Early determinants of overweight and obesity at 5 years old in preschoolers from inner of Minas Gerais, Brazil

Introduction: Brazil is experiencing a nutritional transition characterized by a reduction in the prevalence of nutritional deficits and an increase in overweight and obesity, not only in adults but also in children and adolescents.Objectives: This study was designed to evaluate the factors associated with overweight and obesity in Brazilian 5-year-old preschoolers.Methods: A cross-sectional study of a cohort of 232 preschoolers born in Diamantina/Minas Gerais, Brazil, was undertaken. the data, including socioeconomic status, anthropometry, diet, previous history of the preschoolers and family history, were collected between July of 2009 and July of 2010. To identify the factors associated with overweight and obesity, a logistic regression and a hierarchical model were undertaken.Results: Overweight and obesity occurred in 17.2% of the preschoolers. After adjusting for mother's obesity, per capita income, protective food intake, weight gain at age 0-4 months and time spent playing, the factors associated with overweight and obesity that reached statistical significance were mother's obesity [OR = 3.12 (95% CI 1.41-6.91), P = 0.01], weight gain of more than 0.85 kg/month in the first four months of life [OR = 2.16 (95% CI 1.01-4.64), P = 0.041 and lower per capita income [OR = 0.32 (95 %CI 0.13-0.79), P = 0.01].Conclusion: the results show that more weight gain during the first four months of life and being born of mothers with obesity increased the odds of overweight/obesity in the preschoolers, while lower per capita income was a protective factor.

Voice Performance Evaluation of Street Children From Aracaju, Brazil Using Perceptual-Auditory and Acoustic Analyses

Objective. To compare the voice performance of children involved in street labor with regular children using perceptual-auditory and acoustic analyses.Methods. A controlled cross-sectional study was carried out on 7- to 10-year-old children of both genders. Children from both groups lived with their families and attended school regularly; however, child labor was evident in one group and not the other. A total of 200 potentially eligible street children, assisted by the Child Labor Elimination Programme (PETI), and 400 regular children were interviewed. Those with any vocal discomfort (106, 53% and 90, 22.5%) had their voices assessed for resonance, pitch, loudness, speech rate, maximum phonation time, and other acoustic measurements.Results. A total of 106 street children (study group [SG]) and 90 regular children (control group [CG]) were evaluated. the SG group demonstrated higher oral and nasal resonance, reduced loudness, a lower pitch, and a slower speech rate than the CG. the maximum phonation time, fundamental frequency, and upper harmonics were higher in the SG than the CG. Jitter and shimmer were higher in the CG than the SG.Conclusion. Using perceptual-auditory and acoustic analyses, we determined that there were differences in voice performance between the two groups, with street children having better quality perceptual and acoustic vocal parameters than regular children. We believe that this is due to the procedures and activities performed by the Child Labor Elimination Program (PETI), which helps children to cope with their living conditions.

Recovery of linear and nonlinear heart rate dynamics after coronary artery bypass grafting surgery

Background: Conventional coronary artery bypass grafting (C-CABG) and off-pump CABG (OPCAB) surgery may produce different patients' outcomes, including the extent of cardiac autonomic (CA) imbalance. the beneficial effects of an exercise-based inpatient programme on heart rate variability (HRV) for C-CABG patients have already been demonstrated by our group. However, there are no studies about the impact of a cardiac rehabilitation (CR) on HRV behaviour after OPCAB. the aim of this study is to compare the influence of both operative techniques on HRV pattern following CR in the postoperative (PO) period.Methods: Cardiac autonomic function was evaluated by HRV indices pre- and post-CR in patients undergoing C-CABG (n = 15) and OPCAB (n = 13). All patients participated in a short-term(approximately 5 days) supervised CR programme of early mobilization, consisting of progressive exercises, from active-assistive movements at PO day 1 to climbing flights of stairs at PO day 5.Results: Both groups demonstrated a reduction in HRV following surgery. the CR programme promoted improvements in HRV indices at discharge for both groups. the OPCAB group presented with higher HRV values at discharge, compared to the C-CABG group, indicating a better recovery of CA function.Conclusion: Our data suggest that patients submitted to OPCAB and an inpatient CR programme present with greater improvement in CA function compared to C-CABG.