Comparação do escore Z do IMC (Índice de Massa Corporal) com pregas cutâneas e circunferência abdominal para avaliação do estado nutricional em crianças e adolescentes.
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Data
2022-08-26
Autores
Watanabe, Renata Keiko
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Universidade Estadual Paulista (Unesp)
Resumo
Atualmente, o indicador mais utilizado para classificação do estado nutricional na faixa etária pediátrica é o escore Z do IMC. Outra maneira de avaliar o estado nutricional é por meio do cálculo do conteúdo de gordura corporal e, aproximadamente, metade do conteúdo de gordura corporal localiza-se nos depósitos adiposos subcutâneos e, dessa maneira, a medida das pregas cutâneas relaciona-se diretamente com a gordura total. A obesidade central pode ser avaliada pela aferição da circunferência abdominal. Foi verificada que utilizar a avaliação do estado nutricional pelo escore Z do IMC associado à aferição da circunferência abdominal pode ser útil na classificação do estado nutricional de crianças e adolescentes. Foram recrutados 972 crianças e adolescentes de 5-19 anos, participantes de projetos sociais da cidade de Botucatu, e realizada identificação, antropometria, cálculo do escore Z do IMC, medidas das pregas cutâneas e da circunferência abdominal. Houve uma concordância moderada entre as duas classificações (estado nutricional pelo escore Z do IMC e pelas pregas cutâneas) de 65%. Em relação à circunferência abdominal, 98,6% das crianças avaliadas como obesas pelo escore Z do IMC, enquadram-se na classe de muito elevado (McCarthy et; 2001). Houve uma distribuição semelhante quando foi utilizada a classificação do estado nutricional pelas pregas cutâneas. Devido à dificuldade em realizar as medidas das pregas cutâneas nas consultas associado a dificuldade em se obter os resultados da classificação através de cálculos matemáticos, acreditamos que um método útil para classificar o estado nutricional as crianças e adolescentes, é utilizar a medida da circunferência abdominal associado ao IMC para se obter uma classificação nutricional mais fidedigna e que podem levar a intervenções mais precoces e evitar complicações futuras dos desvios do estado nutricional sobre as condições de saúde dos indivíduos, principalmente a obesidade.
Currently, the most used indicator for classifying nutritional status in the pediatric age group is the BMI Z-score. Another way of assessing nutritional status is by calculating the body fat content, and approximately half of the body fat content is located in subcutaneous adipose deposits and, therefore, the measurement of skinfolds is directly related to the total fat. Central obesity can be assessed by measuring waist circumference. It was found that using the assessment of nutritional status by the BMI Z-score associated with the measurement of waist circumference can be useful in classifying the nutritional status of children and adolescents. A total of 972 children and adolescents aged 5-19 years, participating in social projects in the city of Botucatu, were recruited, and identification, anthropometry, BMI Z-score calculation, skinfold measurements and abdominal circumference were performed. There was a moderate agreement between the two classifications (nutritional status by BMI Z-score and by skinfolds) of 65%. In relation to waist circumference, 98.6% of the children evaluated as obese by the BMI Z-score fall into the very high class (McCarthy et al; 2001). There was a similar distribution when the classification of nutritional status by skinfold was used. Due to the difficulty in performing skinfold measurements in consultations associated with the difficulty in obtaining classification results through mathematical calculations, we believe that a useful method to classify the nutritional status of children and adolescents is to use the measurement of abdominal circumference associated with BMI to obtain a more reliable nutritional classification and that can lead to earlier interventions and avoid future complications of nutritional status deviations on the health conditions of individuals, especially obesity.
Currently, the most used indicator for classifying nutritional status in the pediatric age group is the BMI Z-score. Another way of assessing nutritional status is by calculating the body fat content, and approximately half of the body fat content is located in subcutaneous adipose deposits and, therefore, the measurement of skinfolds is directly related to the total fat. Central obesity can be assessed by measuring waist circumference. It was found that using the assessment of nutritional status by the BMI Z-score associated with the measurement of waist circumference can be useful in classifying the nutritional status of children and adolescents. A total of 972 children and adolescents aged 5-19 years, participating in social projects in the city of Botucatu, were recruited, and identification, anthropometry, BMI Z-score calculation, skinfold measurements and abdominal circumference were performed. There was a moderate agreement between the two classifications (nutritional status by BMI Z-score and by skinfolds) of 65%. In relation to waist circumference, 98.6% of the children evaluated as obese by the BMI Z-score fall into the very high class (McCarthy et al; 2001). There was a similar distribution when the classification of nutritional status by skinfold was used. Due to the difficulty in performing skinfold measurements in consultations associated with the difficulty in obtaining classification results through mathematical calculations, we believe that a useful method to classify the nutritional status of children and adolescents is to use the measurement of abdominal circumference associated with BMI to obtain a more reliable nutritional classification and that can lead to earlier interventions and avoid future complications of nutritional status deviations on the health conditions of individuals, especially obesity.
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Palavras-chave
Pediatria, Nutrição, IMC, Obesidade, Pediatrics, Nutrition