Obesity in children and adolescents: relationship with inflammation, cardiovascular risk and consumption of processed and ultra-processed foods

• Grant number: 19/16990-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2019
• End date: September 30, 2021
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Roseli Oselka Saccardo Sarni
• Grantee: Maria Vitoria Mareschi Barbosa
• Host Institution: Centro Universitário Saúde ABC. Fundação do ABC. Santo André , SP, Brazil

Abstract

The World Health Organization points to obesity as a serious public health problem in the world. The projection is that by 2025, about 2.3 billion adults are overweight and over 700 million obese. The number of overweight children and adolescents could reach 75 million if effective measures are not taken. In Brazil, it is a problem that grows exponentially. The last Survey of Family Budgets (POF) revealed that 30% and 21.5% of Brazilian children and adolescents are overweight, respectively. In addition, it was found that 9% of the Brazilian diet content comes from processed foods and 21.5% from ultra-processed foods, which contain excessive amounts of sodium, free sugars, total saturated and trans fats. Excessive consumption of processed and ultra-processed foods is associated with the development of chronic no communicable diseases such as obesity and cardiovascular diseases Visceral adiposity related to the elevated risk of cardiovascular diseases can be indirectly evaluated by the ratio of abdominal circumference by stature, even in the pediatric age group. The values of the ratio above 0.5 are considered high. In overweight individuals; adipocytes secrete a greater proportion of cytokines that directly or indirectly increase the production and circulation of inflammation-related factors, such as serum amyloid A (SAA), acute phase protein, and early marker of inflammatory activity. It is also known that the inflammation associated with obesity and high consumption of processed foods are determinant for morbidities such as atherosclerotic disease, which comes from endothelial dysfunction amplifying the inflammatory process. Another important point is the oxidative stress that accompanies individuals who frequently consume processed foods: by reducing the consumption of foods in natura there is compromise in the antioxidant defense facilitating the action of free radicals in the vascular endothelium with consequent injury. Through a cross-sectional study, we will evaluate children and adolescents from the Obesity Clinic of the Discipline of Clinical Pediatrics of the ABC Medical School, enrolled in 2018 or in intervention by a multiprofessional team for less than one year (n = 50). Data will be collected from the chart (name, age, provenance, birth weight, exclusive and total breastfeeding time, pubertal stage, weight, height, CB, skin folds and waist circumference, ZIMC and ZEI. (LDL-c/HDL-c, Apo B / Apo AI and TG / HDL, LDL-c / Apo B), PCRus, amyloid protein serum A, apolipoproteins A and B, insulin, glycemia, TGO, TGP and Gama GT. For the evaluation of food consumption, we will make 24-hour reminders collected on the day of the consultation and another nominee for the collection of biochemical tests. In order to evaluate the morphological changes associated with endothelial dysfunction, the carotid intima-media thickness is measured by arterial Doppler ultrasonography, a method that allows the assessment of cardiovascular risk in early and advanced phases of atherosclerotic disease in groups considered at risk; is an important tool in the evaluation of subclinical cardiovascular disease. In this context, considering the paucity of studies in the pediatric range, in this project we will evaluate the biomarkers of inflammation (ultra-sensitive C-reactive protein and serum amyloid A protein) in overweight children and adolescents and will relate insulin resistance, dyslipidemia, mean carotid intima-media thickness and the consumption of processed/ultraprocessed foods. At the end of the project, an awareness-raising action will be taken with the research participants and their families, seeking to assist in the change of lifestyle. (AU)