4. Discussion
lean mass, eating behavior, overweight, guilt
CARDIOVASCULAR DISEASES
Considering the main aim of the present study, which was to investigate the impacts of 12 weeks of family versus isolated multi-professional intervention on the diet of overweight adolescents, it was observed that both isolated and family participation showed a significant improvement in the level of food processing after the intervention period, i.e., both were effective in increasing the food quality of the adolescents participating in the present study.The main results found in the study were: (i) a time effect, with an increase in grams and calories in the consumption of fresh products; (ii) a time effect, with an increase in consumption in grams of minimally processed foods; (iii) a time effect, with reduced calorie consumption from processed foods; and (iv) a time effect, with a decrease in grams of ultra-processed foods, with all differences observed in the post-intervention period.On the other hand, significant differences in body mass, BMI, BMI z-score, consumption in kcals of fresh foods and consumption in grams of processed foods were not found. When investigating the intergroup differences, these differences were not found either. The results suggest that, regardless of family involvement, both groups showed positive results regardless of parental or guardian involvement.Family support can be complex, so support does not only imply encouraging participation together in activities but also changing the family’s habits at home [The progressive gain of autonomy during adolescence makes the individual susceptible to making good or not-good food choices regarding nutritional quality [In line with the present study, the literature presents similar results when evaluating the same variables of body mass, BMI and z-score [The consumption increases of fresh products and minimally processed foods, as well as the reduction of processed and ultra-processed, suggest that theoretical-practical interventions promoted an improvement in the food quality of adolescents; some parameters imply the promotion of healthy autonomy in food decisions and adherence to healthy behaviors. Recent evidence reinforces the need to increase the consumption of fresh and minimally processed foods, reducing the intake of processed and ultra-processed foods [The consistent improvement in these aspects, especially in adolescence, helps to prevent the manifestation of cardiovascular diseases [The adolescents in the present study participated in the activities during the COVID-19 pandemic with many municipal and state restrictions (between March to August/21). In this scenery, caregivers and adolescents had to adapt to the digital environment and experienced cases in which they were overloaded with household chores and work at home, influencing the search for ready-to-eat and quick-to-prepare food [However, the intake influence of certain foods is shaped by the availability at home and, because of this, the parenting style is directly reflected on the acquisition of certain behaviors [Thus, specific resources are necessary to adopt healthy eating habits, physical activities and emotional control [However, even if the family context can determine the environment, the transformation process requires the adolescent’s will and involvement [The answer to this question becomes broader since the multi-professional team will need to evaluate the profile of each adolescent and identify which intervention (family or isolated) can generate more adherence in changing eating behavior and encouraging physical activity. Family involvement can often be challenging and stressful due to demands, pressure, the shame of exposure to treatments, guilt, or even self-criticism, for example [Four limitations may be highlighted of this study: (i) not analyzing the power supply in the middle of the study to advise on possible irregularities; (ii) control of eating after one month of this study to verify whether the change in eating habits was persistent; (iii) a lack of other anthropometric measures, such as waist circumference, hip circumference, neck circumference, arm circumference, as well as body composition measurements (lean mass, fat mass and body fat percentage), as the body composition variables are positively correlated with BMI in adolescents [