Evolução temporal (2005-2015) da prevalência do excesso de peso: estudo de base populacional com pré-escolares do estado de Alagoas, Brasil

Abstract

In pre-school children, overweight is defined by z-score of IMC-i> 2 standard deviations and has been widely used in population-based studies as an indicator of overweight / obesity. This is a global epidemic, affecting around 6.7% of the pre-school population in 2010 and it is estimated that this figure should rise to reach 9.1% by 2020. In Brazil, according to PNDS data, the prevalence of overweight affects about 7.8% of children. These data are worrying, since childhood obesity has short- and long-term consequences, such as respiratory complications, orthopedic disorders, diabetes, hypertension, dyslipidemias and psychosocial disorders. In the last three decades, overweight in children has been presenting an exponentially higher prevalence and has started in increasingly precocious age groups, and it is plausible that this problem becomes even more worrying in the coming decades. The priority of health care at this stage of life is vital, since it builds a foundation for a better quality of life in the future. Alagoas is a state in the Brazilian Northeast characterized by the worst socioeconomic and health indicators in the country. Identifying the nutritional status of children living in different socioeconomic conditions is fundamental for the development and evaluation of public policies aimed at the promotion and prevention. However, few studies have evaluated the evolution of overweight in children. In order to fill these gaps and contribute to the discussion of this problem, the present dissertation was made, which is constituted by a review chapter of the literature and by an original article. The purpose of this study was to investigate the temporal trend and factors associated with the prevalence of overweight in children under five years of age in the State of Alagoas. It is a time-series study using data from the I and II Diagnoses of health of the maternal and child population of the state of Alagoas, performed, respectively, in 2005 and 2015. In 2005, 1,385 children were evaluated and in 2015 it was evaluated 994. Overweight was defined as the standard deviation of the IMC-i> 2 score. In order to express the changes occurring in the prevalences of the variables analyzed between the two surveys, the following equation was used: ((P2-P1) / P1 × 100)), where P1 is the prevalence of 2005 and P2 is the prevalence of 2015 In order to define the factors associated with the occurrence of overweight, the socioeconomic, demographic, health and maternal variables (independent variables) were investigated. The associations with the independent variables that obtained p <0.2 (chi-square) in the raw analysis were subjected to multivariate analysis (Poisson regression with robust variance adjustment). Between 2005 and 2015 there was a positive and significant percentage change in the prevalence of overweight in children. Overweight increased from 7.8% to 15.4% (PR = 1.97, 95% CI: 1.56-2.49), representing an increase of 97.4%. Factors independently associated with overweight maternal schooling (> 8 years), an indicator of better socioeconomic status and maternal overweight (BMI ≥ 25 kg / m2). The high prevalence and the increasing variations of excess weight are worrisome and reveal the need for the implementation of prevention and control actions. Studies such as the present are important in order to monitor the evolution of the problem and contribute to the planning of adequate public policies.