Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz (Fiocruz): Instituto Aggeu Magalhães, Av Prof. Moraes Rego, s.n. Campus UFPE, Cidade Universitária, Recife, PE, CEP: 50.740-465, Brazil.
Universidade Federal de Pernambuco, Recife, PE, Brazil.
BMC Public Health. 2018 Feb 7;18(1):223. doi: 10.1186/s12889-018-5121-6.
The emergence of diseases such as dyslipidemia, systemic arterial hypertension, insulin resistance and metabolic syndrome in children and adolescents has brought about a change in the epidemiologic profile of the pediatric population. As action to promote health in the school environment is a useful tool for changing the pattern of health/disease in the young population, the present study aimed to identify schools that promote healthy eating and physical activity and to study the relationship between these practices and the prevalence of overweight, hypertension, insulin resistance and hypercholesterolemia in adolescents.
A cross-sectional population-based study was conducted with 2400 adolescents aged from 12 to 17 years old and participating in the "Study of Cardiovascular Risk in Adolescents" (ERICA - Estudo de Riscos Cardiovasculares em Adolescente). The association between dependent (overweight, insulin resistance, hypertension and dyslipidemia) and independent variables (implementation of health promoting initiative in schools) was investigated using the chi-square test and prevalence ratio (PR) with a confidence index (CI) of 95%.
The unsatisfactory implementation of a "health promoting environment" (PR = 1.02; CI 95%: 1.0; 1.04) and "partnerships with the health sector" (PR = 1.03; CI 95%: 1.01; 1.05) were linked to a high prevalence of overweight in adolescents. Hypercholesterolemia was found to be higher in the schools with unsatisfactory implementation of "healthy eating and health on the scholar curriculum" (PR = 1.71; CI 95%: 1.22; 2.44) and those lacking a "healthy-eating promoting environment" (PR = 1.29; CI 95%: 1.10; 1.54). Schools with unsatisfactory implementation of a "health-eating promoting environment" (PR = 1.36; CI 95%: 1.04; 1.79) and those lacking "partnership with the health sector" (PR = 2.12; CI 95%: 1.38; 3.24) had more adolescents with insulin resistance. There was no association between hypertension and any other component studied.
Schools which have implemented adequate health promotion in their curriculums showed a lower prevalence of overweight, insulin resistance and hypercholesterolemia in adolescents.
血脂异常、全身性动脉高血压、胰岛素抵抗和代谢综合征等疾病在儿童和青少年中的出现，改变了儿科人群的流行病学特征。由于在学校环境中采取促进健康的行动是改变青少年人群健康/疾病模式的有用工具，因此本研究旨在确定促进健康饮食和身体活动的学校，并研究这些做法与超重、高血压、胰岛素抵抗和青少年高胆固醇血症之间的关系。
采用横断面人群基础研究，对 2400 名年龄在 12 至 17 岁之间、参与“青少年心血管风险研究”（ERICA - Estudo de Riscos Cardiovasculares em Adolescente）的青少年进行研究。使用卡方检验和患病率比（PR）及其置信指数（CI）为 95%来调查依赖变量（超重、胰岛素抵抗、高血压和血脂异常）和独立变量（学校实施健康促进计划）之间的关联。
“促进健康环境”实施情况不佳（PR=1.02；95%CI：1.0；1.04）和“与卫生部门合作”（PR=1.03；95%CI：1.01；1.05）与青少年超重的高患病率有关。在“学者课程中的健康饮食和健康”实施情况不佳的学校（PR=1.71；95%CI：1.22；2.44）和缺乏“促进健康饮食环境”的学校（PR=1.29；95%CI：1.10；1.54）中，发现高胆固醇血症的患病率更高。在“促进健康饮食环境”实施情况不佳的学校（PR=1.36；95%CI：1.04；1.79）和缺乏“与卫生部门合作”的学校（PR=2.12；95%CI：1.38；3.24）中，患有胰岛素抵抗的青少年更多。高血压与研究的任何其他组成部分之间均无关联。
在课程中实施了充分健康促进的学校，其青少年超重、胰岛素抵抗和高胆固醇血症的患病率较低。
