Fatores associados ao ganho de peso excessivo durante o primeiro ano de vida de crianças de baixa renda pertencentes à uma coorte

Abstract

Currently, the emerging face of malnutrition is mainly represented by the emergence and maintenance of excess weight (overweight and obesity). In this scenario, the establishment of this condition among children has occurred early. It is known that the process of excessive weight gain is multi-causal and complex, being related to genetic, physiological, metabolic, environmental and behavioral factors. Considering the epidemiological importance of these factors, this dissertation was prepared, in which it is divided into two sections. The first is a literature review in order to build a theoretical framework on excessive weight gain and childhood obesity. The second section brings an original article entitled “Early-life determinants of excessive weight gain among low-income children: examining the adherence of theoretical frameworks to empirical data using structural equation modeling”, which will be submitted to the journal Pediatric Obesity. This article to analyze direct and indirect effects of environmental, maternal, and individual factors on excess weight gain among low-income children during the first year of life. This is a cohort of live births (SAND Project: Health, Food, Nutrition and Child Development), consecutively recruited between February and August 2017 in the only maternity hospital in the city of Rio Largo/AL. Data were prospectively collected at birth and at 3, 6 and 12 months of life of the children. The outcome variable analyzed - conditional weight gain (CWG) - is the standardized residual of a linear regression model, generated from the difference in weight-for-age (ZPI) Z-scores between birth and the last step with available data, adjusted for birth weight, sex and age of the child. The definition of environmental, maternal and child characteristics was supported by conceptual models for determining child weight gain. For the analyses, structural equation modeling (SEM) was used, which makes it possible to jointly estimate the associations between the variables included in the model and the studied outcome. Our findings allowed us to point out the positive association between childhood consumption of ultra-processed foods and maternal obesity and excessive weight gain during the first year of life. Therefore, the identification of risk factors that can be modified is essential for the prevention and control of rapid weight gain at such a critical stage of life as the first 12 months.