Associação do cálcio e da vitamina D com composição corporal e alterações metabólicas em adolescentes de 15 a 17 anos

Abstract

Adolescent obesity has been considered a public health problem, since the association of excess weight with metabolic abnormalities such as dyslipidemia, hypertension, glucose intolerance, and cardiovascular disease can be readily observed in the group in question here. Recent studies investigate the role of calcium and vitamin D in the prevention of chronic diseases such as hypertension, diabetes, and obesity. Thus, the aim of this study was to investigate the relation of calcium and vitamin D intake, and serum vitamin D, with body composition and metabolic alterations, in adolescents from the Juiz de For a city. The cross-sectional study was conducted in high schools in the central city area of Juiz de Fora with adolescents from 15 to 17 years of age. A sample of 302 students was selected after screening and classification of nutritional status. The analysis included anthropometric variables, nutrient intake, arterial blood pressure, physical activity level, and behavioral variables. In addition, blood samples were collected to evaluate lipid profile, fasting glucose, and fasting insulin. Levels of vitamin D and parathyroid hormone were analyzed on a sub-sample. The database and the statistical analyses were processed using SPSS 17.0. Among the participants, 150 were eutrophic and 152 (50.3%) were overweight. According to biochemical analysis, the highest observed lipid profile alteration was increased total cholesterol (40.4%). With the exception of blood glucose, the overweight teens showed higher biochemical levels. The inadequacy in the percentage of macronutrients in relation to the TEI indicates similarities between the groups and across gender. A higher percentage of overweight adolescents with a fat intake above the AMDR was seen in comparison with eutrophic individuals (62.9 vs. 44.6%, p = 0.006). Logistic regression analysis showed that the ingestion of diet / light foods (OR = 2.95; CI = 1.48-5.89; p = 0.002), whole foods (OR = 2.21; CI = 1.25-3.91; p = 0.006), and high fat diets (OR = 1.81; CI = 1.03-3.15; p = 0.036) serve as factors associated with excess weight. Based on the analysis of the FFQ, a 23.9% and 16.5% daily consumption of fruits and vegetables, respectively, was observed, with no significant association between the groups, lipid profile, and gender. Regarding the consumption of milk and dairy products, 59.5% of the adolescents reported a daily intake, being higher among boys (p = 0.029). Only 5.3% of the adolescents had adequate calcium intake (1100 mg/d). Overweight individuals had a lower calcium intake than those with normal weight (p = 0.019). Negative correlations were observed for calcium intake with BMI, waist and hip circumference, waist / hip ratio, body fat percentage, insulin, HOMA-IR, and systolic blood pressure; and a positive correlation with HDL-cholesterol (p < 0.05). In the bivariate analysis, individuals with low calcium intake were more likely to be overweight (OR = 1.85; p = 0.017), have a high body fat percentage (OR = 2.08; p = 0.015), an elevated waist / height ratio (OR = 1.91; p = 0.012), and hyperinsulinemia (OR = 1.94; p = 0.036). Vitamin D deficiency and insufficiency was observed in 1.25% and 70.6% of the adolescents, respectively. Serum levels of 25 (OH) D were significantly lower in individuals with excess weight, increased WC, hypercholesterolemia, and hyperinsulinemia (p < 0.05). Mean Vitamin D intake (2.18 mg/day) was lower than the EAR. Lower values for BMI and WC were observed among individuals who were in the 3rd tertile of vitamin D intake. This is one of the few studies investigating calcium and vitamin D intake along with adiposity and metabolic alterations in adolescents. This results verify the extra-skeletal function of these micronutrients in the group. Though Brazil is a tropical country, a high frequency of insufficiency of this vitamin was found in this study.