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Introdução: Pacientes com câncer apresentaram risco de desenvolver quadros respiratórios graves quando acometidos por covid-19, com necessidade de suporte intensivo e de ventilação mecânica invasiva (VMI). Objetivo: Avaliar os fatores associados ao óbito em pacientes oncológicos que tiveram covid-19 e evoluíram com insuficiência respiratória e necessidade de VMI. Método: Estudo de coorte retrospectivo de pacientes com câncer em uma unidade de terapia intensiva (UTI) oncológica, com covid-19 e em VMI de abril de 2020 a dezembro de 2021. Foram incluídos de forma sequencial todos os pacientes com câncer admitidos na UTI em VMI ou que evoluíram com VMI por agravamento da covid-19, sendo excluídos aqueles em controle da doença oncológica há mais de cinco anos. Para a análise estatística, foram utilizadas medidas de tendência central e dispersão, assim como frequências absolutas e relativas. A regressão logística múltipla foi aplicada para a avaliação dos fatores associados à mortalidade, considerando estatisticamente significantes valores de p < 0,05. Resultados: Foram incluídos no estudo 85 pacientes. O óbito foi maior entre os pacientes com tumores sólidos (OR = 3,64; IC 95%: 1,06-12,52; p = 0,04), entre os que necessitaram de suporte renal durante a internação na UTI (OR = 6,88; IC 95%: 1,82-25,98; p = 0,004), os que não puderam ser extubados (OR = 8,00; IC 95%: 2,16-29,67; p = 0,002) e os que apresentaram o valor de pressão de distensão alveolar maior do que 15cmH2O por pelo menos um dia (OR = 5,9; IC 95%: 1,76-19,80; p = 0,004). Conclusão: Características clínicas e de VMI estavam associadas à morte de pacientes oncológicos com covid-19 e em VMI.

Los pacientes con cáncer corrían riesgo de desarrollar afecciones respiratorias graves al ser afectados por la COVID-19, requiriendo soporte intensivo y ventilación mecánica invasiva (VMI). Objetivo: Evaluar los factores asociados a la muerte en pacientes con cáncer que tuvieron COVID-19 y que desarrollaron insuficiencia respiratoria y necesidad de VMI. Método: Estudio de cohorte retrospectivo en pacientes oncológicos internados en una unidad de cuidados intensivos (UCI) de oncología, con COVID-19 y en VMI de abril de 2020 a diciembre de 2021. Se incluyeron secuencialmente todos los pacientes con cáncer ingresados en UCI con VMI o que necesitaron VMI por empeoramiento de la COVID-19, excluyendo a aquellos que llevaban más de cinco años bajo control de la enfermedad oncológica. Para el análisis estadístico se utilizaron medidas de tendencia central y dispersión, así como frecuencias absolutas y relativas. Se aplicó regresión logística múltiple para evaluar los factores asociados a la mortalidad, considerando valores de p<0,05 estadísticamente significativos. Resultados: Se incluyeron en el estudio 85 pacientes. La muerte fue mayor entre los pacientes con tumores sólidos (OR= 3,64; IC 95%, 1,06-12,52; p=0,04), entre los que requirieron soporte renal durante la estancia en UCI (OR = 6,88; IC 95%, 1,82-25,98; p= 0,004), entre los que no pudieron ser extubados (OR= 8,00; IC 95%, 2,16-29,67; p= 0,002) y entre los que presentaron un valor de presión de distensión alveolar mayor a 15cmH2O durante al menos un día (OR = 5,9; IC 95%, 1,76-19,80; p=0,004). Conclusión: Las características clínicas y de VMI se asociaron con la muerte en pacientes oncológicos con COVID-19 y en VMI.

Cancer patients were at risk of developing severe respiratory conditions when affected by COVID-19, requiring intensive support and invasive mechanical ventilation (IMV). Objective: Evaluate the factors associated with death of cancer patients by COVID-19 who developed respiratory failure and need of IMV. Method: Retrospective cohort study of cancer patients in an oncology intensive care unit (ICU), with COVID-19 and on IMV was carried out from April 2020 to December 2021. All patients with cancer admitted to the ICU on IMV or who developed IMV due to worsening of COVID-19 were sequentially included, excluding those who had been in follow-up of the oncological disease for more than five years. For statistical analysis, measures of central tendency and dispersion were used, as well as absolute and relative frequencies. Multiple logistic regression was applied to evaluate factors associated with mortality, considering statistically significant values of p < 0.05. Results: 85 patients were included in the study. Death was higher for patients with solid tumors (OR= 3.64; 95% CI, 1.06-12.52; p = 0.04), in addition to those who required renal support while in ICU (OR = 6.88; 95% CI, 1.82-25.98; p = 0.004), those who could not be extubated (OR= 8.00; 95% CI, 2.16-29.67; p = 0.002) and who presented an alveolar distension pressure value greater than 15cmH2O for at least one day (OR= 5.9; 95% CI, 1.76-19.80; p = 0.004). Conclusion:Clinical and IMV characteristics were associated with death in cancer patients with COVID-19 and IMV

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Introdução: Pacientes com leucemia linfocítica crônica (LLC) com alto risco têm menores taxas de resposta, curso clínico mais agressivo e resistência à quimioterapia padrão, representando um desafio para o tratamento. Os inibidores da tirosina quinase de Bruton (BTK ­ ibrutinibe e acalabrutinibe) e o inibidor BCL-2 (venetoclax) podem ser utilizados nesses casos. Objetivo: Identificar e avaliar a eficácia e a segurança do uso de ibrutinibe, acalabrutinibe e venetoclax no tratamento de primeira linha em pacientes com LLC de alto risco. Método: Revisão sistemática de ensaios clínicos randomizados que avaliaram pacientes adultos com LLC, portadores de deleção 17p ou mutação TP53 e sem tratamento prévio. Foram pesquisadas as bases PubMed, EMBASE, LILACS e Cochrane Library, e realizadas avaliação do risco de viés pela ferramenta RoB 2 da Cochrane e avaliação da qualidade da evidência pelo GRADE. Resultados: Na meta-análise em rede para sobrevida livre de progressão (SLP), venetoclax + obinutuzumabe (RR: 0,62; IC 95% 0,41-0,95; p = 0,027) e acalabrutinibe + obinutuzumabe (RR: 0,74; IC 95% 0,55-0,99; p = 0,043) apresentaram menor risco de progressão ou óbito, com significância considerada limítrofe. Ibrutinibe + obinutuzumabe (RR: 0,93; IC 95% 0,86-1,00; p = 0,054) não apresentou diferença significativa na SLP para pacientes com LLC de alto risco. Conclusão: O tratamento de primeira linha com inibidores de BTK (ibrutinibe e acalabrutinibe) e o inibidor BCL-2 (venetoclax), associados a agentes monoclonais anti-CD20 ­ especialmente o obinutuzumabe ­, tem sido proposto como padrão para a maioria dos pacientes com LLC. Entretanto, pelos resultados desta revisão com meta-análise em rede, não foi possível confirmar essa recomendação.

Introduction: Patients with high-risk chronic lymphocytic leukemia (CLL) have lower response rates, a more aggressive clinical course, and resistance to standard chemotherapy, representing a treatment challenge. Bruton's tyrosine kinase inhibitors (BTK ­ ibrutinib and acalabrutinib) and the BCL-2 inhibitor (venetoclax) can be used in these cases. Objective: To identify and evaluate studies on the efficacy and safety of the use of ibrutinib, acalabrutinib and venetoclax in first-line treatment in patients with high-risk CLL. Method:Systematic review of randomized clinical trials that evaluated adult patients with CLL, carriers of 17p deletion or TP53 mutation and without prior treatment. The PubMed, EMBASE, LILACS and Cochrane Library databases were searched, and the risk of bias was assessed using the Cochrane RoB 2 tool and the quality of evidence was assessed with GRADE. Results: In the network meta-analysis for progression-free survival (PFS) venetoclax + obinutuzumab (RR: 0.62; 95%CI 0.41-0.95; p value 0.027) and acalabrutinib + obinutuzumab (RR: 0. 74; 95% CI 0.55-0.99; p value 0.043) presented a lower risk of progression or death, with significance considered borderline. Ibrutinib + obinutuzumab (RR: 0.93; 95% CI 0.86-1.00; p value 0.054) did not show a significant difference in PFS for patients with high-risk CLL. Conclusion: First-line treatment with BTK inhibitors (ibrutinib and acalabrutinib) and the BCL-2 inhibitor (venetoclax) associated with anti-CD20 monoclonal agents ­ especially obinutuzumab ­ have been proposed as the standard for most patients with CLL. However, based on the results of this review with network meta-analysis, it was not possible to confirm this recommendation.

Introducción: Los pacientes con leucemia linfocítica crónica (LLC) de alto riesgo tienen tasas de respuesta más bajas, un curso clínico más agresivo y resistencia a la quimioterapia estándar, lo que representa un desafío para el tratamiento. En estos casos se pueden utilizar los inhibidores de la tirosina quinasa de Bruton (BTK - ibrutinib y acalabrutinib) y el inhibidor de BCL-2 (venetoclax). Objetivo:Identificar y evaluar estudios sobre la eficacia y seguridad del uso de ibrutinib, acalabrutinib y venetoclax en el tratamiento de primera línea en pacientes con LLC de alto riesgo. Método: Revisión sistemática de ensayos clínicos aleatorios que evaluaron pacientes adultos con LLC, portadores de deleción 17p o mutación TP53 y sin tratamiento previo. Se realizaron búsquedas en las bases de datos PubMed, EMBASE, LILACS y Cochrane Library y se evaluó el riesgo de sesgo mediante la herramienta Cochrane RoB 2 y la calidad de la evidencia se evaluó mediante GRADE. Resultados: En el metaanálisis en red para la supervivencia libre de progresión (SSP) venetoclax + obinutuzumab (RR: 0,62; IC 95% 0,41-0,95; valor de p 0,027) y acalabrutinib + obinutuzumab (RR: 0,74; IC 95%). 0,55-0,99; valor de p 0,043) presentaron un menor riesgo de progresión o muerte, con una significación considerada límite. Ibrutinib + obinutuzumab (RR: 0,93; IC del 95 %: 0,86-1,00; valor de p 0,054) no mostró una diferencia significativa en la SSP para pacientes con LLC de alto riesgo. Conclusión: El tratamiento de primera línea con inhibidores de BTK (ibrutinib y acalabrutinib) y el inhibidor de BCL-2 (venetoclax), asociados con agentes monoclonales anti-CD20, especialmente obinutuzumab, se ha propuesto como estándar para la mayoría de los pacientes con LLC. Sin embargo, según los resultados de esta revisión con metaanálisis en red, no fue posible confirmar esta recomendación

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BACKGROUND: Adolescence is a crucial period for body image formation. Weight misperception is the discrepancy between individuals' body weight perception and their actual nutritional status. Both weight concerns and substance use are common among adolescents, and there is evidence of an associations between these two variables. Thus, the aim of this study was to assess the association between weight misperception and substance use (smoking and alcohol) in a national sample of normal weight Brazilian adolescents. METHODS: Data were obtained from the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, multicenter, national, school-based survey, carried out in 124 municipalities with more than 100,000 inhabitants from Brazil. The sample included adolescents aged 12-17 years, classified as normal weight by nutritional status evaluation. The following measures were collected: weight underestimation and overestimation (exposure); having tried cigarette smoking, current smoking, current alcohol consumption, binge drinking and current smoking and alcohol consumption(outcomes); macro-region, sex, type of school, and excessive screen time (confounders). The frequency of variables was calculated with 95% confidence intervals (CI). Poisson regression models were used to estimate prevalence ratios (PR). RESULTS: In total, data from 53,447 adolescents were analyzed. Weight misperception was present in a third of the adolescents, with similar prevalence of weight underestimation and overestimation. In adolescents aged 12-14 years, weight underestimation and overestimation were associated with having tried cigarette smoking (PR: 1.18 and 1.43, respectively), current alcohol consumption (PR: 1.33 for both weight misperception categories), and binge drinking (PR: 1.96 and 2.01, respectively). Weight underestimation was associated with both having tried cigarette smoking and current alcohol consumption in boys (PR: 1.14 and 1.16, respectively) and girls (PR: 1.32 and 1.15, respectively). In girls, weight overestimation was associated with all substance use variables (PR between 1.19 and 1.41). CONCLUSIONS: Our results showed an association between weight misperception and having tried cigarette smoking, alcohol consumption, and binge drinking in younger adolescents. In addition, weight overestimation was associated with all substance use indicators in girls. Based on our findings, interventions aimed to improve weight perception in normal weight adolescents may contribute to the reduction of substance use in this population.

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OBJECTIVES: To assess the cost-effectiveness of varenicline in comparison to currently funded smoking cessation strategies in Brazil. METHODS: We modeled the lifetime direct costs and health-related quality of life of a hypothetical cohort of smokers with a single attempt to quit smoking using one of the following: (1) cognitive behavioral therapy (CBT) without any pharmacological intervention, (2) varenicline, (3) bupropion, (4) nicotine replacement therapy (NRT) with transdermal patch, (5) bupropion in combination with NRT transdermal patch, and (6) combined NRT (oral plus transdermal). All drug alternatives were considered with concomitant CBT. The analysis relied on a Markov model based on the Benefits of Smoking Cessation and Outcomes study and used different age and sex categories in the consideration of relative risks and incidence rates of the diseases included in the model. The analysis was conducted from the healthcare system perspective, and a 3% discounting rate for costs and outcomes was applied. Model parameter values were sourced from published literature. Probabilistic and deterministic sensitivity analyses assessed robustness. RESULTS: Among the smoking cessation alternatives available in Brazil, varenicline and combined NRT were estimated to have higher effectiveness; varenicline, however, was dominated due to its higher average cost. In the base-case analysis, combined NRT had an incremental gain of 0.25 quality-adjusted life-years (QALYs) in comparison to the second-best option (bupropion in combination with NRT transdermal patch) and an incremental cost-effectiveness ratio of R$2173.47/QALY ($595.45/QALY). CONCLUSIONS: Combination of oral and transdermal NRT (coupled with CBT) was the most effective smoking cessation option and was 100% cost-effective within a conservative willingness-to-pay threshold.

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This article aims to evaluate the association between the use of electronic cigarettes and initiation to smoking, through a systematic review with meta-analysis of longitudinal studies. A bibliographic search was performed on the MEDLINE, Embase, LILACS and PsycInfo databases. Reference selection, data extraction and risk of bias assessment of the studies were independently carried out in pairs, and the disagreements were discussed with a third researcher to reach a consensus. Meta-analysis was performed using the Mantel-Haenszel random effects model. Among the 25 studies included, 22 evaluated the outcome of conventional cigarette experimentation and nine assessed the outcome of current smoking (in the last 30 days). The meta-analysis showed that the use of electronic cigarettes increased the risk of conventional cigarette experimentation by almost three and a half times (RR=3.42; 95%CI 2.81-4.15), and by more than four times the risk of current smoking (RR=4.32; 95%CI 3.13-5.94). The risk of smoking initiation is significantly higher among electronic cigarette users. The marketing authorization of such devices may represent a threat to public health policies in Brazil.

O objetivo deste artigo é avaliar a associação entre uso de cigarros eletrônicos e iniciação ao tabagismo, por meio de uma revisão sistemática com meta-análise de estudos longitudinais. Busca bibliográfica foi realizada nas bases MEDLINE, Embase, LILACS e PsycInfo. As etapas de seleção de referências, extração dos dados e avaliação do risco de viés dos estudos foi realizada em dupla, de forma independente e as divergências discutidas com um terceiro pesquisador para obtenção de consenso. Meta-análise foi realizada por meio do modelo Mantel-Haenszel de efeitos aleatórios. Dentre os 25 estudos incluídos, 22 avaliaram o desfecho de experimentação de cigarro convencional e nove avaliaram o desfecho de tabagismo atual (nos últimos 30 dias). A meta-análise demonstrou que o uso de cigarro eletrônico aumentou em quase três vezes e meia o risco de experimentação de cigarro convencional (RR=3,42; IC95% 2,81-4,15) e em mais de quatro vezes o risco de tabagismo atual (RR=4,32; IC95% 3,13-5,94). O risco de iniciação ao tabagismo é significativamente maior entre usuários de cigarro eletrônico. A liberação da comercialização desses dispositivos pode representar uma ameaça para as políticas de saúde pública no Brasil.

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Resumo O objetivo deste artigo é avaliar a associação entre uso de cigarros eletrônicos e iniciação ao tabagismo, por meio de uma revisão sistemática com meta-análise de estudos longitudinais. Busca bibliográfica foi realizada nas bases MEDLINE, Embase, LILACS e PsycInfo. As etapas de seleção de referências, extração dos dados e avaliação do risco de viés dos estudos foi realizada em dupla, de forma independente e as divergências discutidas com um terceiro pesquisador para obtenção de consenso. Meta-análise foi realizada por meio do modelo Mantel-Haenszel de efeitos aleatórios. Dentre os 25 estudos incluídos, 22 avaliaram o desfecho de experimentação de cigarro convencional e nove avaliaram o desfecho de tabagismo atual (nos últimos 30 dias). A meta-análise demonstrou que o uso de cigarro eletrônico aumentou em quase três vezes e meia o risco de experimentação de cigarro convencional (RR=3,42; IC95% 2,81-4,15) e em mais de quatro vezes o risco de tabagismo atual (RR=4,32; IC95% 3,13-5,94). O risco de iniciação ao tabagismo é significativamente maior entre usuários de cigarro eletrônico. A liberação da comercialização desses dispositivos pode representar uma ameaça para as políticas de saúde pública no Brasil.

Abstract This article aims to evaluate the association between the use of electronic cigarettes and initiation to smoking, through a systematic review with meta-analysis of longitudinal studies. A bibliographic search was performed on the MEDLINE, Embase, LILACS and PsycInfo databases. Reference selection, data extraction and risk of bias assessment of the studies were independently carried out in pairs, and the disagreements were discussed with a third researcher to reach a consensus. Meta-analysis was performed using the Mantel-Haenszel random effects model. Among the 25 studies included, 22 evaluated the outcome of conventional cigarette experimentation and nine assessed the outcome of current smoking (in the last 30 days). The meta-analysis showed that the use of electronic cigarettes increased the risk of conventional cigarette experimentation by almost three and a half times (RR=3.42; 95%CI 2.81-4.15), and by more than four times the risk of current smoking (RR=4.32; 95%CI 3.13-5.94). The risk of smoking initiation is significantly higher among electronic cigarette users. The marketing authorization of such devices may represent a threat to public health policies in Brazil.

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The association between body image and eating behaviors or weight control strategies has been demonstrated in the scientific literature, but there is a lack of evidence on the association between weight misperception and food consumption indicators in adolescents. This study aimed to evaluate the association between weight misperception and dietary patterns (DPs) in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA). It was a national school-based cross-sectional study conducted among students aged 12-17 years. Data were collected in the form of anthropometric measurements, responses in self-answered questionnaires, and 24-h dietary recall. The following variables were assessed: weight underestimation and overestimation (independent variables), which were defined as the presence of a disagreement between nutritional status and self-perceived weight; dietary patterns (dependent variables), defined by a posteriori method using principal component factor analysis; and individual and demographic variables (covariates). Data analysis was performed using the Poisson regression models method, stratified by sex. A total of 52,038 adolescents with normal weights were evaluated. The weight misperception prevalence was 34.0% (95% confidence interval [CI]: 33.0, 35.0). Three DPs were identified: "Traditional Brazilian," "Processed meat sandwiches and coffee," and "Ultra-processed and sweet foods." In girls, weight underestimation was directly associated with the "Traditional Brazilian" (1.24; 95% CI: 1.08, 1.43) and "Ultra-processed and sweet foods" DPs (1.29; 95% CI: 1.09, 1.54), and overestimation was inversely associated with all the DPs. In boys, a direct association between underestimation and the "Ultra-processed and sweet foods" DP (1.29; 95% CI: 1.10, 1.51) was found. Overestimation was inversely associated with the "Traditional Brazilian" DP (0.79; 95% CI: 0.63, 0.99). The inverse association between overestimation and the "Traditional Brazilian" DP, and the direct association between underestimation and the "Ultra-processed and sweet foods" DP indicated that weight misperception was related to unhealthy eating habits in Brazilian adolescents.

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Abstract Objectives: This study aimed to assess the quality of systematic reviews on prevention and non-pharmacological treatment of overweight and obesity in children and adolescents. Data source: A search was done in electronic databases (Medline via PubMed, Web of Science, Scopus, LILACS, the Cochrane Library, and Clinical Trials), including only systematic reviews with meta-analysis. Reviews were selected by two researchers, and a third one solved the divergences. PRISMA statement and checklist were followed. Summary of data: A total of 4574 records were retrieved, including 24 after selection. Six reviews were on obesity prevention, 17 on obesity treatment, and one on mixed interventions for prevention and treatment of obesity. The interventions were very heterogeneous and showed little or no effects on weight or body mass index. Mixed interventions that included dieting, exercise, actions to reduce sedentary behavior, and programs involving the school or families showed some short-term positive effects. Reviews that analyzed cardiovascular risk factors demonstrated significant improvements in the short-term. Conclusion: The systematic reviews of interventions to prevent or reduce obesity in children and adolescents generally showed little or no effects on weight or body mass index, although cardiovascular profile can be improved. Mixed interventions demonstrated better effects, but the long-term impact of obesity treatments of children and adolescents remains unclear.

Resumo Objetivos: Este estudo teve como objetivo avaliar a qualidade das revisões sistemáticas sobre prevenção e tratamento não farmacológico do sobrepeso e da obesidade em crianças e adolescentes. Fontes de dados: Foi realizada uma busca em bases de dados eletrônicas (Medline via Pubmed, Web of Science, Scopus, LILACS, The Cochrane Library e Ensaios Clínicos), incluindo apenas revisões sistemáticas com meta-análise. As revisões foram selecionadas por dois pesquisadores e um terceiro resolveu as divergências. A lista de recomendações do PRISMA foi seguida. Síntese dos dados: Foram identificados 4.574 publicações, e 24 foram incluídas após seleção. Seis publicações eram sobre prevenção da obesidade, 17 sobre tratamento da obesidade e 1 sobre intervenções mistas para prevenção e tratamento da obesidade. As intervenções eram muito heterogêneas e mostraram pouco ou nenhum efeito sobre o peso ou índice de massa corporal. Intervenções mistas que incluíam dieta, exercícios, ações para reduzir o comportamento sedentário e programas que envolviam a escola ou as famílias mostraram alguns efeitos positivos de curto prazo. Revisões que analisaram fatores de risco cardiovascular demonstraram melhoras significativas em curto prazo. Conclusão: As revisões sistemáticas de intervenções para prevenir ou reduzir a obesidade em crianças e adolescentes geralmente mostraram pouco ou nenhum efeito sobre o peso ou índice de massa corporal, embora o perfil cardiovascular possa ter melhorado. Intervenções mistas demonstraram melhores efeitos, mas o impacto em longo prazo dos tratamentos da obesidade de crianças e adolescentes ainda não está claro.

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The study aimed to identify the dietary patterns of Brazilian adolescents in each of Brazil's five major geographic regions and verify possible differences in adherence to dietary patterns according to age, sex, and type of school. Data were analyzed from 71,298 adolescents 12 to 17 years of age that participated in the Study of Cardiovascular Risk in Adolescents (ERICA), a cross-sectional nationwide, multicenter, school-based survey. Food consumption data were obtained using a 24-hour food recall, and identification of dietary patterns used factor analysis. Associations between the adolescents' sociodemographic characteristics and dietary patterns were verified by linear regression analyses, stratified by age and adjusted for nutritional status, total energy intake, and physical activity. In the five geographic regions, three dietary patterns with similar characteristics were identified: traditional pattern, bread-and-coffee pattern, and unhealthy pattern. The North of Brazil showed a fourth dietary pattern characterized by typical regional foods, called the traditional-North pattern. In all five regions, male adolescents showed the highest adherence to the traditional pattern and the lowest adherence to the unhealthy pattern. Private school students showed higher adherence to the unhealthy pattern and lower adherence to the traditional pattern. The results suggest that in this sample of adolescents, males were associated with traditional Brazilian foods such as rice and beans, while higher socioeconomic status was associated with the consumption of unhealthy foods like sugary beverages and snacks.

O estudo teve como objetivo identificar os padrões alimentares de adolescentes brasileiros para cada uma das cinco regiões do país, e verificar se há diferença na adesão dos padrões alimentares de acordo com idade, sexo e tipo de escola. Foram analisados dados de 71.298 adolescentes de 12 a 17 anos que participaram do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA), pesquisa transversal, nacional, multicêntrica e de base escolar. Os dados de consumo alimentar foram obtidos por meio de recordatório alimentar de 24hs, e para a identificação dos padrões alimentares foi aplicada análise fatorial. A associação entre as características dos adolescentes e os padrões alimentares foi verificada por meio de análises de regressão linear, estratificadas por idade e ajustadas por estado nutricional, ingestão energética total e atividade física. Nas cinco regiões foram identificados três padrões alimentares com características similares: padrão tradicional, padrão pão e café e padrão não saudável. A Região Norte apresentou um quarto padrão alimentar caracterizado por alimentos típicos da região: padrão tradicional Norte. Em todas as regiões, os adolescentes do sexo masculino registraram maior adesão ao padrão tradicional e menor adesão ao padrão não saudável. entre os estudantes de escolas privadas foi observada maior adesão ao padrão não saudável e menor adesão ao padrão tradicional. Os resultados sugerem que, entre os adolescentes avaliados, ser do sexo masculino foi associado ao maior consumo de alimentos tradicionalmente brasileiros como o arroz e feijão, já o maior nível socioeconômico esteve associado ao consumo de alimentos não saudáveis como bebidas açucaradas e lanches.

El objetivo del estudio fue identificar los patrones alimentarios de adolescentes brasileños para cada una de las cinco regiones del país, y verificar si existen diferencias en la adhesión a los patrones alimentarios, de acuerdo a la edad, sexo y tipo de escuela. Se analizaron datos de 71.298 adolescentes de 12 a 17 años que participaron en el Estudio de Riesgos Cardiovasculares en Adolescentes (ERICA), investigación transversal, nacional, multicéntrica y de base escolar. Los datos de consumo alimentario se obtuvieron mediante un recordatorio alimentario de 24h, y para la identificación de los patrones alimentarios se aplicó el análisis factorial. La asociación entre las características de los adolescentes y los patrones alimentarios se verificó mediante un análisis de regresión lineal, estratificado por edad y ajustado por estado nutricional, ingestión energética total y actividad física. En las cinco regiones se identificaron tres patrones alimentarios con características similares: patrón tradicional, patrón pan y café y patrón no saludable. La Región Norte presentó un cuarto patrón alimentario caracterizado por alimentos típicos de la región: patrón tradicional Norte. En todas las regiones, los adolescentes del sexo masculino registraron una mayor adhesión al patrón tradicional y menor adhesión al patrón no saludable. Entre los estudiantes de escuelas privadas se observó una mayor adhesión al patrón no saludable y menor adhesión al patrón tradicional. Los resultados sugieren que, entre los adolescentes evaluados, ser de sexo masculino se asoció a un mayor consumo de alimentos tradicionalmente brasileños como el arroz y frijoles, por otra parte, un mayor nivel socioeconómico estuvo asociado al consumo de alimentos no saludables como bebidas azucaradas y aperitivos.

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OBJECTIVES: This study aimed to assess the quality of systematic reviews on prevention and non-pharmacological treatment of overweight and obesity in children and adolescents. DATA SOURCE: A search was done in electronic databases (Medline via PubMed, Web of Science, Scopus, LILACS, the Cochrane Library, and Clinical Trials), including only systematic reviews with meta-analysis. Reviews were selected by two researchers, and a third one solved the divergences. PRISMA statement and checklist were followed. SUMMARY OF DATA: A total of 4574 records were retrieved, including 24 after selection. Six reviews were on obesity prevention, 17 on obesity treatment, and one on mixed interventions for prevention and treatment of obesity. The interventions were very heterogeneous and showed little or no effects on weight or body mass index. Mixed interventions that included dieting, exercise, actions to reduce sedentary behavior, and programs involving the school or families showed some short-term positive effects. Reviews that analyzed cardiovascular risk factors demonstrated significant improvements in the short-term. CONCLUSION: The systematic reviews of interventions to prevent or reduce obesity in children and adolescents generally showed little or no effects on weight or body mass index, although cardiovascular profile can be improved. Mixed interventions demonstrated better effects, but the long-term impact of obesity treatments of children and adolescents remains unclear.

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