Abstract Objectives To review and discuss the role of an elimination diet in food-allergic children, emphasizing nutritional aspects for a better practical approach. Sources Non-systematic review of the literature. Findings Under an elimination diet, food-allergic patients may suffer from growth impairment or obesity and compromised quality of life. Disease phenotype, age, type, number of foods excluded, comorbidities, eating difficulties, economic status, and food availability must be considered for an appropriate diet prescription. Diet quality encompasses diversity and degree of food processing, which may alter immune regulation. Conclusions A friendly food elimination diet prescription depends on a multidisciplinary approach beyond macro and micronutrients. foodallergic allergic children Nonsystematic Non systematic literature life phenotype age type excluded comorbidities difficulties status processing regulation micronutrients

SUMMARY OBJECTIVE: The objective of this study was to evaluate the relationship between quality of life, perceived stress, anxiety, and depression in medical students and the university teaching method: traditional method versus active methodology. METHODS: Four questionnaires were administered to volunteer students (n=361) enrolled in two institutions that employ active (Universidade Tiradentes) or traditional (Faculdade de Medicina do ABC) teaching methodology: socioeconomic level; brief quality of life (World Health Organization Quality of Life-Bref); perceived stress scale (PSS10); and depression and anxiety scale (hospital anxiety and depression scale). RESULTS: Of the students who responded to the questionnaires (226 UNIT and 135 FMABC), 70% were female and 67% were White. The majority did not use medication for depression (90%), anxiety (81%), and stress management (91%). Regarding anxiety, it was found: absence in the traditional method and moderate anxiety in the active methodology (26% UNIT×13% FMABC) (p<0.001). Regarding quality of life, it was found to be better quality of life in the environment domain at FMABC (78.12%) versus 71.88% at the UNIT (p<0.001). There was no difference between the institutions in relation to depression and perceived stress, and in quality of lifethere was only a difference in the environmental domain (p<0.001). In relation to gender, stress was higher in females (93.7%) than males (79.6%) with p<0.001. CONCLUSION: Differences were recorded between the groups regarding anxiety, with a predominance in UNIT students (active methodology), and no differences were recorded in relation to depression, perceived stress, and quality of life in all domains, except for the environment domain, which was higher in the traditional methodology, although about one-third of participants used medication for anxiety/depression. OBJECTIVE METHODS n=361 n361 n 361 (n=361 Universidade Tiradentes Faculdade ABC level World LifeBref Life Bref Life-Bref) PSS10 PSS (PSS10) hospital scale. . scale) RESULTS 226 (22 13 FMABC, , 70 67 White 90%, 90 90% (90%) 81%, 81 81% (81%) 91%. 91 91% (91%) 26% 26 (26 UNIT13 UNIT×13 p0001 p p<0.001 0 001 (p<0.001) 78.12% 7812 78 12 (78.12% 7188 71 88 71.88 gender 93.7% 937 93 7 (93.7% 79.6% 796 79 6 (79.6% CONCLUSION methodology) domains onethird one third anxietydepression anxiety/depression n=36 n36 36 (n=36 Life-Bref PSS1 (PSS10 22 (2 1 9 (90% 8 (81% (91% 2 UNIT1 UNIT×1 p000 p<0.00 00 (p<0.001 78.12 781 (78.12 718 71.8 93.7 (93.7 79.6 (79.6 n=3 n3 3 (n=3 (PSS1 ( (90 (81 (91 UNIT× p00 p<0.0 (p<0.00 78.1 (78.1 71. 93. (93. 79. (79. n= (n= (PSS (9 (8 p0 p<0. (p<0.0 78. (78. (93 (79 (n p<0 (p<0. (78 (7 p< (p<0 (p< (p

SUMMARY OBJECTIVE: The aim of this study was to analyze the prescription of packed red blood cells performed by emergency physicians for adults with sickle cell anemia. METHODS: Transfusions performed in adults with sickle cell anemia treated at an emergency service in São Bernardo do Campo, São Paulo Brazil, between January 2018 and January 2022 were evaluated. For data comparison, the chi-square2 test was used. The significance level adopted was 5%. RESULTS: A total of 114 transfusions were performed. The mean age was 41.8±16.4 years, and pretransfusion hemoglobin was 6.1±1.23 g/dL. Regarding the indication, the adequacy of transfusions performed in symptomatic individuals was significantly higher compared to asymptomatic individuals (100% vs. 3.9%, p<0.001). Symptomatic individuals received excessive volumes of packed red blood cells less frequently than asymptomatic individuals (17.5% vs. 56.9%, p<0.001). The filtered subtype, indicated for sickle cell anemia, was prescribed in only a quarter of the patients. However, non-indicated subtypes were frequently prescribed. CONCLUSION: This study found low adequacy in the indication and calculation of the transfusion volume of packed red blood cells in asymptomatic individuals. Few patients received filtered red blood cells, resulting in increased risks of transfusion reactions. On the contrary, non-indicated subtypes were prescribed in a quarter of transfusions, which resulted in higher costs and delay in receiving packed red blood cells. OBJECTIVE METHODS Campo Brazil 201 202 evaluated comparison chisquare2 chisquare chi square2 square chi-square used 5 5% RESULTS 11 418164 41 8 16 4 41.8±16. years 61123 6 1 23 6.1±1.2 gdL g dL g/dL 100% 100 (100 vs 39 3 9 3.9% p<0.001. p0001 p p<0.001 . 0 001 p<0.001) 17.5% 175 17 (17.5 569 56 56.9% subtype However nonindicated non CONCLUSION reactions contrary 20 41816 41.8±16 6112 2 6.1±1. 10 (10 3.9 p000 p<0.00 00 17.5 (17. 56.9 4181 41.8±1 611 6.1±1 (1 3. p00 p<0.0 17. (17 56. 418 41.8± 61 6.1± ( p0 p<0. 41.8 6.1 p<0 41. 6. p<

SUMMARY OBJECTIVE: The aim of this study was to describe homocysteine concentrations in overweight and obese children and adolescents and relate them to blood pressure levels, renal function, and insulin resistance. METHODS: This is a cross-sectional and observational study with 64 overweight children and adolescents (mean age: 11.6±3.5 years) in outpatient follow-up. The following parameters were evaluated: body mass index z-score, waist-to-height circumference ratio, pubertal stage, blood pressure, serum homocysteine, glycemia, insulin, lipid profile, renal function, high-sensitivity C-reactive protein, microalbuminuria, and creatinuria. Statistical analysis: analysis of variance and logistic regression (dependent variable: homocysteine) (p<0.05). RESULTS: The mean body mass index z-score was 2.9±1.1. The mean homocysteine concentrations were 8.6±2.2 μmol/L (10th and 90th percentiles: 6.6 and 11.2 μmol/L, respectively), with no difference when compared with children with severe obesity and obesity/overweight (p=0.431). High values of waist-to-height ratio (93.8%), systolic blood pressure (18.8%), diastolic blood pressure (12.5%), glycemia (4.7%), low-density lipoprotein cholesterol (31.1%), triglycerides (35.9%), non-high-density lipoprotein cholesterol (34.4%), and microalbuminuria (21.9%) were obtained. The mean glomerular filtration rate was 122.9±24.6 mL/min/1.73 m². Homocysteine concentrations were not associated with any of the studied variables (R²=0.095). CONCLUSION: Homocysteine concentrations in overweight children and adolescents (mean 8.6±2.2 μmol/L) were not associated with body mass index z-score, blood pressure, renal function, and insulin resistance. OBJECTIVE levels function resistance METHODS crosssectional cross sectional 6 age 11635 11 3 5 11.6±3. years followup. followup follow up. up follow-up evaluated zscore, zscore z score, score waisttoheight waist height stage profile highsensitivity high sensitivity Creactive C reactive protein creatinuria dependent variable p<0.05. p005 p p<0.05 . 0 05 (p<0.05) RESULTS 2911 2 9 1 2.9±1.1 8622 8 8.6±2. μmolL μmol L 10th th percentiles 66 6. 112 11. respectively, respectively , respectively) obesityoverweight p=0.431. p0431 p=0.431 431 (p=0.431) 93.8%, 938 93.8% 93 (93.8%) 18.8%, 188 18.8% 18 (18.8%) 12.5%, 125 12.5% 12 (12.5%) 4.7%, 47 4.7% 4 7 (4.7%) lowdensity low density 31.1%, 311 31.1% 31 (31.1%) 35.9%, 359 35.9% 35 (35.9%) nonhighdensity non 34.4%, 344 34.4% 34 (34.4%) 21.9% 219 21 (21.9% obtained 1229246 122 24 122.9±24. mLmin173 mLmin mL min 73 mL/min/1.7 m² m R²=0.095. R²0095 R R²=0.095 R² 095 (R²=0.095) CONCLUSION 1163 11.6±3 p00 p<0.0 (p<0.05 291 2.9±1. 862 8.6±2 p043 p=0.43 43 (p=0.431 93.8 (93.8% 18.8 (18.8% 12.5 (12.5% 4.7 (4.7% 31.1 (31.1% 35.9 (35.9% 34.4 (34.4% 21.9 (21.9 122924 122.9±24 mLmin17 mL/min/1. R²009 R²=0.09 09 (R²=0.095 116 11.6± p0 p<0. (p<0.0 29 2.9±1 86 8.6± p04 p=0.4 (p=0.43 93. (93.8 18. (18.8 12. (12.5 4. (4.7 31. (31.1 35. (35.9 34. (34.4 21. (21. 12292 122.9±2 mLmin1 mL/min/1 R²00 R²=0.0 (R²=0.09 11.6 p<0 (p<0. 2.9± 8.6 p=0. (p=0.4 (93. (18. (12. (4. (31. (35. (34. (21 1229 122.9± mL/min/ R²0 R²=0. (R²=0.0 p< (p<0 2.9 8. p=0 (p=0. (93 (18 (12 (4 (31 (35 (34 (2 122.9 mL/min R²=0 (R²=0. (p< 2. p= (p=0 (9 (1 ( (3 122. R²= (R²=0 (p (p= (R²= (R² (R

SUMMARY OBJECTIVE: The aim of this study was to evaluate serum 25(OH)D concentrations in the homebound elderly people and relate them to level of dementia, nutritional risk, and route of dietary administration. METHODS: This is a cross-sectional study involving 207 bedridden elderly people assisted by the Home Care Service in the city of Santo André – SP, from June to December 2016. The following factors were evaluated: dietary intake of vitamin D, arm circumference, triceps skin fold thickness, calf circumference, nutritional risk by Mini-Nutritional Assessment, level of dementia by the adapted Clinical Dementia Rating questionnaire, and laboratory tests such as serum concentrations of 25(OH)D, ultrasensitive C-reactive protein, alkaline phosphatase, serum calcium, and parathormone. RESULTS: The mean age of the elderly people was 81.6 (9.2) years. Deficiency of 25(OH)D was observed in 76.3% of the elderly people. There was an inverse correlation between serum concentrations of 25(OH)D: parathormone (r=-0.418, p<0.001) and alkaline phosphatase (r=-0.188, p=0.006) and a direct correlation with serum calcium (r=-0.158, p=0.022). Logistic regression showed that vitamin D deficiency was directly and independently associated with oral feeding (odds ratio 7.71; 95%CI 2.91–20.40). CONCLUSION: Bedridden households showed high prevalence of vitamin D deficiency without association with nutritional risk and level of dementia. Oral diet was associated with vitamin D deficiency, possibly due to low consumption of source foods. OBJECTIVE 25OHD OHD 25 OH administration METHODS crosssectional cross sectional 20 SP 2016 evaluated circumference thickness MiniNutritional Mini Nutritional Assessment questionnaire 25OHD, Creactive C reactive protein RESULTS 816 81 6 81. 9.2 92 9 2 (9.2 years 763 76 3 76.3 r=0.418, r0418 r r= 0.418, 0 418 (r=-0.418 p<0.001 p0001 p 001 r=0.188, r0188 0.188, 188 (r=-0.188 p=0.006 p0006 006 r=0.158, r0158 0.158, 158 (r=-0.158 p=0.022. p0022 p=0.022 . 022 p=0.022) odds 7.71 771 7 71 95CI CI 95 2.91–20.40. 2912040 2.91–20.40 91 40 2.91–20.40) CONCLUSION foods 201 8 9. (9. 76. r=0.418 r041 0418 0.418 41 (r=-0.41 p<0.00 p000 00 r=0.188 r018 0188 0.188 18 (r=-0.18 p=0.00 r=0.158 r015 0158 0.158 15 (r=-0.15 p002 p=0.02 02 7.7 77 291204 2.91–20.4 4 (9 r=0.41 r04 041 0.41 (r=-0.4 p<0.0 p00 r=0.18 r01 018 0.18 1 (r=-0.1 p=0.0 r=0.15 015 0.15 7. 29120 2.91–20. ( r=0.4 r0 04 0.4 (r=-0. p<0. p0 r=0.1 01 0.1 p=0. 2912 2.91–20 r=0. 0. (r=-0 p<0 p=0 291 2.91–2 r=0 (r=- p< p= 29 2.91– (r= 2.91 (r 2.9 2.

ABSTRACT Objective To compare serum amyloid A concentrations between overweight and eutrophic children and adolescents and to relate it to lipid profiles, glucose tolerance, and carotid intima-media thickness. Methods One hundred children and adolescents (mean age: 10.8±3.16 years) were included and divided into two groups: overweight and non-overweight. The following were evaluated: Z-score body mass index, carotid intima-media thickness, lipid metabolism biomarkers (lipid profile and apolipoproteins A1 and B), inflammatory biomarkers (ultra-sensitive C-reactive protein and serum amyloid A), and glucose homeostasis model assessment of insulin resistance. Results The groups were homogeneous in age, sex, and pubertal stage. Higher levels of triglycerides, apolipoprotein B, homeostasis model assessment of insulin resistance, ultrasensitive C-reactive protein, serum amyloid A, and carotid intima-media thickness were observed in the overweight group. In the multivariate analysis, age (OR=1.73; 95%CI: 1.16-2.60, p=0.007), Z-score body mass index (OR=3.76; 95%CI: 1.64-8.59, p=0.002), apolipoprotein-B (OR=1.1; 95%CI: 1.01-1.2, p=0.030), and carotid intima-media thickness (OR=5.00; 95%CI: 1.38-18.04, p=0.014) were independently associated with serum amyloid A levels above the fourth quartile of the studied sample (>9.4mg/dL). Conclusion Overweight children and adolescents had higher serum amyloid A concentrations than eutrophic children. There was an independent association between higher concentrations of serum amyloid A and Z-score, body mass index, apolipoprotein B, and carotid intima-media thickness, indicating the importance of this inflammatory biomarker in identifying the early risk of atherosclerosis. profiles tolerance intimamedia intima media mean 108316 10 8 3 16 10.8±3.1 years nonoverweight. nonoverweight non overweight. non-overweight evaluated Zscore Z score B , B) ultra sensitive Creactive C reactive A) resistance sex stage triglycerides group analysis OR=1.73 OR173 OR 1 73 (OR=1.73 95%CI 95CI CI 95 1.162.60, 116260 1.16 2.60, 2 60 1.16-2.60 p=0.007, p0007 p p=0.007 0 007 p=0.007) OR=3.76 OR376 76 (OR=3.76 1.648.59, 164859 1.64 8.59, 64 59 1.64-8.59 p=0.002, p0002 p=0.002 002 p=0.002) apolipoproteinB OR=1.1 OR11 (OR=1.1 1.011.2, 10112 1.01 1.2, 01 1.01-1.2 p=0.030, p0030 p=0.030 030 p=0.030) OR=5.00 OR500 5 00 (OR=5.00 1.3818.04, 1381804 1.38 18.04, 38 18 04 1.38-18.04 p=0.014 p0014 014 >9.4mg/dL. 94mgdL mgdL >9.4mg/dL . 9 4mg dL mg (>9.4mg/dL) Zscore, score, atherosclerosis 10831 10.8±3. OR=1.7 OR17 7 (OR=1.7 162 1.162.60 11626 116 1.1 260 2.60 6 1.16-2.6 p000 p=0.00 OR=3.7 OR37 (OR=3.7 648 1.648.59 16485 164 1.6 859 8.59 1.64-8.5 OR=1. OR1 (OR=1. 011 1.011.2 1011 101 1.0 12 1.2 1.01-1. p003 p=0.03 03 OR=5.0 OR50 (OR=5.0 3818 1.3818.04 138180 138 1.3 1804 18.04 1.38-18.0 p=0.01 p001 (>9.4mg/dL 1083 10.8±3 1.162.6 1162 11 1. 26 2.6 1.16-2. p00 p=0.0 OR=3. OR3 (OR=3. 1.648.5 1648 85 8.5 1.64-8. OR=1 (OR=1 1.011. 1.01-1 OR=5. OR5 (OR=5. 381 1.3818.0 13818 13 180 18.0 1.38-18. 108 10.8± 1.162. 2. 1.16-2 p0 p=0. OR=3 (OR=3 1.648. 8. 1.64-8 OR= (OR= 1.011 1.01- OR=5 (OR=5 1.3818. 1381 18. 1.38-18 10.8 1.162 1.16- p=0 1.648 1.64- (OR 1.3818 1.38-1 10. p= 1.381 1.38-

SUMMARY OBJECTIVE: Children with cow’s milk allergy may be at nutritional risk due to the lower intake of nutrients, such as protein, calcium, and vitamin A, which are present in cow’s milk. The objective was to evaluate children’s diets with Children with cow’s milk allergy compared with healthy controls as well as to compare the intake of proteins and amino acids from the diet followed by Children with cow’s milk allergy who consume special infant formula or plant-based dairy alternatives with Children with cow’s milk allergy who do not consume special infant formula or plant-based dairy alternatives. METHODS: Through a cross-sectional controlled study, the dietary intake of 57 children (27 with immunoglobulin E-mediated Children with cow’s milk allergy and 30 healthy controls) was evaluated. Using 24-h nutritional recalls, the total energy intake value, macronutrients, and amino acids were calculated. RESULTS: No statistically significant difference was found between the Children with cow’s milk allergy group and healthy controls for the intake of proteins and amino acids. However, the Children with cow’s milk allergy do not consume special infant formula or plant-based dairy alternatives group had a lower protein (g/kg) and branched-chain amino acid (mg/kg) intake than the Children with cow’s milk allergy consume special infant formula or plant-based dairy alternatives group. CONCLUSIONS: The Children with cow’s milk allergy group achieved the recommendations for the intake of proteins and amino acids compared to the healthy control group. However, the Children with cow’s milk allergy do not consume special infant formula or plant-based dairy alternatives group had a lower intake of protein (g/kg) and branched-chain amino acid (mg/kg) than the Children with cow’s milk allergy consume special infant formula or plant-based dairy alternatives group.

SUMMARY OBJECTIVE: This study aimed to compare neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio of overweight children and adolescents with the eutrophic ratios and to verify whether these ratios are associated with age, inflammation, Z-score of body mass index, and waist-to-height ratio. METHODS: This is a cross-sectional study involving 64 overweight and 106 eutrophic children and adolescents. Data on weight, height, and waist circumference (body mass index and waist-to-height ratio), blood count (neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio), and high-sensitivity C-reactive protein were collected. RESULTS: The mean age of participants was 8.4±3.2 years. The ratios did not differ between the overweight and non-overweight groups. The platelet-to-lymphocyte ratio has shown a direct and independent association with body mass index (p=0.031) and waist-to-height ratio (p=0.018), a fact not observed for neutrophil-to-lymphocyte ratio. The ultrasensitive C-reactive protein level was higher in the obesity group (p=0.003). Both ratios had a direct and independent association with age. CONCLUSION: The ratios did not differ between the overweight and non-overweight groups. There was a direct and independent association of platelet-to-lymphocyte ratio with overweight, not observed in neutrophil-to-lymphocyte ratio. The ratios have significantly increased according to the age of the participants.

Abstract Objective: To describe the participation of the environment in the childhood obesity epidemic, since childhood obesity currently represents a great challenge, with high prevalence worldwide, including in Brazil. Data source: Survey of articles published in the last 10 years in PubMed, evaluating the interface between the environment and childhood obesity. Data synthesis: Recent studies show that the environment is very important in the etiopathogenesis of obesity and its comorbidities. Therefore, factors such as air pollution, exposure to chemical substances that interfere with the metabolism, excessive consumption of ultra-processed foods, changes in the intestinal microbiota, and sedentary lifestyle are associated with increased obesity, insulin resistance, type 2 diabetes, and changes in lipid metabolism. These factors have a greater impact on some stages of life, such as the first thousand days, as they affect the expression of genes that control the adipogenesis, energy expenditure, and the mechanisms for hunger/satiety control. Conclusions: Environmental aspects must be taken into account in the prevention and treatment of childhood obesity, both from the individual and the population point of view, with adequate and comprehensive public health policies.

Abstract Objective: To present an updated and evidence-based guideline for the use of dual-energy x-ray absorptiometry (DXA) to assess body composition in clinical practice. Materials and methods: This Official Position was developed by the Scientific Committee of the Brazilian Association of Bone Assessment and Metabolism ( Associação Brasileira de Avaliação Óssea e Osteometabolismo , ABRASSO) and experts in the field who were invited to contribute to the preparation of this document. The authors searched current databases for relevant publications in the area of body composition assessment. In this second part of the Official Position, the authors discuss the interpretation and reporting of body composition parameters assessed by DXA and the use of DXA for body composition evaluation in special situations, including evaluation of children, persons with HIV, and animals. Conclusion: This document offers recommendations for the use of DXA in body composition evaluation, including indications, interpretation, and applications, to serve as a guiding tool in clinical practice and research for health care professionals in Brazil.

SUMMARY OBJECTIVE The aim of this study was to describe the prevalence of anemia and iron deficiency anemia (IDA) in infants and verify the association of iron deficiency with nutritional status. METHODS This cross-sectional and observational study included 104 infants aged between 7 and 9 months, assisted from August to September 2021 by the Family Health Strategy program in Sousa municipality (Paraíba, Brazil). Clinical and anthropometric data were collected, and a 24-h food recall questionnaire was applied using the DietPro software (version 5.0) in order to verify food consumption and assess iron intake. Variables associated with iron deficiency (p<0.05) were analyzed using multiple logistic regression. RESULTS Anemia and IDA were observed in 40.4% and 19.2% of infants, respectively. Only one infant was taking prophylactic supplementation (ferrous sulfate). Infants with IDA presented reduced hemoglobin (p<0.001) and ferritin (p<0.001) and increased Z-scores of body mass index-for-age (Z-BMI) (p=0.027), weight-for-height (p=0.007), and weight-for-age (p=0.032). All Z-scores were inversely correlated with ferritin (Z-BMI [rho: -0.37; p<0.001], weight-for-height [rho: -0.37; p<0.001], and weight-for-age [rho: -0.29; p=0.002]). Ferritin was also directly correlated with daily iron intake (rho: 0.22; p=0.018). Finally, multiple logistic regression showed a significant and direct association of iron deficiency with weight-for-height Z-score (odds ratio: 2.86; 95% confidence interval: 1.38–5.64; p=0.004). CONCLUSION About 60% of infants presented anemia or IDA. Iron deficiency was associated with the weight-for-height Z-score, showing the vulnerability of infants during the introduction of complementary feeding.

SUMMARY OBJECTIVE: This study aimed to describe the prevalence of acanthosis nigricans and high blood pressure in children and adolescents from low-income families, and to verify the association of elevated blood pressure with nutritional status and the presence of acanthosis nigricans. METHODS: This is a cross-sectional and controlled study with 232 children and adolescents from an institution for low-income families. Pubertal stage, body mass index Z-score, waist-to-height circumference ratio (increased waist-to-height circumference ratio >0.5), the presence of acanthosis nigricans, and blood pressure were assessed. RESULTS: The prevalence of excess weight and the change in waist-to-height circumference ratio was 37.9%. Acanthosis nigricans and increased blood pressure occurred in 20.3 and 34.8%, respectively. The prevalence of acanthosis nigricans and hypertension was higher in individuals with excess weight (p<0.001; p<0.001) and with an increased waist-to-height circumference ratio (p=0.009; p<0.001). Logistic regression showed a significant and independent association of body mass index Z-score (OR 2.35; 95%CI 1.52–3.65; p<0.001) and the presence of acanthosis nigricans (OR 2.43; 95%CI 1.12–5.23; p=0.023) with elevated blood pressure. CONCLUSION: Acanthosis nigricans and elevated blood pressure occurred in one-fifth and one-third of the individuals in an institution for children from low-income families. Overweight and the presence of acanthosis nigricans increased the risk of high blood pressure more than twofold.

SUMMARY OBJECTIVE: To evaluate whether there is an association between the body mass index z-score and waist-to-height ratio of children and adolescents. METHODS: This was a cross-sectional study conducted in a school in Santo André, SP, between June and August 2019. Body mass index was measured for all participants, adopting the z-score cutoff of +2 recommended by the World Health Organization. The waist-to-height ratio was determined in children over two years of age and considered abnormal when ≥0.5. The qualitative variables are presented as absolute numbers and percentages. To compare qualitative data, we used the χ2 test or Fisher's exact test. Pearson's test was applied to assess the correlation between BMI and waist-to-height ratio. The level of significance adopted was 5%. RESULTS: The body mass index was calculated for 518 children and the waist-to-height ratio for 473 children. Regarding body mass index, 60.6% of the participants had normal weight, 3.1% were underweight, and 36.3% were overweight. overweight (24.7%) and obesity (22.7%) were more prevalent in adolescents. The waist-to-height ratio was abnormal in 50.5% of the sample. There was an increasing association between body mass index and waist-to-height ratio with age, according to the Pearson correlation coefficients for the age groups <5 years (r=0.459; p<0.001), 5 to 10 years (r=0.687; p<0.001) and >10 years (r=0.805; p<0.001). CONCLUSION: There was a significant correlation between body mass index and waist-to-height ratio. This association was higher in adolescents. The waist-to-height ratio is easy to apply and may be useful as a predictor of cardiometabolic risk.

SUMMARY OBJECTIVE: To evaluate the prevalence of breastfeeding in a metropolitan region in Brasil and to identify factors influencing the lack of adherence to exclusive breastfeeding for 6 months and total breastfeeding for 2 years. METHODS: In this cross-sectional study, demographic and socioeconomic characteristics of mothers and children in pediatric outpatient clinics were analyzed. Logistic regression was performed using the backward stepwise method to analyze factors associated with the lack of breastfeeding compliance. RESULTS: In total, 385 mothers who visited the pediatric outpatient clinics were included. Among the mothers, 38.44% reported exclusive breastfeeding for >6 months and 22.6% reported total breastfeeding for 2 years or more. The predictive factors for the lack of adherence to exclusive breastfeeding for 6 months included single mothers (OR=1.976; 95%CI 1.245–3.135; p=0.004), use of a pacifier (OR=2.25; 95%CI 1.436–3.524; p<0.001), and low birth weight (OR=2.21; 95%CI 1.192–4.102; p=0.012). Predictive factors for the lack of adherence to total breastfeeding for 2 or more years included use of a pacifier (OR=4.82; 95%CI 2.722–8.54; p<0.001), planned pregnancy (OR=0.51; 95%CI 0.305–0.875; p=0.014), and breastfeeding in the first hour of life (OR=0.36; 95%CI 0.208–0.641; p<0.001). CONCLUSIONS: The prevalence of exclusive breastfeeding for 6 months and total breastfeeding for 2 years or more was insufficient in the studied population. Several factors were associated with the lower duration of exclusive breastfeeding and total breastfeeding. The use of a pacifier and no breastfeeding in the first hour were preventable factors associated with both modalities.