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Whitakers World Of Facts 2007 Pdf

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This characteristic is partly reflected in the wide range observed in the number of participants: from , adolescents assessed in the "Avena Study" 34 to the adolescents examined in a case-control study conducted in Brazil Only 5 studies assessed adolescents between 10 and 19 years of age. The age group studied most frequently was that between 12 and 19 years. The group of independent variables studied most frequently were socioeconomic variables, followed by dietary ones, then exercising, and other behaviors related to lifestyle followed by demographics.

None of the studies assessed adopted the WHO's recommended diagnostic criteria for overweight. In the group of studies with highest points, the cohort design was observed to be more frequent in comparison to the lowest point group. Socioeconomic variables were assessed more frequently in the group of studies with lowest points. Most studies found a statistically significant association between factors studied and OW, and only in three studies no association was found.

Fourteen studies that assessed obesity as outcome, presented, in general, results similar to those observed for OW. Socioeconomic, demographic and environmental variables and EP Of all studies, 45 studied socioeconomic variables: 28, demographic and 9, environmental. An inverse association between socioeconomic level and OW was observed in developed countries 34, , while a direct relation was observed in developing countries.

The fact that these results were also found in studies with a higher point percentage according to the STROBE report checklist 44,48,51 should also be pointed out. Environmental variables that characterize geographical areas as sites of higher or lower development living in cities with 10, or more inhabitants; living in urban areas and mean income of neighborhood were also inversely associated with OW in developed countries.

In three studies, two of them conducted in Brazil 52,53 and one in China 54 , a direct association between living in an urban area and OW was observed. This pattern of association was similar when analyses were stratified by sex. However, in two studies carried out in developed countries whose specific objective was to identify the association between socioeconomic level and OW, no statistically significant association was observed among girls 34, Behavioral variables and OW Among behavioral variables, 30 studies assessed dietary variables, 31 evaluated factors related to physical exercise PE and 29 measured other behaviors.

Being or having been on a diet to lose weight or having a restrictive diet behavior had a direct association with OW in all studies analyzed 14, 35, , except for a study conducted in Brazil Attitudes related to weight loss ex: taking pills, laxatives to lose weight without medical guidance 55 , consumption of soft drinks 3 days or more per week 40 , and the habit of downloading a snack at school 51 were also positively associated with OW.

There was an inverse association with OW for: habit of having breakfast 59, , amount of energy, fibers and cholesterol consumed in the past 24 hours 47 , consumption of fruit and greenery in the past seven days 63 , habit of having cereal for breakfast 64 , and having more meals during the day 14,60, By comparing these findings to those found in analyses stratified by sex, a study presented discordant result among girls: being on a diet to lose weight was inversely associated with OW The habit of having dinner with family was inversely associated with OW in one of the two studies that analyzed this behavior 36, Exercising PE and its frequency at and outside school, especially more intense PE vigorous and intense exercise , assessed by different tools, were inversely associated with OW in 12 studies 40, 51, 55, 59, 61, 62, In a longitudinal study conducted by Gordon-Larsen et al.

Only two studies identified a positive association between PE and OW 55, When other behaviors were assessed, a direct association was observed between the number of hours spent in front of the TV, video-game or computer and OW in all studies that showed statistical significance in the analysis of the relation 39,60,61,67,68, The number of hours of night sleep was inversely associated with OW in two of the six studies that assessed this variable 72, Psychological variables and OW Seven studies 19,37,44,55,57,59,77 assessed psychological variables and, of these, three presented significant associations with OW.

Directly associated with OW, both in boys and girls were: a higher score of depressive symptoms 77 ; presence of a food disorder characterizing a restrictive behavior 59 and the presence of trace of anxiety However, OW was inversely associated with the presence of eating disorders due to external stimuli, when only girls were taken into consideration One article identified a direct association between parents currently smoking and OW A similar result was observed when analyses were stratified by sex.

Duration of breastfeeding for two or more months had a protecting effect on OW in three studies 14,17, Previous nutritional status of adolescents and nutritional status of parents also proved as relevant conditions for the occurrence of OW in adolescence. Despite the heterogeneity observed in the design and in the selection of variables and exposure indicators, patterns of association between socioeconomic variables and OW were shown to be consistent, highlighting the difference of the direction of this association between developed and developing countries, observed in some surveys with nationwide representativeness 2,38, Studies using data from the past three decades in the United States USA showed that the increase in the prevalence of overweight is higher in families who live below the poverty line, especially among older adolescents 15 to 17 years and Afro-American individuals in comparison to white and Hispanic individuals of the same socioeconomic level.

In a more recent period - , an inverse association between socioeconomic level and OW was observed to be statistically significant only among girls 40, In Brazil, for example, in a period similar to that of the studies performed in the US, a direct relation between family income and OW was observed among adolescents and the relation is becoming weaker among girls 2.

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Methodological explanations may justify this finding, apparently without biological plausibility. Such design does not guarantee that exposure preceded outcome. Another explanation is the possible occurrence of systematic error in assessment, given OW adolescents would tend to give more socially expected answers, underestimating their food consumption and answering this question positively.

Neumark et al. In addition to methodological explanations, in the longitudinal study where this association was observed, the authors assessed characteristics associated with restrictive eating behaviors that are associated with the occurrence of OW.

Adolescents with these behaviors limit their food intake, skip meals, feel very hungry and have little control over their eating and for this reason may be more susceptible to overweight We also identified eating behaviors that protect against the study's outcome, such as the habit of having breakfast and having more meals during the day.

These behaviors are related to a more regular and defined meal pattern and are inversely associated with the habit of "snacking" foods with high energetic density throughout the day and, directly with vigorous physical exercise 20,56, Skipping breakfast is also suggested to be directly associated with other restrictive eating behaviors 59, Despite the heterogeneity observed in variables and indicators presented by studies to measure exercising and intensity of physical activity ex.

These findings are corroborated by recent systematic revisions that identified the efficacy and effectiveness of exercising and reduction in TV watching time in the prevention of OW in childhood and adolescence 23,25, Few studies have identified association between psychological variables and OW. In the process of selecting studies, many articles were excluded because they assessed OW as a risk factor for psychological disorders, suggesting that psychological disorders are studied more as consequences than determinants of OW among adolescents.

Although it was not the objective of the present revision, some of the studies selected pointed toward a higher likelihood of OW among adolescents with at least one parent that was obese or that had been overweight during childhood. A survey with children also identified the presence of OW in parents as a risk factor for obesity 7. The interaction between a complex network of genes associated with obesity and the environments that favor their expression has been appointed as the background for the occurrence of obesity among individuals of the same family Among studies selected, distinct criteria were adopted for the diagnosis of OW.

The authors observed considerable differences among prevalences and recommend care in the comparison of results when distinct criteria are used. Despite this limitation, criteria for the diagnosis of OW used internationally were considered in the present revision aimed at expanding the selection of relevant literature to comply with the objective of the study. Moreover, the objective of the present study was to revise the association between certain factors and OW and not to compare the magnitude of the condition in diverse scenarios.

The agreement between results of studies that utilized different criteria for diagnosing OW corroborates the consistency of the associations described in them. As to the quality of studies, Khan et al.

It should be also pointed out that, for some factors, it is possible to guarantee preceding time relations, as, for example, for variables that assess the socioeconomic level of families and those that relate to initial life.

On the conduction of studies, great heterogeneity in the selection and methods utilized for assessment of independent variables was observed, and also in the criteria adopted for diagnosis of OW, which makes their joint analysis difficult.

This limitation seems to compromise, mainly, the analysis of association between eating behaviors and consumption variables with OW. Eleven of the 25 articles that assessed food consumption did not present any information on the validity or reliability of the tool used toward that end 14,18,39,40,47,62,64,66,69,76, However, for certain variables, there seems to not have been an influence of this limitation, given the similarity of the results observed, as was the case of variables related to exercise.

As to the care adopted in the analysis of results, nine studies carried out univariate analyses, without adjustment for potential confounding variables. The results of these studies, in general terms, were similar to those found in the studies that performed adjusted analyses.

Some limitations of the present revision should be pointed out. The first one refers to the possibility of a relevant study being ignored, as only publications in English, Spanish or Portuguese were analyzed. No search was performed to identify unpublished studies or those published in annals of congresses, symposiums, etc.

The second limitation refers to the interpretation of results of articles that assessed previous characteristics, given the initial objective of the present study was not to identify factors of initial life nor behaviors or nutritional status of parents; therefore, search strategies were not specified with that aim.

whitaker's world of facts 2007 pdf

Consequently, articles that studied this association may have been missed. The acknowledgement of the complexity of its determinants and involvement of several sectors of society to prepare actions to promote health and prevent the condition is one of the current challenges in the global public health agenda. Despite the limitations in the comparison and analysis of selected studies, the revision points out a set of socioeconomic and behavioral factors that were shown to be associated with OW among adolescents and that are prone to intervention, and also highlights population groups in which the likelihood of the condition occurring is higher.

The present authors, therefore, recommend that interventions oriented toward adolescents, both at the collective and individual level, take into account the factors herein identified, that is: socioeconomic level of families; food restriction behaviors; the habit of having breakfast; frequency and intensity of exercise, and time spent in sedentary activities.

In addition to these, other factors of environmental, cultural and political nature are still little explored and should be considered, given the complexity and dynamics of the network that determines overweight in this age group still very susceptible to the changes experienced by societies.

Last, it should be pointed out that other eating behaviors, such as the consumption of certain foods and nutrients, habit of family meals, psychological variables, and environmental characteristics were little studied or did not present consistent associations between selected studies and, therefore, require further investigation. References 1.

World Health Organization.

Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation.

Geneva; Rio de Janeiro; Obesity in children and young people: a crisis in public health. Obes Rev ; 5: S4-S Am J Clin Nutr ; Body mass index and height from childhood to adulthood in the British born cohort. Do obese children become obese adults? A review of the literature. Media, Racism and What they media exercise is the power to represent the world in certain definite ways. The ideas of such Whittaker's research noted the extraordinary increase in the number of In fact, with the intensified engagement of private actors, soci Reinicke, W.

Florence R. Lacy-McKinney v.

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Last, it should be pointed out that other eating behaviors, such as the consumption of certain foods and nutrients, habit of family meals, psychological variables, and environmental characteristics were little studied or did not present consistent associations between selected studies and, therefore, require further investigation.

On the conduction of studies, great heterogeneity in the selection and methods utilized for assessment of independent variables was observed, and also in the criteria adopted for diagnosis of OW, which makes their joint analysis difficult.

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