were less frequent consumption of foods in the ‘mixed diet’ dietary pattern, higher body mass index, and higher level of maternal education. This study shows that despite the young age of the group under study, they already present a high prevalence of dyslipidemia, which is an important risk factor for cardiovascular disease.

Keywords:

Hypercholesterolemia

Body mass index

Feeding behavior

Resumo

Objetivo

O objetivo deste estudo foi investigar os determinantes de dislipidemia em pré-escolares.

Métodos

A partir de um desenho transversal, foi avaliado um total de 227 pré-esco- lares com 5 anos de idade residentes em uma área urbana da cidade de Diamantina, Minas Gerais, Brasil. Foram avaliados: variáveis bioquímicas, antropométricas, condição socioeconômica e comportamental, a partir de um questinário; e ingestão alimentar, a partir de um questionário de fequência de consumo de alimentos. Os padrões alimen- tares denominados “dieta mista”, “fast food” e “não saudável” foram identificados por meio de análise de componentes principais. Os determinantes de dislipidemia foram examinados através da análise de regressão de Poisson.

Resultados

A prevalência de dislipidemia, neste estudo, foi de 65,19%. Os pré-escolares que consumiam com menos frequência alimentos do padrão “dieta mista” tiveram um risco maior de concentrações mais altas de lipoproteína de baixa densidade (PR = 2,30; p = 0,004), em comparação com aqueles com um consumo mais frequente do padrão “dieta mista”. Os pré-escolares cujas mães apresentaram uma escolaridade mais baixa tiveram menor risco de concentrações mais altas de lipoproteína de baixa densidade (PR = 0,43; p = 0,003), e os pré-escolares que estavam com sobrepeso/obesos apresentaram maior risco de concentrações mais altas de lipoproteína de baixa densidade (PR = 2,23; p = 0,003).

Conclusão

Os determinantes de dislipidemia identificados neste estudo foram o consu- mo menos frequente de alimentos do padrão “dieta mista”, índice de massa corporal mais alto e um maior nível de escolaridade materna. Este estudo mostra que, apesar da baixa idade do grupo em estudo, já estão apresentando alta prevalência de dislipidemia, que é um fator de risco importante para doença cardiovascular.

Palavras-chave:

Hipercolesterolemia

Índice de massa corporal

Comportamento alimentar

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Referências

[1]

R.D. Santos.

Sociedade Brasileira de Cardiologia III Brazilian guidelines on dyslipidemias and guideline of atherosclerosis prevention from atherosclerosis. Departmento da Sociedade Brasileira de Cardiologia.

Arq Bras Cardiol., 77 (2001), pp. 1-48

Medline

[2]

Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128:S213-56.

[3]

S.N. Al-Shehri, Z.A. Saleh, M.M. Salama, Y.M. Hassan.

Prevalence of hyperlipidemia among Saudi school children in Riyadh.

Ann Saudi Med., 24 (2004), pp. 6-8

Medline

[4]

I. Giuliano, C. de, M.S. Coutinho, S.F. Freitas, M.M. Pires, J.N. Zunino, R.Q. Ribeiro.

Serum lipids in school kids and adolescents from Florianópolis, SC.

Brazil - Healthy Floripa 2040 study. Arq Bras Cardiol., 85 (2005), pp. 85-91

[5]

R.Q. Ribeiro, P.A. Lotufo, J.A. Lamounier, R.G. Oliveira, J.F. Soares, D.A. Botter.

Additional cardiovascular risk factors associated with excess weight in children and adolescents: the Belo Horizonte heart study.

Arq Bras Cardiol., 86 (2006), pp. 408-418

http://dx.doi.org//S0066-782X2006000600002 | Medline

[6]

L.N. Nobre, S.N. Sammour, P.S. Costa Sobrinho, F.C. Elias, S.C. Cavaca, R. Trindade, et al.

Lipid profile and weight excess among school children.

Rev Med Minas Gerais., 18 (2008), pp. 252-259

[7]

P.B. Pereira, I.K. Arruda, A.M. Cavalcanti, A. Diniz, S. da.

Lipid profile of schoolchildren from Recife.

PE. Arq Bras Cardiol., 95 (2010), pp. 606-613

[8]

M.V. Araki, C. Barros, E.G. Santos.

Análise do perfil lipídico de crianças e adolescentes do estado de Sergipe.

Scientia Plena., 6 (2010), pp. 1-6

[9]

O.D. Alcântara Neto, R.C. Silva, A.M. Assis, E. Pinto, J. de.

Factors associated with dyslipidemia in children and adolescents enrolled in public schools of Salvador.

Bahia. Rev Bras Epidemiol., 15 (2012), pp. 335-345

[10]

L. Barbosa, O.C. Chaves, R.C. Ribeiro.

Anthropometric and body composition parameters to predict body fat percentage and lipid profile in schoolchildren.

Rev Paul Pediatr., 30 (2012), pp. 520-528

[11]

M. Juonala, J.S. Viikari, T. Rönnemaa, J. Marniemi, A. Jula, B.M. Loo, et al.

Associations of dyslipidemias from childhood to adulthood with carotid intima-media thickness, elasticity, and brachial flow-mediated dilatation in adulthood: the Cardiovascular Risk in Young Finns Study.

Arterioscler Thromb Vasc Biol., 28 (2008), pp. 1012-1017

http://dx.doi.org/10.1161/ATVBAHA.108.163329 | Medline

[12]

M.G. Frontini, S.R. Srinivasan, J. Xu, R. Tang, M.G. Bond, G.S. Berenson.

Usefulness of childhood non-high density lipoprotein cholesterol levels versus other lipoprotein measures in predicting adult subclinical atherosclerosis: the Bogalusa Heart Study.

Pediatrics., 121 (2008), pp. 924-929

http://dx.doi.org/10.1542/peds.2007-1472 | Medline

[13]

I. Cowin, P. Emmett, Cholesterol, triglyceride concentrations.

birthweight and central obesity in pre-school children. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.

Int J Obes Relat Metab Disord., 24 (2000), pp. 330-339

Medline

[14]

K. Asayama, H. Hayashibe, K. Dobashi, N. Uchida, T. Nakane, K. Kodera, et al.

Increased serum cholesteryl ester transfer protein in obese children.

Obes Res., 10 (2002), pp. 439-446

http://dx.doi.org/10.1038/oby.2002.61 | Medline

[15]

D.S. Freedman, W.H. Dietz, S.R. Srinivasan, G.S. Berenson.

The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study.

Pediatrics., 103 (1999), pp. 1175-1182

Medline

[16]

C.L. Coronelli, E.C. de Moura.

Hypercholesterolemia and its risk factors among schoolchildren.

Rev Saude Publica., 37 (2003), pp. 24-31

Medline

[17]

Y. Liao, Y. Liu, J. Mi, C. Tang, J. Du.

Risk factors for dyslipidemia in Chinese children.

Acta Paediatr., 97 (2008), pp. 1449-1453

http://dx.doi.org/10.1111/j.1651-2227.2008.00946.x | Medline

[18]

V.R. Dishchekenian, M.A. Escrivão, D. Palma, F. Ancona-Lopez, E.A. Araújo, J.A. Taddei.

Dietary patterns of obese adolescents and different metabolic effects.

Rev Nutr., 24 (2011), pp. 17-29

[19]

K. Northstone, P. Emmett.

Multivariate analysis of diet in children at four and seven years of age and associations with socio- demographic characteristics.

Eur J Clin Nutr., 59 (2005), pp. 751-760

http://dx.doi.org/10.1038/sj.ejcn.1602136 | Medline

[20]

G.L. Ambrosini, R.C. Huang, T.A. Mori, B.P. Hands, T.A. O'Sullivan, N.H. de Klerk, et al.

Dietary patterns and markers for the metabolic syndrome in Australian adolescents.

Nutr Metab Cardiovasc Dis., 20 (2010), pp. 274-283

http://dx.doi.org/10.1016/j.numecd.2009.03.024 | Medline

[21]

K.C. Ribeiro, R.C. Shintaku.

The influence of the lipids of the diet on aterosclerose.

ConScientiae Saúde., 3 (2004), pp. 73-83

[22]

A.C. Lessa.

Alimentação e crescimento no primeiro ano de vida: um estudo de coorte [tese].

Universidade Federal da Bahia, (2010),

[23]

Wikipedia. Diamantina. [acessado em 1 Oct 2012]. Disponível em: http://pt.wikipedia.org/wiki/Diamantina.

[24]

M.H. Pestano, J.N. Gageiro.

Análise de dados para ciências sociais: a complementaridade do SPSS.

Edições Sílabo, (2005),

[25]

L.G. Portney, M.P. Watkins.

Foundations of clinical research: applications to practice.

3rd ed., Prentice-Hall, (2008),

[26]

D.B. Jelliffe.

Evaluación del estado de nutrición de la comunidad.

World Health Organization, (1968),

[27]

World Health Organization (WHO). WHO Multicentre Growth Reference SXXXtudy GXXXroup. WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for- height and body mass index-for-age: methods and development. Geneva: World Health Organization. Department of Nutrition for Health and Development; 2006.

[28]

R.L. Sales, M.M. Silva, N.M. Costa, M.P. Euclydes, V.F. Eckhardt, C.M. Rodrigues, et al.

Development of a questionnaire to assess food intake of population groups.

Rev Nutr., 19 (2006), pp. 539-552

[29]

L.N. Nobre, J.A. Lamounier, S.C. Franceschini.

Preschool children dietary patterns and associated factors.

J Pediatr (Rio J)., 88 (2012), pp. 129-136

[30]

I. Back Giuliano, C. de, B. Caramelli, L. Pellanda, B. Duncan, S. Mattos, F.H. Fonseca, et al.

I guidelines of prevention of atherosclerosis in childhood and adolescence.

Arq Bras Cardiol., 85 (2005), pp. 4-36

Medline

[31]

C.G. Victora, S.R. Huttly, S.C. Fuchs, M.T. Olinto.

The role of concep- tual frameworks in epidemiological analysis: a hierarchical approach.

Int J Epidemiol., 26 (1997), pp. 224-227

Medline

[32]

American Academy of Pediatrics. National Cholesterol Education Program: report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics. 1992;89:525-84.

[33]

S. Bertrais, B. Balkau, M.A. Charles, S. Vol, C. Calvet, J. Tichet, et al.

Puberty-associated differences in total cholesterol and triglyceride levels according to sex in French children aged 10-13 years.

Ann Epidemiol., 10 (2000), pp. 316-323

Medline

[34]

A. Fesharakinia, A. Zarban, G.R. Sharifzadeh.

Lipid profiles and prevalence of dyslipidemia in schoolchildren in south Khorasan Province, eastern Iran.

Arch Iran Med., 11 (2008), pp. 598-601

Medline

[35]

J.A. Duarte, J.C. Ribeiro, J. Oliveira, J. Mota.

The relationship between physical activity cholesterol levels in children and adolescents.

Rev Bras Saude Matern Infant., 4 (2004), pp. 185-192

[36]

E.S. Ford, C. Li, G. Zhao, A.H. Mokdad.

Concentrations of low- density lipoprotein cholesterol and total cholesterol among children and adolescents in the United States.

Circulation., 119 (2009), pp. 1108-1115

http://dx.doi.org/10.1161/CIRCULATIONAHA.108.816769 | Medline

[37]

C.M. Berg, G. Lappas, E. Strandhagen, A. Wolk, K. Torén, A. Rosengren, et al.

Food patterns and cardiovascular disease risk factors: the Swedish INTERGENE research program.

Am J Clin Nutr., 88 (2008), pp. 289-297

Medline

[38]

X. Shang, Y. Li, A. Liu, Q. Zhang, X. Hu, S. Du, et al.

Dietary pattern and its association with the prevalence of obesity and related cardiometabolic risk factors among Chinese children.

PLoS One., 7 (2012), pp. e43183

http://dx.doi.org/10.1371/journal.pone.0043183 | Medline

[39]

P.R. Deshmukh-Taskar, C.E. O’Neil, T.A. Nicklas, S.J. Yang, Y. Liu, J. Gustat, et al.

Dietary patterns associated with metabolic syndrome, sociodemographic and lifestyle factors in young adults: the Bogalusa Heart Study.

Public Health Nutr., 12 (2009), pp. 2493-2503

http://dx.doi.org/10.1017/S1368980009991261 | Medline

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Como citar este artigo: Nobre LN, Lamounier JA, Franceschini SC. Sociodemographic, anthropometric and dietary determinants of dyslipidemia in preschoolers. J Pediatr (Rio J). 2013;89:462-9.

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