Mastigação em crianças e adolescentes com sobrepeso ou obesidade: uma revisão sistemática

SANTOS, Renata Emmanuele Assunção; LACERDA, Diego Cabral; SILVA, Maria Giselda da; BARBOSA, Danielly Alves Mendes; PINHEIRO, Isabeli Lins; FERRAZ PEREIRA, Kelli Nogueira

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Sumário

Review • Rev Nutr 34 • 2021 • https://doi.org/10.1590/1678-9865202134e190201 copiar

Mastigação em crianças e adolescentes com sobrepeso ou obesidade: uma revisão sistemática

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Estudos têm demonstrado que alterações na mastigação estão relacionadas ao excesso de peso em crianças e adolescentes, o que pode levar ao aumento do consumo alimentar. O objetivo deste artigo foi caracterizar, através de uma revisão sistemática, a mastigação em crianças e adolescentes com sobrepeso ou obesidade. Para isso, dois autores independentes realizaram uma revisão sistemática nas bases de dados eletrônicas Medical Literature Analysis and Retrieval System Online, Scopus, Cumulative Index to Nursing and Allied Health, Web of Science e Literatura Latino-Americana e do Caribe em Ciências da Saúde. As características mastigatórias foram consideradas desfechos primários; os métodos de análise da mastigação, as características físicas dos alimentos/materiais utilizados nas análises e o tempo de jejum foram classificados como desfechos secundários. Esta revisão foi elaborada de acordo com os itens dos relatórios preferenciais para análise sistemática e metanálises. O protocolo de revisão sistemática foi submetido ao Registro Internacional Prospectivo de Revisões Sistemáticas. Nove artigos foram incluídos nesta revisão. Os resultados dos artigos revisados sugerem que crianças e/ou adolescentes com sobrepeso ou obesidade apresentam danos mastigatórios, pois possuem pior performance mastigatória e características miofuncionais orofaciais alteradas.

Palavras-chave
Adolescente; Criança; Mastigação; Obesidade; Sistema estomatognático

Author	Domains
Author	Study Question	Study Population	Comparability of Subjects	Exposure/ Intervention	Outcome Measure	Statistical Analysis	Results	Discussion	Funding
Pedroni-Pereira et al. [¹⁵15 Pedroni-Pereira A, Araujo DS, Scudine KGO, Prado DGA, Lima DANL, Castelo PM. Chewing in adolescents with overweight and obesity: an exploratory study with behavioral approach. Appetite. 2016;107:527-33. https://doi.org/10.1016/j.appet.2016.08.122 https://doi.org/10.1016/j.appet.2016.08.... ]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
Sun et al. [²⁴24 Sun KT, Chen SC, Li YF, Chiang HH, Tsai HH, Li CY, et al. Bite-force difference among obese adolescents in central Taiwan. J Formos Med Assoc. 2016;115(6):404-10. https://doi.org/10.1016/j.jfma.2015.05.007 https://doi.org/10.1016/j.jfma.2015.05.0... ]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
Berlese et al. [¹⁹19 Berlese DB, Copetti F, Weimmann ARM, Ferreira PF, Haefffner LSB. Myofunctional characteristics and electromyographic of obese children and adolescents. Rev Cefac. 2013;15(4):913-21. https://doi.org/10.1590/S1516-18462013000400020 https://doi.org/10.1590/S1516-1846201300... ]	⬤	⬤	◯	⬤	⬤	⬤	⬤	⬤	⬤
Araujo et al. [²²22 Araujo DS, Marquezin MCS, Barbosa TDS, Gavião MBD, Castelo PM. Evaluation of masticatory parameters in overweight and obese children. Eur J Orthod. 2016;38(4):393-7. https://doi.org/10.1093/ejo/cjv092 https://doi.org/10.1093/ejo/cjv092... ]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
Soares et al. [²³23 Soares ME, Ramos-Jorge ML, Alencar BM, Marques LS, Pereira LJ, Ramos-Jorge J. Factors associated with masticatory performance among preschool children. Clin Oral Investig. 2017;21(1):159-66. https://doi.org/10.1007/s00784-016-1768-5 https://doi.org/10.1007/s00784-016-1768-... ]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
Soares et al. [¹³13 Soares ME, Ramos-Jorge ML, Alencar BM, Oliveira SG, Pereira LJ, Ramos-Jorge J. Influence of masticatory function, dental caries and socioeconomic status on the body mass index of preschool children. Arch Oral Biol. 2017;81:69-73. https://doi.org/10.1016/j.archoralbio.2017.04.032 https://doi.org/10.1016/j.archoralbio.20... ]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
Souza & Guedes [²⁰20 Souza NC, Guedes ZCF. Mastigação e deglutição de crianças e adolescentes obesos. Rev Cefac. 2016;18(6):1340-7. https://doi.org/10.1590/1982-0216201618617015 https://doi.org/10.1590/1982-02162016186... ]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	◯
Sato & Yoshiike [¹⁴14 Sato N, Yoshiike N. Factors associated with the masticatory behavior of children assessed by the number of chews for a test meal of usual school lunch menu. Japanese J Nutr Diet. 2010;68(4):253-62. https://doi.org/10.5264/eiyogakuzashi.68.253 https://doi.org/10.5264/eiyogakuzashi.68... ]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
De Morais Tureli et al. [²⁵25 De Morais Tureli MC, De Souza Barbosa T, Gavião MBD. Associations of masticatory performance with body and dental variables in children. Pediatr Dent. 2010;32(4):283-8.]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤

Author	n	Age (years)	Methods of mastication analysis	Parameters analysed	Results
Pedroni-Pereira et al. [¹⁵15 Pedroni-Pereira A, Araujo DS, Scudine KGO, Prado DGA, Lima DANL, Castelo PM. Chewing in adolescents with overweight and obesity: an exploratory study with behavioral approach. Appetite. 2016;107:527-33. https://doi.org/10.1016/j.appet.2016.08.122 https://doi.org/10.1016/j.appet.2016.08.... ]	231	14 to 17	• Qualitative evaluation of mastication/Questionnaire “Quality of Masticatory Function” • Orofacial myofunctional evaluation. • Evaluation of masticatory performance • Bite Force Assessment • Oral Clinical Evaluation	• Food Consistency and eating Habits • Color change in a chewing gum • Maximum bite force • Protocol OMES-e, domain “mastication” • Presence of dental caries and malocclusion.	Girls with overweight/obesity (compared to normal weight girls): • Need to add liquid to food and consumption of fruit in small pieces. • Unilateral mastication. Girls and boys with overweight/obesity (compared to normal weight boys and girls): • There were no changes in masticatory performance. • They did not show differences in maximum bite force. • There were no differences related to the presence of dental caries and malocclusion.
Araujo et al. [²²22 Araujo DS, Marquezin MCS, Barbosa TDS, Gavião MBD, Castelo PM. Evaluation of masticatory parameters in overweight and obese children. Eur J Orthod. 2016;38(4):393-7. https://doi.org/10.1093/ejo/cjv092 https://doi.org/10.1093/ejo/cjv092... ]	204	8 to 10	• Qualitative evaluation of mastication/Questionnaire “Food Type Verification Protocol” • Bite Force Assessment • Oral Clinical Evaluation	• Food Consistency and eating Habits • Maximum bite force • Presence of dental caries and malocclusion	Girls and boys with overweight and with obesity (compared to eutrophic boys and girls): • There were no changes in the consistency of the food consumed. Girls and boys with higher BMI (through a correlation test). Less bite force. • Greater need for orthodontic treatment.
Soares et al. [²³23 Soares ME, Ramos-Jorge ML, Alencar BM, Marques LS, Pereira LJ, Ramos-Jorge J. Factors associated with masticatory performance among preschool children. Clin Oral Investig. 2017;21(1):159-66. https://doi.org/10.1007/s00784-016-1768-5 https://doi.org/10.1007/s00784-016-1768-... ]	279	3 to 5	• Qualitative evaluation of mastication/Food Registry for three days • Evaluation of masticatory performance • Oral Clinical Evaluation	• Food Consistency • Median particle size (X50) of a chewable material for masticatory function tests (Optocal) • Presence of cavitated teeth and malocclusion	Girls and boys with higher BMI (through a regression test): • Those who consumed more liquid foods presented worse masticatory performance. • Larger median food particle size (X50) expelled after twenty masticatory cycles. • Greater number of cavitated teeth (both anterior and posterior)
Sato & Yoshiiken [¹⁴14 Sato N, Yoshiike N. Factors associated with the masticatory behavior of children assessed by the number of chews for a test meal of usual school lunch menu. Japanese J Nutr Diet. 2010;68(4):253-62. https://doi.org/10.5264/eiyogakuzashi.68.253 https://doi.org/10.5264/eiyogakuzashi.68... ]	61	5 to 6	• Qualitative evaluation of mastication/Questionnaire formulated by the authors • Evaluation of masticatory performance • Bite Force Assessment • Oral Clinical Evaluation	• Eating Habits • Number of masticatory cycles, meal time and masticatory frequency • Maximum bite force • Presence of dental caries and malocclusion	Girls and boys with higher degree of obesity (through a correlation test): • They spent more time swallowing food and swallowing without chewing properly. • Less meal time and fewer masticatory cycles. • No changes were observed in the occlusion force. • There were no differences related to the presence of dental caries and malocclusion.
Sun et al. [²⁴24 Sun KT, Chen SC, Li YF, Chiang HH, Tsai HH, Li CY, et al. Bite-force difference among obese adolescents in central Taiwan. J Formos Med Assoc. 2016;115(6):404-10. https://doi.org/10.1016/j.jfma.2015.05.007 https://doi.org/10.1016/j.jfma.2015.05.0... ]	577	13 to 16	• Bite Force Assessment	• Maximum bite force	Girls with obesity: • Higher bite force than underweight and normal weight girls Overweight Boys: • Higher bite force than underweight, normal weight and obesity boys
Berlese et al. [¹⁹19 Berlese DB, Copetti F, Weimmann ARM, Ferreira PF, Haefffner LSB. Myofunctional characteristics and electromyographic of obese children and adolescents. Rev Cefac. 2013;15(4):913-21. https://doi.org/10.1590/S1516-18462013000400020 https://doi.org/10.1590/S1516-1846201300... ]	28	8 to 16	• Orofacial myofunctional evaluation • Electromyographic evaluation	• Protocol OMES – All domains • Electromyographic activity of the masseter and temporal muscles	Girls and boys with obesity (Compared to each other): • Orofacial myofunctional characteristics within normality • There was no difference in the mean electric activity of the muscles during rest, mastication, and swallowing
Soares et al. [¹³13 Soares ME, Ramos-Jorge ML, Alencar BM, Oliveira SG, Pereira LJ, Ramos-Jorge J. Influence of masticatory function, dental caries and socioeconomic status on the body mass index of preschool children. Arch Oral Biol. 2017;81:69-73. https://doi.org/10.1016/j.archoralbio.2017.04.032 https://doi.org/10.1016/j.archoralbio.20... ]	285	3 to 5	• Evaluation of masticatory performance • Evaluation of the deglutition threshold • Oral Clinical Evaluation	• Median particle size (X50) of a chewable material for masticatory function tests (Optocal) • Median particle size (X50) expelled before the desire to swallow the chewable material (Optocal) • Presence of dental caries and malocclusion	Girls and boys with higher BMI (through a regression test): • Larger median food particle size (X50) expelled after twenty masticatory cycles • Larger median food particle size (X50) during the evaluation of the swallowing threshold Girls and boys with lower BMI (through a regression test): • Less amount of dental caries
Souza & Guedes [²⁰20 Souza NC, Guedes ZCF. Mastigação e deglutição de crianças e adolescentes obesos. Rev Cefac. 2016;18(6):1340-7. https://doi.org/10.1590/1982-0216201618617015 https://doi.org/10.1590/1982-02162016186... ]	50	9 to 18	• Orofacial myofunctional evaluation	• Protocol OMES-e – All domains	Girls and boys with obesity (compared to eutrophic boys and girls): • Worse performance in the aspects of tonicity and mobility of the cheeks
De Morais Tureli et al. [²⁵25 De Morais Tureli MC, De Souza Barbosa T, Gavião MBD. Associations of masticatory performance with body and dental variables in children. Pediatr Dent. 2010;32(4):283-8.]	97	8 to 12	• Evaluation of masticatory performance	• Median particle size (X50) of a chewable material for masticatory function tests (Optocal)	Girls and boys with overweight/obesity (compared to boys and girls with normal weight and underweight): • Larger median food particle size (X50) expelled after twenty masticatory cycles

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[1] Correspondence to: K.N. FERRAZ PEREIRA. E-mail: kelliferraz@hotmail.com.