Omissão do café da manhã e excesso de peso em adolescentes escolares brasileiros

Abstract

Introduction: The prevalence of overweight in adolescents is increasing both worldwide and nationally, requiring immediate attention, since it worsens health and causes damage to quality of life, in addition to being one of the main concerns of public health. Regular breakfast consumption has been associated with several health benefits such as better nutritional profile, higher cognitive performance, including lower body mass index. However, adolescents are increasingly skipping breakfast, resulting in an unbalanced diet, unhealthy eating patterns, in addition to bringing health problems, which can make adolescents more susceptible to weight gain and its consequences and also have repercussions in the adult. Objective: Adolescent students aged 11 to 19 years, who participated in the National School Health Survey between April and September 2015 were evaluated. The sample considered students who regularly attending the 6th to 9th grade of elementary school and 1st to 3rd grade of high school in the morning, afternoon or evening shifts, selected from 371 public and private schools in 179 Brazilian municipalities, with representation for Brazil and macro-regions. The independent variable of interest was skipping breakfast, obtained through the question: “Do you usually eat breakfast?”, being considered as the frequency of having a meal for less than 5 days in the last week. The dependent variable was excess of weight (overweight or obesity), classified by the body mass index, obtained by measuring weight and height measurements, and analyzed according to sex and age. The covariates analyzed were sociodemographic and economic characteristics (sex, age group, socioeconomic status, skin color, maternal schooling, paid work and living with parents); school-related variables (administrative dependence, school shift and presence of a canteen at school); lifestyle (physical activity, alcohol consumption, smoking, sedentary behavior, consumption of processed foods, meals with parents and school meals) and self-perception of body image. Poisson regression was used to analyze the association with adjustment for the covariates, and the final model was built using the backward elimination method, which retained only the variables considered significant at the 5% level. Results: A total of 16,556 adolescent students were evaluated, 50.8% male, 46.1% aged between 11 and 14 years old, 86.6% from public schools, 30.2% regular consumption of processed foods. The prevalence of overweight was 25.2% (95% CI: 24.2; 26.3) and of skipping breakfast was 33.8% (95% CI: 32.1; 35.4). After adjusting for confounding factors, skipping breakfast was associated with excess weight (OR: 1.02; 95%CI: 1.01; 1.04) among Brazilian schoolchildren, being significant even when stratified by sex (male - OR: 1.04; 95%CI: 1.02; 1.06 and female - OR: 1.04; 95%CI: 1.02; 1.06). Conclusion: There was an association between skipping breakfast and being overweight in a nationally representative sample of Brazilian schoolchildren, contributing to the aggregation of knowledge on the subject to the national literature and in the direction of public policies for the implementation of guidelines and strategies prevention or treatment of overweight in adolescents.