ABC | Volume 112, Nº6, June 2019

Original Article Reuter et al Dyslipidemia and associated factors in schoolchildren Arq Bras Cardiol. 2019; 112(6):729-736 1. Santos MG, Pegoraro M, Sandrini F, Macuco EC. Risk factors for the development of atherosclerosis in childhood and adolescence. Arq Bras Cardiol. 2008;90(4):301-8. 2. Almajed HT, AlAttar AT, Sadek AA, AlMuaili TA, AlMutairi OA, Shaghouli AS, et al. Prevalence of dyslipidemia and obesity among college students in Kuwait. Alexandria J Med. 2011;47(1):67-71. 3. Cook S, Kavey RE. Dyslipidemia and pediatric obesity. Pediatr Clin North Am. 2011;58(6):1363-73. 4. Kit BK, Kuklina E, Carroll MD, Ostchega Y, Freedman DS, Ogden CL. Prevalence of and trends in dyslipidemia and blood pressure among US children and adolescents, 1999-2012. JAMA Pediatr. 2015;169(3):272-9. 5. Nobre LN, Lamounier JA, Franceschini SC. Sociodemographic, anthropometric and dietary determinants of dyslipidemia in preschoolers. J Pediatr (Rio J). 2013;89(5):462-9. 6. Reuter CP, da Silva PT, Renner JDP, deMello ED, ValimARM, Pasa L, da Silva R, Burgos MS. Dyslipidemia is associated with unfit and overweight-obese children and adolescents. Arq Bras Cardiol. 2016;106(3):188-93. 7. PersaudN,MaguireJL,LebovicG,CarsleyS,KhovratovichM,RandallSimpson JA,etal.Associationbetweenserumcholesterolandeatingbehavioursduring early childhood: a cross-sectional study. CMAJ. 2013;185(11):E531-6. 8. Gama SR, Carvalho MS, Chaves CRMM. Childhood prevalence of cardiovascular risk factors. Cad. Saúde Pública 2007;23(9):2239-45. References Thus faced with this increasing impact of dyslipidemia on health conditions in the pediatric population, recommendations suggest that children be screened for risk factors in order to promote early identification of high levels of LDL-c and reduce cardiovascular events in young adults. 24 This notwithstanding, it is assumed that only 18% of this population receives this form of primary care. 25 The National Academy of Medicine of the United States recommends that children have access to healthy food and that parents and guardians offer nutritious foods that promote fullness. It is also necessary to increase time dedicated to practicing physical activities and reduce activities that stimulate sedentary behavior in the pediatric population. 26 With respect to treating dyslipidemia, it is estimated that changes involving lifestyle intervention are alternatives with excellent results and that they provoke positive response and adaptation, with treatment involving medication being used only in rare cases. 27 In the same manner, the results of our study suggest that these recommendations should continue during subsequent years to include the periods of adolescence and adulthood. We recognize the fact that the questionnaire was self‑reported by the schoolchildren as a limitation to this study, given that these reports may not be compatible with reality. Additionally, due to the cross-sectional design, it was not possible to show causality. The study includes the evaluations of schoolchildren in a municipality in the South of Brazil, which may not be representative of the reality of children and adolescents in other contexts. At the same time, this may be considered a strong point of our study, to the extent that it indicates that the high prevalence of dyslipidemia found corresponds to and even exceeds those which were indicated in studies in other territories of Brazil, providing a current estimate that the occurrence of this condition tends toward a growing increase. Furthermore, the study structurally explores variables that are relevant to schoolchildren’s cultural context, proposing estimates and describing factors that are apparently associated with the high prevalence of dyslipidemia in children and adolescents. The data thus permit health management organizations dedicated to children and adolescents to establish more precise guidelines for this population. Conclusion The results of this study show that there is a high prevalence of dyslipidemia in schoolchildren and that this is related to low cardiorespiratory fitness and cultural factors, especially those related to sedentary behavior. These findings highlight the need for interventions that promote healthy habits and lifestyles, beginning with the first years of childhood. Author contributions Conception and design of the research: Reuter CP, Brand C, Renner JDP, Franke SIR, Burgos MS; Acquisition of data: Reuter CP, Silva PT, Reuter EM, Renner JDP, Franke SIR, Burgos LT, Schneiders LB, Burgos MS; Analysis and interpretation of the data: Reuter CP, Brand C, Silva PT, Reuter EM, Renner JDP, Franke SIR, Mello ED, Burgos LT, Schneiders LB, Burgos MS; Statistical analysis: Reuter CP, Silva PT; Writing of the manuscript and Critical revision of the manuscript for intellectual content: Reuter CP, Brand C, Silva PT, Reuter EM, Renner JDP, Franke SIR, Mello ED, Schneiders LB, Burgos MS. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association The article is part of a research Programa de Pós-graduação em Promoção da Saúde of the Universidade de Santa Cruz do Sul (UNISC). Ethics approval and consent to participate This study was approved by the Ethics Committee of the Universidade Santa Cruz do Sul under the protocol number 2525/10. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 735