Age at the initiation of puberty and at menarche are key maturational indicators. They reflect health both within and between populations; in that a declining average age is associated with improving health, nutrition, and socio-economic conditions. Knowledge of the timing of pubertal development and menarche is important as earlier development within a population, in particular, has been linked with an increased risk of negative sequelae including overweight and obesity, development of risk factors for non-communicable diseases such as hypertension and insulin resistance, and engagement in risk behaviours such as early sexual debut and substance abuse. The main aims of this study were to investigate the timing of, and the early life factors (such as body composition and growth velocities) associated with pubertal development and age at menarche in Black and White urban South African adolescents. Mixed-longitudinal data (n = 401) from the Birth to Twenty (Bt20) birth-cohort study, initiated in 1990 and set in SowetoJohannesburg, South Africa were used. Median age at the initation of puberty and at menarche was derived by fitting logistic curves to cumulative frequency plots. Logistic regression models were constructed to examine the early life predictors of the timing of puberty and menarche. Data were also collected from adolescents and Bt20 staff (n = 72) using focus groups to explore views on the pubertal development questionnaire used in the Bt20 study. Median age at the initiation of genitalia development was 10.4 years (95% Cl = 8.4, 12.4) for Black boys and 9.8 years (95% Cl = 9.4, 10.2) for White boys. Median age for the initiation of pubic hair development for Black males was 10.8 years (95% Cl = 9.6, 12.0) compared to White males, which was 10.2 years (95% Cl = 8.4, 12.0). Median age at the initiation of breast development in Black females was 10.1 years (95% Cl = 9.3, 10.9) compared to White females which was 10.2 years (95% Cl = 8.2, 12.2). Median age for the initiation of pubic hair was 10.3 years (95% Cl = 9.3, 11.3) and 10.5 years (95% Cl = 8.7, 12.3) for Black and White girls, respectively. Results from logistic regression showed that a greater weight and height velocity in late childhood significantly increased the odds of achieving early breasU genitalia development. Furthermore, a low socio-economic status (SES) index at 9/10 years significantly reduced the odds of achieving early breasUgenitalia development. A greater weight, height, body mass index (BM I), and growth rate during infancy and childhood significantly increased the odds of achieving early pubic hair development. Median age at menarche for Black females was 12.4 years (95% Cl = 12.2, 12.6) and 12.5 . years (95% Cl = 11.7,13.3) for White females. Average menarcheal age for Black girls has declined by 0.56 years per decade and 0.32 years for White girls in South Africa, when comparing the current study findings with those from previous studies. Results from logistic regression showed that being taller, fatter and heavier in late childhood significantly increased the odds of achieving earlier menarche. The focus groups provided a range of opinions relating to the Bt20 pubertal development questionnaire and procedure. The majority of views were positive and included the ease of understanding and completion of the tool. Negative views revolved around the language used and privacy issues. These qualitative results provided a unique insight into the way in which pubertal development data are assessed and how these methods can potentially be improved to enhance the reliability and accuracy of pubertal development data collection. The results from this study provide the most recent estimates of age at the. initiation of puberty and age at menarche for urban Black and White South African adolescents. This is particularly important given the social, nutritional, and economic transition currently occurring in this country as these key maturity indicators reflect population health. This study has also added to our knowledge of the factors that are associated with pubertal development, showing that proximate rather than distal factors are the most sensitive indicators in this urban transitioning environment. In addition, the results from the focus groups provided a unique insight into how pubertal development data are assessed and how these methods could be improved. The negative health outcomes which have been associated with earlier pubertal development and age at menarche are major public health concerns, particularly in the South African context given the HIV/AIDS epidemic and rising levels of obesity. This study highlights the need for renewed research and resources for intervention strategies and policy programmes which target appropriate sex and obesity education in urban South African children.

Objetivo. Delinear sistema de classificação baseado na distribuição brasileira do Índice de Massa Corporal (IMC) para avaliação do estado nutricional de crianças e adolescentes brasileiros. Método. Foram utilizados o método LMS para o cálculo dos parâmetros da curva do IMC e a função polinomial para modelá-los ao longo das idades. A distribuição saudável do IMC foi delineada a partir dos indivíduos de 2 a 19 anos da Pesquisa Nacional Nutrição e Saúde, realizada em 1989. Os valores críticos para classificação do estado nutricional foram expressos segundo centis ou equivalentes aos valores de IMC 17,5; 25 e 30 kg/m2 no início da idade adulta. A curva brasileira foi calibrada contra a população de referência e comparada outras curvas de referência estrangeiras. Finalmente, a curva brasileira foi empregada para descrever a mudança secular no grupo estudado ao longo de três décadas. Resultados. Os resultados foram apresentados na forma de cinco artigos. No primeiro foram descritos, em intervalos semestrais, os parâmetros L, M e S da curva brasileira e os valores críticos dos centis tradicionalmente empregados e aqueles adulto-equivalentes. No segundo, os parâmetros L, M e S gerados foram comparados à população original. No terceiro, a curva nacional foi comparada, em seus fundamentos, a curvas estrangeiras. No quarto, verificou-se o impacto clínico decorrente do emprego da curva nacional ou das curvas estrangeiras à população brasileira. No quinto, foi descrita a mudança secular da distribuição do IMC e da classificação do estado nutricional de crianças e adolescentes brasileiros ao longo de três décadas. / Objetive. Drawing the Brazilian reference curve Body Mass lndex (BMI) to evaluate the nutritional status from Brazilian children and adolescents. Method. It were used the LMS method to calculate the BMI curve parameters and the polynomial function to model the parameters across age. The BMI healthy distribution was taken from data of individuais from 2 to 19 years of the Pesquisa Nacional Saúde e Nutrição, carried out in 1989. The BMI cutoff values to classify nutritional status were realized as percentiles and as BMI adult-equivalent values to 17.5, 25 and 30 kg/m2 at earty adult age. The Brazilian curve was calibrated against the reference population and compared to others foreign reference curves. Finally, the Brazilian curve was used to describe the secular change of the studied group across three decades. Results. The results were realized in five papers. The first one presents the L, M and S parameters and the BMI cutoffs as percentiles and as adult-equivalents values. At the second, the I, M and S parameters were calibrated according to the source reference population. At the third one, the Brazilian curve was compared, using the basics, to foreign curves. At the fourth, the clinical consequences from employment of the Brazilian and foreign curves to the Brazilian population were measured. At the fifth, the secular changes in BMI distribution and at the nutritional status from Brazilian children and adolescents were described through three decades.

The diploma thesis is focused on the evaluation of secular changes in linear proporcionality of body in actual preschool children in the last 27 years. In this context, the research also aims to determine the need for validation of the reference data for linear parameters of preschool children, which are currently used from 1990. The study was realized in six kindergartens in Prague and the surrounding area in the years 2016-2017. A total of 369 children (189 boys and 180 girls) aged 4 - 6 years were examined. The body height, BMI, 11 length and height markers and 10 indexes were measured. Statistically significant differences were not found in most of the observed parameters. Significant differences were not clinically relevant. The effect of secular changes on the characteristics of linear body proportionality of Czech preschool children was not confirmed. Therefore, for clinical practise remaind recommended to use the reference data from 1990, which are valid. Key words:secular trend, linear proporcionality, preschool age

Orientador: Maria Beatriz Rocha Ferreira / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação Fisica / Made available in DSpace on 2018-08-13T09:22:35Z (GMT). No. of bitstreams: 1 FigueiraJunior_AyltonJose_D.pdf: 2121934 bytes, checksum: eb3e476d446a31227f8846d476a09293 (MD5) Previous issue date: 2009 / Resumo: O presente estudo teve o objetivo de delinear pelo corte transversal a análise das variáveis de estilo de vida, nível de atividade e aptidão física de adolescentes residentes em duas regiões do Estado de São Paulo, em duas regiões distintas: uma na região metropolitana da cidade de São Paulo (Município de Santo André) e a outra cidade localizada em área do interior (São Bento do Sapucaí). Comparamos o estilo de vida, nível de atividade física e de aptidão física de adolescentes residentes nas duas regiões em 1997 e 2007, bem como o nível de atividade física, aptidão física e fatores psicosocioculturais (fatores determinantes) nos adolescentes residentes na mesma cidade em 1997 e 2007. Analisamos a relação do nível de atividade física e os fatores socioculturais e biológicos de adolescentes de ambos os sexos no corte amostral de 2007 (regressão multivariada - Modelo Hierárquico). Avaliamos 484 adolescentes de ambos os sexos residentes nas duas regiões e períodos. A avaliação dos indicadores psicosocioculturais foi realizada pelo Questionário de Atividade Física e Estilo de Vida proposto por Figueira Junior e Rocha Ferreira (2000), com questões das características da moradia, prática de atividade física na escola, prática de atividade física fora da escola, nível de atividade física e hábitos da vida. A avaliação da aptidão física seguiu protocolo de Matsudo,V (2005) das medidas antropométricas: peso corporal (kg) e estatura (m); metabólica pela potência aeróbica-teste de consumo de oxigênio (corrida de 12 minutos); neuromotores: força muscular de membros inferiores-impulsão vertical sem (cm) e com auxílio (cm) dos braços, impulsão horizontal (cm), força de tronco-teste abdominal (rep/min) e agilidade-teste de shuttle-run (s). Utilizamos a estatística descritiva, teste t de Student; teste de Mann-Whitney para a análise não paramétrica, teste do qui-quadrado (?2) para a tendência linear e teste Exato de Fisher. A análise do Modelo Hierárquico utilizou a regressão multivariada de Poisson com IC-95%. Resultados comparativos entre os períodos de avaliação em cada região, indicaram mudança (p<0,05) na estatura dos adolescentes (1997-2007) e no peso em Santo André (masculino). O comportamento da força muscular mostrou incremento nos adolescentes das duas regiões e sexos. A mesma tendência foi encontrada para a agilidade e força de tronco. O valor do consumo de oxigênio aumentou (1997-2007) nos dois grupos. A análise por sexo mostrou que as meninas não apresentaram mudança significativa, exceto nas adolescentes de São Bento do Sapucaí que aumentou. A prevalência de adolescentes ativos aumentou em 2007 comparado com 1997 nas duas regiões e sexos. A caminhada como forma de deslocamento parece contribuir significativamente. As barreiras da atividade física mostraram maior prevalência em Santo André que São Bento do Sapucaí em 2007 que 1997, o que explicaria o nível de atividade física. A preocupação com o aspecto físico, falta de estímulo dos pais e local para a prática de atividade física foram às barreiras mais citadas. A análise de regressão multivariada mostrou que a participação nas aulas de educação física, maior número de irmãos, caminhar ou pedalar para a escola são fatores de proteção para a inatividade física nas duas regiões. Podemos concluir que o intervalo de 10 anos de avaliação em duas regiões promoveu impacto diferente no comportamento de adolescentes ambos os sexos. / Abstract: This paper aimed to analyze throughout cross-sectional approach the lifestyle, physical activity level and adolescents physical fitness living at two different regions from Sao Paulo State: one at metropolitan area and other (Santo André) city and other from Sao Paulo countryside area (São Bento do Sapucaí). We compared the lifestyle in both region in 1997 and 2007, as well as the physical activity level, physical fitness and psychological and cultural factors (determinants factor) in adolescents from the same city, but ten years evaluation gap (1997-2007). The relationship among physical activity level and socio, cultural and biological variables were evaluated at 2007 sample, by multiple regression analysis (Hierarchical Model). 484 both sexes adolescents from different regions and periods were evaluated. The psycho-socio-cultural variables were determined by the Physical Activity and Lifestyle Questionnaire (Figueira Junior and Rocha Ferreira, 2000), that was organized to find the house characteristics; school physical activity practice, physical activity level and lifestyle indicators. The physical fitness variables were evaluated following Matsudo,V (2005) to anthropometric measures: body weight (Kg), statures (m); metabolic by maximal aerobic oxygen consumption (12 minutes run test) and neuromotors variables: lower limbs strength test by vertical jump test with and without help of arms movement, stand long jump, trunk abdominal strength and shuttle-run agility test. The descriptive statistics analysis chosen was the Student t test, Mann-Whitney to non-parametric approaches and Chi-Square (?2) to linear trend and Fisher Test. The hierarchical model was assessed by Poisson multivariate regression with CI - 95%. The results were compared between regions and evaluation period and presented changes (p.<05) on male adolescents stature (1997-2007) and body weight (Santo André). The muscle strength showed increases for both groups and period. The same trend was observed for agility and trunk strength. The analysis by sex did not presented chances girls on physical fitness, except from Sao Bento do Sapucaí adolescents. The active adolescents' physical activity increased in 2007 compared to 1997 in both region and sex. Walking as health-related locomotion, positively contribute for total physical activity. The barriers to physical activity showed higher prevalence in Santo André sample than in Sao Bento do Sapucaí in 2007 than 1997, that can explain the physical activity level. The physical appearance worry, lack of parents stimulus and place to physical activity practice were the most barriers found. Multivariate regression showed that physical education classes participation, more siblings walking or riding a bike to or back from school are variables that may protect against physical inactivity at both regions. So, we may conclude that 10 years interval between evaluations resulted on different adolescents behavior related to physical activity level and sociocultural approaches. / Doutorado / Atividade Fisica, Adaptação e Saude / Doutor em Educação Física

Objetivo. Delinear sistema de classificação baseado na distribuição brasileira do Índice de Massa Corporal (IMC) para avaliação do estado nutricional de crianças e adolescentes brasileiros. Método. Foram utilizados o método LMS para o cálculo dos parâmetros da curva do IMC e a função polinomial para modelá-los ao longo das idades. A distribuição saudável do IMC foi delineada a partir dos indivíduos de 2 a 19 anos da Pesquisa Nacional Nutrição e Saúde, realizada em 1989. Os valores críticos para classificação do estado nutricional foram expressos segundo centis ou equivalentes aos valores de IMC 17,5; 25 e 30 kg/m2 no início da idade adulta. A curva brasileira foi calibrada contra a população de referência e comparada outras curvas de referência estrangeiras. Finalmente, a curva brasileira foi empregada para descrever a mudança secular no grupo estudado ao longo de três décadas. Resultados. Os resultados foram apresentados na forma de cinco artigos. No primeiro foram descritos, em intervalos semestrais, os parâmetros L, M e S da curva brasileira e os valores críticos dos centis tradicionalmente empregados e aqueles adulto-equivalentes. No segundo, os parâmetros L, M e S gerados foram comparados à população original. No terceiro, a curva nacional foi comparada, em seus fundamentos, a curvas estrangeiras. No quarto, verificou-se o impacto clínico decorrente do emprego da curva nacional ou das curvas estrangeiras à população brasileira. No quinto, foi descrita a mudança secular da distribuição do IMC e da classificação do estado nutricional de crianças e adolescentes brasileiros ao longo de três décadas. / Objetive. Drawing the Brazilian reference curve Body Mass lndex (BMI) to evaluate the nutritional status from Brazilian children and adolescents. Method. It were used the LMS method to calculate the BMI curve parameters and the polynomial function to model the parameters across age. The BMI healthy distribution was taken from data of individuais from 2 to 19 years of the Pesquisa Nacional Saúde e Nutrição, carried out in 1989. The BMI cutoff values to classify nutritional status were realized as percentiles and as BMI adult-equivalent values to 17.5, 25 and 30 kg/m2 at earty adult age. The Brazilian curve was calibrated against the reference population and compared to others foreign reference curves. Finally, the Brazilian curve was used to describe the secular change of the studied group across three decades. Results. The results were realized in five papers. The first one presents the L, M and S parameters and the BMI cutoffs as percentiles and as adult-equivalents values. At the second, the I, M and S parameters were calibrated according to the source reference population. At the third one, the Brazilian curve was compared, using the basics, to foreign curves. At the fourth, the clinical consequences from employment of the Brazilian and foreign curves to the Brazilian population were measured. At the fifth, the secular changes in BMI distribution and at the nutritional status from Brazilian children and adolescents were described through three decades.

The aim of the diploma thesis is to describe and evaluate the relation of mass proportionality and adiposity in the context of secular changes in body composition of Czech preschool children over the last 25 years. The study was conducted in the form of transversal research between years 2016-2018 at seven kindergartens from Prague and its surroundings and one from Ústí nad Labem. 551 children (271 boys, 280 girls), in age of four to six years, were examined. The data was supplemented by a set of 208 children (101 boys and 107 girls), which were part of a pilot study from 2013-2014. In total, the group comprised 759 children. The actual set of individuals was compared with a representative database of Czech preschool children from the 1990s. There was no significant difference in the parameters describing weight proportionality in current preschool children, however the proportion of the individual components of the body composition has changed. The fat component increased significantly in six-year-old boys, five- year-old and six-year-old girls. At the same time, we observed insufficient development of active body mass in relation to the reference group. These trends are also evidenced by the increase in the percentage of latent forms of obesity over the past 25 years. The lack of active movement...

INTRODUÇÃO: As recomendações alimentares na infância são a exclusividade do leite materno (LM) até o 6º mês, sua extensão mínima até o 24º mês e introdução programada de alimentos semissólidos e sólidos até os dois anos. O padrão alimentar na infância influencia preferências sensoriais e indicadores de saúde nos ciclos de vida subsequentes. OBJETIVO: Analisar a tendência secular da alimentação de crianças brasileiras menores de cinco anos nas três últimas décadas. MÉTODOS: Os dados foram provenientes da amostra de crianças menores de cinco anos das três Pesquisas de Demografia e Saúde realizadas no Brasil em 1986, 1996 e 2006. O aleitamento materno (AM) foi descrito segundo indicadores propostos pela Organização Mundial da Saúde (2008). As medianas do AM e do aleitamento materno exclusivo (AME) e os seus fatores preditores foram estimadas por modelo de regressão de Cox. Os padrões alimentares (PA) foram identificados por análise de componentes principais (ACP) e, em seguida, foram calculados os escores de cada PA. Estes PA foram incluídos como desfechos em modelos de efeitos mistos cujos fatores preditores associados foram aqueles referentes à saúde materno-infantil e sociodemográficos. RESULTADOS: Entre 1986 e 2006, o percentual de crianças expostas ao LM foi de 91 para 97 por cento e a duração mediana, de 6 para 12 meses. Entre 1996 e 2006 a mediana do AME aumentou de 0,7 para 2 meses. A amamentação na 1ª hora de vida foi fator protetor para a duração do AME e do AM. A duração mediana do AME foi homogênea entre as regiões, associada de forma direta com relação de pré-natal, escolaridade materna e índice de riqueza. A duração mediana do AM foi associada de forma inversa com nascimento por parto cesáreo em hospital privado, intervalo interpartal inferior a 24 meses e difere segundo região geográfica, sendo superior no Norte brasileiro. Foram identificados quatro padrões alimentares para as crianças com idade entre 6 e 59 meses: PA1(iogurte, carnes, tubérculos, hortaliças, frutas), PA2(líquidos, leites não-maternos, carnes e carga fatorial negativa para leite materno e papas à base de farinhas enriquecidas), PA3(líquidos, sucos de frutas, papas à base de amido industrializado, papas à base de farinha enriquecida, iogurte e carga fatorial negativa para carnes vermelhas) e PA4(leite não-materno, fórmulas e carga fatorial negativa papas à base de farinhas enriquecidas e ovopeixefrango). A prática dos padrões PA1 e PA3 foi superior entre crianças que recebiam leite materno. O padrão PA1 foi distribuído de forma homogênea entre as regiões enquanto os outros padrões alimentares apresentaram comportamento distinto entre as regiões. A mudança mais expressiva no período analisado foi a virtual substituição do PA4 pelo PA3, cuja composição de alimentos se aproxima mais das recomendações para faixa etária. CONCLUSÃO: O quadro pró-aleitamento materno é centrado principalmente na exposição universal ao LM e na sustentação desta exposição, refletida no incremento da sua duração mediana. Entretanto, o avanço na duração do AME é menos expressivo no período. O aumento da exposição aos alimentos sólidos entre as crianças menores de 12 meses representa a principal alteração dos padrões alimentares entre 1996 e 2006. Três padrões alimentares das crianças menores de cinco anos são influenciados regionalmente e um deles socialmente. / INTRODUCTION: The infant and recommendations are exclusive breastfeeding (EBF) at six months, breastfeeding at least 24th months and the programmed introduction of solid, semi-solid or soft foods with breast milk until 24 months. Early dietary patterns can explain the sensory preferences and the health indicators throughout the life course. OBJECTIVE: To analyze the secular trend of Brazilian young child feeding practices in last three decades. METHODS: The under five children sample was from three probabilistic Brazilian Demographic Health Surveys carried out in 1986, 1996 and 2006. The breastfeeding (BF) was described according to the indicators from World Health Organization (WHO, 2008). The BF and exclusive breastfeeding (EBF) medians and the predictor factors were estimated using Cox regression model. The dietary patterns (DP) were identified by principal component analysis (PCA) and the dietary pattern scores were included as outcome variables in logistic mixed model. The predictive variables were sociodemographic, maternal and infant health. The complex design sample was considered in statistical analysis. RESULTS: In the period between 1986 and 2006, the percentage of children exposed to breast milk increased from 91 to 97 per cent and the BF median increased from 6 to 12 months and the EBF increased from 0.7 to 2.0 months. Early initiation of breastfeeding was a protective factor for BF and EBF length. The EBF length was uniform among geographic regions and it was directly associated with antenatal care, maternal schooling and wealth index. The EF median was inversely associated with cesarean delivery in private hospital, birth interval less than 24 months and it was different among regions (higher in North). Four DP were identified for children age 6 to 59 months: PA1(composed of yogurt, red meat, chicken, eggs, tubers, vegetables and fruits), PA2(composed of liquids, non-breast milk, red meat, chicken, eggs and negative loadings for breast milk and enriched starch porridge), PA3(composed of liquids, fruit juices, industrialized starch porridge, yogurt and negative factor loadings for red meat) and PA4( composed of non-breast milk, formula and negative factor loadings for enriched starch porridge and egg/fish/chicken). The PA1 and PA3 practices were higher among breastfed children. The PA1 dietary pattern was uniform among geographic regions otherwise, another patterns were differently distribute. The most important DP change was the virtual replacement PA4 for PA3, that was more appropriated for children aged higher than 12 months. CONCLUSION: The pro-breastfeeding scenarium is focused mainly in children universally exposed to BF and the upkeeping of BF, assessed by BF median duration. However, in this survey periods, the increase of EBF duration is lower than the BF duration. The increased solids exposure in children under 12 months expresses the main dietary pattern change between 1996 and 2006. Three dietary patterns of under five children are predicted by geographic region factors and one of them by socioeconomic factors.

INTRODUÇÃO: As recomendações alimentares na infância são a exclusividade do leite materno (LM) até o 6º mês, sua extensão mínima até o 24º mês e introdução programada de alimentos semissólidos e sólidos até os dois anos. O padrão alimentar na infância influencia preferências sensoriais e indicadores de saúde nos ciclos de vida subsequentes. OBJETIVO: Analisar a tendência secular da alimentação de crianças brasileiras menores de cinco anos nas três últimas décadas. MÉTODOS: Os dados foram provenientes da amostra de crianças menores de cinco anos das três Pesquisas de Demografia e Saúde realizadas no Brasil em 1986, 1996 e 2006. O aleitamento materno (AM) foi descrito segundo indicadores propostos pela Organização Mundial da Saúde (2008). As medianas do AM e do aleitamento materno exclusivo (AME) e os seus fatores preditores foram estimadas por modelo de regressão de Cox. Os padrões alimentares (PA) foram identificados por análise de componentes principais (ACP) e, em seguida, foram calculados os escores de cada PA. Estes PA foram incluídos como desfechos em modelos de efeitos mistos cujos fatores preditores associados foram aqueles referentes à saúde materno-infantil e sociodemográficos. RESULTADOS: Entre 1986 e 2006, o percentual de crianças expostas ao LM foi de 91 para 97 por cento e a duração mediana, de 6 para 12 meses. Entre 1996 e 2006 a mediana do AME aumentou de 0,7 para 2 meses. A amamentação na 1ª hora de vida foi fator protetor para a duração do AME e do AM. A duração mediana do AME foi homogênea entre as regiões, associada de forma direta com relação de pré-natal, escolaridade materna e índice de riqueza. A duração mediana do AM foi associada de forma inversa com nascimento por parto cesáreo em hospital privado, intervalo interpartal inferior a 24 meses e difere segundo região geográfica, sendo superior no Norte brasileiro. Foram identificados quatro padrões alimentares para as crianças com idade entre 6 e 59 meses: PA1(iogurte, carnes, tubérculos, hortaliças, frutas), PA2(líquidos, leites não-maternos, carnes e carga fatorial negativa para leite materno e papas à base de farinhas enriquecidas), PA3(líquidos, sucos de frutas, papas à base de amido industrializado, papas à base de farinha enriquecida, iogurte e carga fatorial negativa para carnes vermelhas) e PA4(leite não-materno, fórmulas e carga fatorial negativa papas à base de farinhas enriquecidas e ovopeixefrango). A prática dos padrões PA1 e PA3 foi superior entre crianças que recebiam leite materno. O padrão PA1 foi distribuído de forma homogênea entre as regiões enquanto os outros padrões alimentares apresentaram comportamento distinto entre as regiões. A mudança mais expressiva no período analisado foi a virtual substituição do PA4 pelo PA3, cuja composição de alimentos se aproxima mais das recomendações para faixa etária. CONCLUSÃO: O quadro pró-aleitamento materno é centrado principalmente na exposição universal ao LM e na sustentação desta exposição, refletida no incremento da sua duração mediana. Entretanto, o avanço na duração do AME é menos expressivo no período. O aumento da exposição aos alimentos sólidos entre as crianças menores de 12 meses representa a principal alteração dos padrões alimentares entre 1996 e 2006. Três padrões alimentares das crianças menores de cinco anos são influenciados regionalmente e um deles socialmente. / INTRODUCTION: The infant and recommendations are exclusive breastfeeding (EBF) at six months, breastfeeding at least 24th months and the programmed introduction of solid, semi-solid or soft foods with breast milk until 24 months. Early dietary patterns can explain the sensory preferences and the health indicators throughout the life course. OBJECTIVE: To analyze the secular trend of Brazilian young child feeding practices in last three decades. METHODS: The under five children sample was from three probabilistic Brazilian Demographic Health Surveys carried out in 1986, 1996 and 2006. The breastfeeding (BF) was described according to the indicators from World Health Organization (WHO, 2008). The BF and exclusive breastfeeding (EBF) medians and the predictor factors were estimated using Cox regression model. The dietary patterns (DP) were identified by principal component analysis (PCA) and the dietary pattern scores were included as outcome variables in logistic mixed model. The predictive variables were sociodemographic, maternal and infant health. The complex design sample was considered in statistical analysis. RESULTS: In the period between 1986 and 2006, the percentage of children exposed to breast milk increased from 91 to 97 per cent and the BF median increased from 6 to 12 months and the EBF increased from 0.7 to 2.0 months. Early initiation of breastfeeding was a protective factor for BF and EBF length. The EBF length was uniform among geographic regions and it was directly associated with antenatal care, maternal schooling and wealth index. The EF median was inversely associated with cesarean delivery in private hospital, birth interval less than 24 months and it was different among regions (higher in North). Four DP were identified for children age 6 to 59 months: PA1(composed of yogurt, red meat, chicken, eggs, tubers, vegetables and fruits), PA2(composed of liquids, non-breast milk, red meat, chicken, eggs and negative loadings for breast milk and enriched starch porridge), PA3(composed of liquids, fruit juices, industrialized starch porridge, yogurt and negative factor loadings for red meat) and PA4( composed of non-breast milk, formula and negative factor loadings for enriched starch porridge and egg/fish/chicken). The PA1 and PA3 practices were higher among breastfed children. The PA1 dietary pattern was uniform among geographic regions otherwise, another patterns were differently distribute. The most important DP change was the virtual replacement PA4 for PA3, that was more appropriated for children aged higher than 12 months. CONCLUSION: The pro-breastfeeding scenarium is focused mainly in children universally exposed to BF and the upkeeping of BF, assessed by BF median duration. However, in this survey periods, the increase of EBF duration is lower than the BF duration. The increased solids exposure in children under 12 months expresses the main dietary pattern change between 1996 and 2006. Three dietary patterns of under five children are predicted by geographic region factors and one of them by socioeconomic factors.

Thesis is focused on the analysis of intersexual differences in adiposity markers within urban population of Czech children from 11,00 to 15,99 years. This age range encompasses puberty which is one of the critical periods for the possible development of overweight and obesity. The sample PRAHA 2013 consists of 356 girls and 353 boys which were surveyed for basic anthropometric indicators - body height, body weight, BMI, mid- upper arm circumference and the thickness of four skinfolds. Intersexual differences discovered in measured parameters show statistical significance (p<0,01 resp. p<0,001) and it corresponds with the characteristic changes of pubertal development in both of genders. Testing file PRAHA 2013 against reference standards and its comparison with the results of the last Czechoslovak spartakiade in 1985 points to positive secular trend of increasing body height. However increase in weight parametres is still continuing. Probands from the year 2013 reach higher body weight values, BMI and skinfold thickness in comparison with children of the same age in 1985, 1991 resp. 2001. Significant differences were found out in the most of age categories in both of genders. Keywords: adiposity tissue, subcutaneous fat, skinfolds, body fat distribution, sexual dimorphism, obesity, secular trend

Thesis aims to analyze some auxological aspects of menarche in a sample of peripubertal school-aged Prague girls. Sample PRAHA 2012 consists of 293 girls from Prague within the age ranging from 11,00 - 14,99 years. Ascertained median age of menarche 12,4 years is significantly lower (p = 0,0004) than median of Prague population - 13,04 years, respectively lower than median age of menarche of Czech population - 13,00 years according to data from the last national anthropological survey (CAV 2001). Our investigation suggests a "break off" in long-term stagnation age of menarche (minus 0,6 year) at least in a urban population in Czech Republic. According to our findings deceleration age of menarche wasn't accompanied by increase of average body height or other nutritional characteristics (body weight, BMI, arm circumference, thickness of skinfolds) in comparison with actual pediatrics standards. Though, there is a clearly evidence that participant's body composition affected age of menarche. A comparison of premenarcheal (n = 139) and postmenarcheal (n = 154) girls of the same age showed statistically significant elevated values in body weight (42,5 kg, 47,6 kg vs 56,3 kg, 54,1 kg), BMI (17,6 kg/mš, 18,3kg/mš vs 21,3 kg/mš, 20,7 kg/mš) and percentage of body fat (19,4%, 19,7% vs 24,5% a 23,1%) at...