Relação do ambiente obesogênico e das práticas parentais com o estado nutricional de adolescentes

Abstract

Obesity is a public health problem that affects the health of children and adolescents early. Among the several factors involved in its etiology are aspects of the environment in which people live, called obesogenic, as well as parental practices, which can favor unhealthy food consumption and physical inactivity, with consequent weight gain. Therefore, the relationship between the obesogenic environment and parental practices with overweight (overweight / obesity) in school adolescents was assessed. This was a case-control study nested in an intervention study conducted with students of both sexes, aged between 12 and 16 years, from public schools in Campina Grande, Paraíba, Brazil, with adolescents with an index body mass ≥ +2 z-scores (obesity) and overweight (≥ + 1 z-score and <+2 z-score) and, as controls, eutrophic (≥ -2 z-score and <+1 score -z), matched by gender, age and class. The final sample consisted of 148 adolescents, 80 cases and 68 controls, in addition to their parents / caregivers. Sociodemographic characteristics of adolescents and their parents / caregivers were assessed, in addition to nutritional status. To assess the obesogenic environment, aspects of the home environment, characteristics of the adolescents' displacement, sedentary and eating behaviors were investigated, all using a form. Regarding educational parenting practices, it was evaluated through three factors described in the child's food questionnaire (QAC) adjusted for this study. Statistical analyzes were performed using the Statistical Package for the Social Sciences (SPSS) software, version 22.0. To test the association, between cases and controls, with demographic, biological and obesogenic environment variables and parental practices, Odds Ratio (OR) was calculated, adopting the lowest risk category as the reference category. Pearson's chi-square test was used, with Fisher correction, when necessary. For all analyzes, the 95% confidence interval was considered. It was possible to observe that the majority were: female, 55% in the cases and 45% controls; 53% of cases and 48% of controls were over 12 years of age; residents with father and / or mother 53% in cases, and 47% in controls. Regarding nutritional status, 48 (32.4%) were overweight, 32 (21.6%) were obese and 68 (46.0%) were eutrophic. Among the caregivers: the majority had less than eight years of schooling, 59% in cases and 41% in controls; and in the nutritional status classified as overweight / obesity (79.1%), 62% in cases and 38% in controls, being associated with the adolescent's nutritional status (OR = 5.688, p <0.01). Regarding the obesogenic environment, with regard to the characteristics of the home environment, there was no statistically significant association with the nutritional status of the adolescents, as well as with sedentary behaviors and eating habits considered inappropriate. There was a high percentage of adolescents who do not practice physical activity outside school (66.2%), who spend at least two hours a day in front of screens (85.8%) and who spend less than that time in activities that they run (79.7%); in addition, all reported eating out at home five times a week. Regarding parenting practices, there was a higher percentage of overweight / obesity among adolescents submitted to restrictive practices related to the consumption of sweets; already under pressure to eat, among the caregivers who disagree with this practice, a significantly higher proportion of overweight / obese adolescents was observed; and there was a higher percentage of overweight children among parents / caregivers who report monitoring the consumption of caloric foods most of the time. Thus, it is concluded that, although the characteristics of the obesogenic environment have not been shown to be associated with the adolescent's nutritional status, when combined with negative educational parenting practices, the risk of adolescents developing overweight and obesity is increased, especially in terms of nutritional status. caregivers.