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Impacto a longo prazo do excesso de peso e da obesidade na infância e adolescência
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A prevalência da obesidade tem escalado nas últimas décadas, tanto em Portugal, como em todo
o mundo, e está cada vez mais presente num dos grupos mais vulneráveis da nossa sociedade,
a população infantojuvenil. Esta doença está relacionada com o aparecimento de patologias
como a diabetes mellitus tipo 2, doença cardiovascular e hepática, e é alarmante o aumento do
seu diagnóstico nas faixas etárias mais jovens. É necessário perceber qual o impacto que a
obesidade pode ter no aparecimento e evolução destas comorbilidades durante a juventude e na
vida futura.
O desenvolvimento de obesidade está principalmente associado a um excesso de ingestão
calórica, que resulta num balaço energético positivo com acumulação de gordura no tecido
adiposo. No século XXI, o estilo de vida sedentário e a má alimentação das crianças são os
principais desencadeadores do ganho de peso, embora a presença de obesidade possa também
ser secundária a patologias genéticas.
Vários estudos têm demonstrado que o excesso de adiposidade desencadeia um estado de
inflamação crónica e alterações na produção hormonal, que podem ter consequências em
diversos órgãos e sistemas. A hipertensão arterial e a dislipidemia presente em crianças obesas,
está intimamente relacionada com a ocorrência futura de eventos de risco cardiovascular.
Também a saúde óssea e mental é negativamente afetada e os jovens obesos apresentam maior
probabilidade de fraturas dos membros inferiores, assim como maior prevalência de episódios
depressivos.
O diagnóstico destas patologias em idades precoces tem consequências a longo prazo e pode
ter um grande impacto na qualidade de vida destes jovens enquanto adultos. Está, no entanto,
demonstrado que é possível reduzir as consequências, através da normalização do peso
corporal. A implementação de alterações no estilo de vida numa fase inicial da doença pode
contribuir para a diminuição do excesso de peso, podendo ser necessário recorrer a terapêutica
farmacológica ou cirúrgica em casos de obesidade infantil severa, à qual já estejam associadas
comorbilidades.
O farmacêutico, como profissional de saúde, pela proximidade à população e pelo seu
conhecimento científico, pode ter um papel ativo na prevenção da obesidade infantil e no
acompanhamento do seu tratamento quando este é necessário.
The prevalence of obesity has increased in recent decades, both in Portugal, and worldwide, and it has become more present in one of the most vulnerable groups of our society, the child and youth population. This disease is related to the appearance of pathologies such as type 2 diabetes mellitus, cardiovascular and hepatic disease, and its increased diagnosis in younger age groups is alarming. It is necessary to understand which impact obesity may have on the onset and evolution of these comorbidities during youth and later life. The development of obesity is mainly associated with an excess calorie intake, which results in a positive energy balance with consequent accumulation of fat in adipose tissue. In the 21st century, sedentary lifestyles and poor diet in children are the main triggers of weight gain, but the presence of obesity may also be secondary to genetic pathologies. Several studies have shown that excess adiposity triggers a state of chronic inflammation and changes in hormone production, which can have consequences on several organs and systems. Hypertension and dyslipidemia present in obese children are closely related to the future occurrence of cardiovascular events. Bone and mental health are also negatively affected and obese adolescents have a higher probability of lower limb fractures, as well as a higher prevalence of depressive episodes. Diagnosis of these conditions at an early age has long-term consequences and can have a major impact on the quality of life of these young people as adults. However, it has been shown that it is possible to reduce the consequences by normalizing body weight. The implementation of lifestyle changes at an early stage of the disease may contribute to the reduction of overweight, and it may be necessary to consider pharmacological or surgical therapy in cases of severe childhood obesity, already associated with comorbidities. The pharmacist, as a health professional, due to his proximity to the population and his scientific knowledge, can play an active role in prevention of childhood obesity and monitoring its treatment when necessary.
The prevalence of obesity has increased in recent decades, both in Portugal, and worldwide, and it has become more present in one of the most vulnerable groups of our society, the child and youth population. This disease is related to the appearance of pathologies such as type 2 diabetes mellitus, cardiovascular and hepatic disease, and its increased diagnosis in younger age groups is alarming. It is necessary to understand which impact obesity may have on the onset and evolution of these comorbidities during youth and later life. The development of obesity is mainly associated with an excess calorie intake, which results in a positive energy balance with consequent accumulation of fat in adipose tissue. In the 21st century, sedentary lifestyles and poor diet in children are the main triggers of weight gain, but the presence of obesity may also be secondary to genetic pathologies. Several studies have shown that excess adiposity triggers a state of chronic inflammation and changes in hormone production, which can have consequences on several organs and systems. Hypertension and dyslipidemia present in obese children are closely related to the future occurrence of cardiovascular events. Bone and mental health are also negatively affected and obese adolescents have a higher probability of lower limb fractures, as well as a higher prevalence of depressive episodes. Diagnosis of these conditions at an early age has long-term consequences and can have a major impact on the quality of life of these young people as adults. However, it has been shown that it is possible to reduce the consequences by normalizing body weight. The implementation of lifestyle changes at an early stage of the disease may contribute to the reduction of overweight, and it may be necessary to consider pharmacological or surgical therapy in cases of severe childhood obesity, already associated with comorbidities. The pharmacist, as a health professional, due to his proximity to the population and his scientific knowledge, can play an active role in prevention of childhood obesity and monitoring its treatment when necessary.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2023, Universidade de Lisboa, Faculdade de Farmácia
Palavras-chave
Crianças e jovens Excesso de peso Obesidade infantil Consequências futuras. Mestrado Integrado - 2023