Estratégias terapêuticas para a obesidade pediátrica e sua influência nos marcadores de risco cardiovascular
Resumo
A obesidade pediátrica é actualmente um problema de saúde pública crescente. Portugal não é excepção sendo que um terço da população pediátrica e adolescente apresenta excesso de peso ou mesmo obesidade. A abordagem comportamental é a pedra basilar dos tratamentos da obesidade, focando-se em alterações do estilo de vida e substituição de hábitos nefastos por outros saudáveis.
Um elevado número de estratégias foram estudadas para responder a este problema crescente apresentando, contudo, resultados variáveis. A heterogeneidade de resultados apresentada na literatura cientifica pode ser explicada por diferentes desenhos de estudo e de populações alvo. Não obstante, os resultados apontam no sentido de que melhorias na dieta e no padrão de actividade fisica estão associados com melhorias no factor de risco cardiovascular, nomeadamente do perfil aterogénico lipidico, resistência à insulina, inflamação, para além da redução da própria adiposidade.
A combinação de dieta e exercício na mesma intervenção parece ser benéfica e complementar. No entanto, diferentes tipos de actividade fisica e de dieta podem levar a resultados diferentes. O uso de adjuvantes farmacológicos no tratamento da obesidade pediátrica é altamente limitado na prática clinica, especialmente devido à falta de estudos adequeados; contudo algumas opções demonstraram contribuir para uma pequena mas consistente melhoria da adiposidade. A cirurgia é uma solução de ultimo recurso e para casos extremos.
A obesidade pediátrica tende a manter-se até à idade adulta e está associada a um aumento do risco cardiovascular futuro. Uma actuação tão precoce quanto possível, quando é mais fácil a aquisição de habitos adequados, é crucial
Os governos estão a prestar cada vez mais atenção a este assunto. Contudo, muito mais pode ser feito em termos de politicas globais, no sentido de criar um ambiente menos propicio à obesidade e favorável à escolha de opções mais saudáveis.Referências
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