Abstract
ABSTRACTObjective: To establish waist circumference cut off points according to pubertal staging to identify overweight in adolescents. Methods: Longitudinal study approved by the Ethics Research Committee and conducted with 557 adolescents, aged 10 to 15 years old, selected from public schools. Waist, arm, neck and hip circumferences, body fat percentage, body mass index (BMI), height and blood pressure were measured. Pubertal staging was evaluated by Tanner self assessment scale. The Receiver Operating Characteristic Curve (ROC curve) was used to determine predictive power, sensitivity, specificity and waist circumference cut off points to detect overweight. Results: There was a positive correlation between waist circumference and weight, BMI, upper arm and hip circumferences, waist-to-hip ratio and blood pressure in both sexes. Cut off points for waist circumference according to pubertal stage as related to overweight in adolescents with the best performances in ROC curve were: 71.65 cm for prepubescent girls, 67.90 cm for pubescent girls, 70.25 cm for post pubescent girls, and 66.45 cm for pubescent boys. Age, weight, height, BMI, body fat percentage, arm and hip circumferences were associated to altered waist circumference. Conclusions: The establishment of cut off points for waist circumference according to pubertal staging was proven a good means to identify overweight. These cut off points can be considered reliable for the Brazilian adolescent population, as the isolated use of chronological age in adolescents may underestimate their nutritional status.
Highlights
According to the World Health Organization (WHO),[1] adolescents are individuals aged between 10 years and 19 years, 11 months and 29 days, characterized as going through intense physiological, psychosocial, behavioral, cultural, and emotional changes.[2,3] In puberty, hormonal changes responsible for the appearance of secondary elements and physical changes take place
Mean body mass index (BMI), HC, and BF% values were higher in girls, and NC was higher in boys
Across three years of research, pubertal staging progressed for subjects of both genders
Summary
According to the World Health Organization (WHO),[1] adolescents are individuals aged between 10 years and 19 years, 11 months and 29 days, characterized as going through intense physiological, psychosocial, behavioral, cultural, and emotional changes.[2,3] In puberty, hormonal changes responsible for the appearance of secondary elements and physical changes take place. The degree of physical development of adolescents cannot be solely determined by chronological age, since it is influenced by other environmental and intrinsic factors.[4]. Studies have shown that adolescents have inadequate food preferences, with high consumption of processed and ultra-processed foods, which may favor diseases such as obesity, diabetes, hypertension, and metabolic syndrome.[5,6,7] Obesity is explained as an inflammatory disease of multifactorial etiology, resulting from imbalance of energy balance and promoting accumulation of adipose tissue. Fat accumulation in the abdominal region implies increase in inflammatory adipokines, which, in turn, intensifies the risk of insulin resistance and the frequency of cardiovascular diseases.[5]
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