Ana Mayra A. de Oliveira

Bio: Ana Mayra A. de Oliveira is an academic researcher from State University of Feira de Santana. The author has contributed to research in topics: Overweight & Childhood obesity. The author has an hindex of 9, co-authored 11 publications receiving 623 citations.

ERICA: prevalences of hypertension and obesity in Brazilian adolescents

Abstract: OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population. RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%. CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.

The study of cardiovascular risk in adolescents – ERICA: rationale, design and sample characteristics of a national survey examining cardiovascular risk factor profile in Brazilian adolescents

Abstract: The Study of Cardiovascular Risk in Adolescents (Portuguese acronym, “ERICA”) is a multicenter, school-based country-wide cross-sectional study funded by the Brazilian Ministry of Health, which aims at estimating the prevalence of cardiovascular risk factors, including those included in the definition of the metabolic syndrome, in a random sample of adolescents aged 12 to 17 years in Brazilian cities with more than 100,000 inhabitants. Approximately 85,000 students were assessed in public and private schools. Brazil is a continental country with a heterogeneous population of 190 million living in its five main geographic regions (North, Northeast, Midwest, South and Southeast). ERICA is a pioneering study that will assess the prevalence rates of cardiovascular risk factors in Brazilian adolescents using a sample with national and regional representativeness. This paper describes the rationale, design and procedures of ERICA.

Sobrepeso e obesidade infantil: influência de fatores biológicos e ambientais em Feira de Santana, BA

Abstract: Childhood overweight and obesity have a high prevalence and multifactorial character. To determine the influence of biological and environmental factors in their development, a cross-sectional study was performed with 699 children, ranging from 5 to 9 years of age, from the public and private schools in the urban area of Feira de Santana, BA. Overweight and obesity were defined as body-mass index > the 85th and 95th percentiles for age and gender, respectively. Interviews with the children's responsible were used to determine the influence of these factors. It was observed as statistic significance for the development of both conditions: high level of parent's education and income, being an only child, studying at private school, having household appliances and using computers. The white ethnic group was related only to overweight. There was an inverse association regarding school flunking and practice of systematic physical activity. The odds ratio showed a predictive and independent association with studying at private school and being an only child. In conclusion there was an influence of biological and environmental factors in the development of childhood overweight and obesity, confirming the multifactorial etiology of these conditions.

Prevalência de sobrepeso e obesidade infantil na cidade de Feira de Santana-BA: detecção na família x diagnóstico clínico

Abstract: OBJECTIVES: to determine the prevalence of overweight and obesity in children attending public and private schools in the urban area of Feira de Santana-BA; to evaluate both the perception of excessive weight gain by guardians and the prevalence of treatment of those children. METHOD: cross-sectional study with 699 children, whose age ranged from 5 to 9 years old, attending public and private schools of Feira de Santana-BA in 2001. Overweight was defined as body mass index (BMI) > 85th percentile and obesity as BMI > 95th percentile both for age and gender. The level of perception of children's excessive weight gain by guardians was evaluated by means of individual interviews. RESULTS: total prevalence rates were 9.3% for overweight and 4.4% for obesity, without statistically significant difference among age and gender. White ethnic group was related only to overweight. Prevalence for overweight and obesity was, respectively, 6.5% and 2.7% for public schools and 13.4% and 7.0% for private ones. Guardians suspected that 11.7% of the children presented excessive weight gain. Only 11.1% of them were submitted to treatment. A percentage of 22.2% of these treatments were performed by specialized professionals. CONCLUSIONS: the prevalence of overweight and obesity was high and similar to some studies in Brazil; even though excessive weight gain can be recognized by children's guardians, they are not aware of the necessity of treatment.

ERICA: prevalence of metabolic syndrome in Brazilian adolescents

Abstract: OBJECTIVE To determine the prevalence of metabolic syndrome and its components in Brazilian adolescents. METHODS We evaluated 37,504 adolescents who were participants in the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, school-based, national study. The adolescents, aged from 12 to 17 years, lived in cities with populations greater than 100,000 inhabitants. The sample was stratified and clustered into schools and classes. The criteria set out by the International Diabetes Federation were used to define metabolic syndrome. Prevalences of metabolic syndrome were estimated according to sex, age group, school type and nutritional status. RESULTS Of the 37,504 adolescents who were evaluated: 50.2% were female; 54.3% were aged from 15 to 17 years, and 73.3% were from public schools. The prevalence of metabolic syndrome was 2.6% (95%CI 2.3-2.9), slightly higher in males and in those aged from 15 to 17 years in most macro-regions. The prevalence was the highest in residents from the South macro-region, in the younger female adolescents and in the older male adolescents. The prevalence was higher in public schools (2.8% [95%CI 2.4-3.2]), when compared with private schools (1.9% [95%CI 1.4-2.4]) and higher in obese adolescents when compared with nonobese ones. The most common combinations of components, referring to 3/4 of combinations, were: enlarged waist circumference (WC), low HDL-cholesterol (HDL-c) and high blood pressure; followed by enlarged WC, low HDL-c and high triglycerides; and enlarged WC, low HDL-c, high triglycerides and blood pressure. Low HDL was the second most frequent component, but the highest prevalence of metabolic syndrome (26.8%) was observed in the presence of high triglycerides. CONCLUSIONS ERICA is the first Brazilian nation-wide study to present the prevalence of metabolic syndrome and describe the role of its components. Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.

A systematic review of parental perception of overweight status in children.

Abstract: To systematically review the proportion of parents able to recognize overweight status in their children who were recorded as being overweight by internationally recognized standards. Two independent reviewers searched electronic databases including MEDLINE, EMBASE, PSYCHINFO, and CINAHL for studies from inception to August 2007 using search terms related to childhood overweight and parents. Twenty-three studies satisfied inclusion criteria, representing 3864 overweight children from 7 countries and 5 distinct standard definitions of overweight status. Seventeen of 23 studies employed either greater than 95th centile or the International Obesity Task Force criteria. Parental recognition of their child's overweight status ranged from 6.2% to 73%, but in 19 of 23 studies, it was less than 50%. More than half of parents cannot recognize when their child is overweight. Relying on parents to seek help for their overweight children is likely to be ineffective, and hence population-based screening may be justified.

Diabetic Polyneuropathy in Type 2 Diabetes Mellitus: Inflammation, Oxidative Stress, and Mitochondrial Function.

Abstract: Diabetic polyneuropathy (DPN) is defined as peripheral nerve dysfunction. There are three main alterations involved in the pathologic changes of DPN: inflammation, oxidative stress, and mitochondrial dysfunction. Inflammation induces activation of nuclear factor kappa B, activator protein 1, and mitogen-activated protein kinases. Oxidative stress induced by hyperglycemia is mediated by several identified pathways: polyol, hexosamine, protein kinase C, advanced glycosylation end-products, and glycolysis. In addition, mitochondrial dysfunction accounts for most of the production of reactive oxygen and nitrosative species. These free radicals cause lipid peroxidation, protein modification, and nucleic acid damage, to finally induce axonal degeneration and segmental demyelination. The prevalence of DPN ranges from 2.4% to 78.8% worldwide, depending on the diagnostic method and the population assessed (hospital-based or outpatients). Risk factors include age, male gender, duration of diabetes, uncontrolled glycaemia, height, overweight and obesity, and insulin treatment. Several diagnostic methods have been developed, and composite scores combined with nerve conduction studies are the most reliable to identify early DPN. Treatment should be directed to improve etiologic factors besides reducing symptoms; several approaches have been evaluated to reduce neuropathic impairments and improve nerve conduction, such as oral antidiabetics, statins, and antioxidants (alpha-lipoic acid, ubiquinone, and flavonoids).

ERICA: prevalences of hypertension and obesity in Brazilian adolescents

Abstract: OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population. RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%. CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.

Sobrepeso e obesidade infantil: influência de fatores biológicos e ambientais em Feira de Santana, BA

Abstract: Childhood overweight and obesity have a high prevalence and multifactorial character. To determine the influence of biological and environmental factors in their development, a cross-sectional study was performed with 699 children, ranging from 5 to 9 years of age, from the public and private schools in the urban area of Feira de Santana, BA. Overweight and obesity were defined as body-mass index > the 85th and 95th percentiles for age and gender, respectively. Interviews with the children's responsible were used to determine the influence of these factors. It was observed as statistic significance for the development of both conditions: high level of parent's education and income, being an only child, studying at private school, having household appliances and using computers. The white ethnic group was related only to overweight. There was an inverse association regarding school flunking and practice of systematic physical activity. The odds ratio showed a predictive and independent association with studying at private school and being an only child. In conclusion there was an influence of biological and environmental factors in the development of childhood overweight and obesity, confirming the multifactorial etiology of these conditions.