20 An electronic scale with a 100-gram resolution, calibrated before the measurements, was used to measure body mass. Children were weighed standing barefoot, wearing shorts and T-shirts. A portable stadiometer with a 1-mm resolution fixed to a wall without baseboard was used to measure height, taking as

reference points the vertex and the plantar regions, following the procedures described by Lohman.21 BMI was determined by the formula: weight (kg) divided by height (m) squared. Anthropometric measurements were performed twice by the same examiner, using a third measurement and calculating the mean, in case TGFbeta inhibitor of disagreement. The Pediatric Quality of Life Inventory (PedsQL 4.0, generic version for children22) Alpelisib was used to assess

the health-related quality of life, after being validated for the Brazilian population.23 The PedsQL 4.0 comprises 23 items divided into four domains (physical, emotional, social, and school). Questions are answered according to a scale from 0 to 4 (never, almost never, sometimes, many times/often, almost always) and regarding the last month experienced by the child. The items are measured and converted to a linear scale from 0 to 100, yielding a mean; the higher the score, the better the quality of life.22 The overall quality of life is determined by the mean of all domains, while the psychosocial aspect is determined by the mean score of the social, emotional, and school domains. The questionnaire was designed to assess the dimensions of physical, mental, and social health, following the proposal of the WHO, considering the role of the school domain.23 The instrument has two parallel questionnaire Chlormezanone formats, one for children and one for parents. This study considered only the version for children (self-report). The intervention program consisted of physical exercises with recreational activities, and nutritional counseling to children and parents, for 12 consecutive weeks. The physical exercises were performed in a gym and on a field (twice weekly) and a pool (once weekly), at the Sports

Center (Centro de Desportos –CDS) of the Universidade Federal de Santa Catarina (UFSC), Brazil. Nutritional guidelines were given in a classroom of the CDS/UFSC (one session per week). The exercises were performed in three weekly sessions, lasting 60 minutes each, totaling 36 sessions. Each session consisted of stretching/warm-up (5-10 minutes), aerobic exercises (40-45 minutes), and cool-down (5-10 minutes). The exercises were pre-programmed, developed by two physical education professionals and one physical education student, and consisted of moderate to vigorous intensity recreational activities.12 and 19 The main focus of the planned activities was recreational and aerobic characteristics.