Abstract
Objective To examine changes in measures of adiposity and determine the prevalence of excess adiposity in relation to height in school children between 2010 and 2020. Methods 5–12-year-old urban school-age children participated in two cross-sectional surveys in 2010 (n = 1274) and 2020 (n = 1550). Standard procedures were used for anthropometric measurements. Changes in BMI, waist circumference (WC), and waist-to-height ratio (WHtR) and the corresponding proportions of children with excess adiposity were analyzed and adjusted for design variables (class and school type) and age. Children were classified according to quartiles of height z-score and prevalence of excess adiposity estimated across each quartile. Results There was a 2.4% and 3.3% increase in adjusted mean BMI and WC, respectively, between 2010 and 2020. The prevalence of central overweight/obesity (WC) and WHtR ≥ 0.5 increased by 7.3% (X2 = 27.151, p < 0.001) and 5.3% (X2 = 26.117, p < 0.001), respectively, between the two surveys except BMI overweight/obesity. The odds of excess adiposity significantly increased in 2020 for central overweight/obesity (WC) (OR 2.8, 95% CI 2.0–3.6) and WHtR ≥ 0.5 (OR 1.8, 95% CI 1.3–2.4) and not for BMI overweight/obesity (OR 1.3, 95% CI 0.8–1.7). The prevalence of BMI overweight/obesity significantly increased from 33% in 2010 to 51.5% in 2020 in the fourth quartile of height z-score (X2 = 19.198, p < 0.001). Similarly, the prevalence of central overweight/obesity (WC) significantly increased from 23.5% in 2010 to 42.4% in 2020 in the fourth quartile of height z-score (X2 = 18.733, p < 0.001). Conclusion Central overweight/obesity has increased more than BMI overweight/obesity over the last decade. Children with a higher height-for-age tend to accumulate more adiposity. Objective monitoring of adiposity levels and height of children is needed in future to identify groups for targeted intervention and prevention of chronic diseases.
Highlights
Results. ere was a 2.4% and 3.3% increase in adjusted mean Body mass index (BMI) and waist circumference (WC), respectively, between 2010 and 2020. e prevalence of central overweight/obesity (WC) and waist-to-height ratio (WHtR) ≥ 0.5 increased by 7.3% (X2 27.151, p < 0.001) and 5.3% (X2 26.117, p < 0.001), respectively, between the two surveys except BMI overweight/obesity. e odds of excess adiposity significantly increased in 2020 for central overweight/obesity (WC) and WHtR ≥ 0.5 and not for BMI overweight/obesity. e prevalence of BMI overweight/obesity significantly increased from 33% in 2010 to 51.5% in 2020 in the fourth quartile of height z-score (X2 19.198, p < 0.001)
Our analysis indicated that there is no significant change in the prevalence of BMI overweight/obesity over time. is is contrary to a report by Lazzeri et al [30], which indicated that BMI overweight/obesity decreased over a ten-year period in Tuscan school children. e authors highlighted different initiatives that could have contributed to the decrease including official dietary guidelines, nutrition recommendations, national surveillance, and programmes aimed at encouraging fruit and vegetable intake in children
Our current analysis indicates that this association has persisted over time when BMI and WC are used to assess adiposity suggesting that tallness could predict both the level and distribution of adiposity in children
Summary
Recent studies in the Littoral and North West Regions among school-age children have shown prevalence estimates of 14.4% [10] and 17.6% [11], respectively. A recent nationwide survey indicated that the highest prevalence of overweight/obesity in children is in the Grassfield area of the country that includes the North West Region and West Region [12]. A study had suggested that WHtR is an easy-to-use measure of central adiposity, and it would prevent the misclassification of many muscular children as overweight/obese that occurs when BMI is used [17]. Is study was undertaken to examine recent trends in BMI, WC, and WHtR and determine the prevalence of excess adiposity in relation to stature in two samples of school children between 2010 and 2020 in the NWR of Cameroon
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