Abstract
Objective: To perform a comparative analysis of the nutritional status of schoolchildren assessed by two international standards. Methods: In 2011 a cross-sectional survey on a nationally representative sample of 4360 schoolchildren aged 6 - 18 years was conducted. Height and weight were measured. Overweight and obesity of schoolchildren were assessed by BMI, using the WHO Growth Reference 2007 and the IOTF standard 2000. The prevalence of overweight and obesity in the schoolchildren evaluated by each standard was compared. Results: The combined prevalence of overweight and obesity in the studied children according to the WHO reference standards was 30.2% versus 25.3% established by the IOTF standard. Values for obesity were respectively 12.7% and 8.4%. The overweight prevalence in all studied age groups (6-9; 10-13; 14-18) assessed on the basis of WHO reference values was similar compared to those for pre-obesity evaluated by the IOTF standards. The obesity prevalence among children was evaluated at higher values when WHO reference values were applied as the differences in obesity prevalence were significant for boys aged 6-9 years (IOTF -11.1%, WHO 20.4%) and 10-13 years (IOTF 9.6%, WHO 17.1%) and for girls aged 10-13 years (IOTF 6.7%, WHO 10.8%). Conclusion: The differences between rates of obesity in children and adolescents assessed by the most applied standards represent challenges in the current evaluation of obesity and related health risks in this age at individual and national level.
Highlights
The assessment of the growth and development of children and adolescents based on anthropometric indices is a prerequisite for determination of child nutritional and health status[1,2].The anthropometric data received in the study of schoolchildren in Bulgaria is a basis for planning, conducting and evaluating the intervention programs related to health and nutrition promotion[3].The currently used child growth standards in Bulgaria were created on the basis of a study conducted 30 years ago (1980-1982) in a representative sample of practically healthy children, the recruited children were only of a Bulgarian ethnic origin[4]
The mentioned standards and their application do not result in an adequate assessment of overweight and obesity because only the Height-for-age (HA) and Weight-for-age (WA) anthropometric indices are included in the Bulgarian standards, while the international criteria Weight-for-Height and Body Mass Index have not been used
The aim of the present study is to perform a comparative analysis of the nutritional status of children and adolescents in Bulgaria assessed by an anthropometric indicator (Body Mass Index) following the WHO Growth Reference5 2007 and the International Obesity Task Force standard[6] (IOTF) 2000
Summary
The assessment of the growth and development of children and adolescents based on anthropometric indices is a prerequisite for determination of child nutritional and health status[1,2].The anthropometric data received in the study of schoolchildren in Bulgaria is a basis for planning, conducting and evaluating the intervention programs related to health and nutrition promotion[3].The currently used child growth standards in Bulgaria were created on the basis of a study conducted 30 years ago (1980-1982) in a representative sample of practically healthy children, the recruited children were only of a Bulgarian ethnic origin[4]. The assessment of the growth and development of children and adolescents based on anthropometric indices is a prerequisite for determination of child nutritional and health status[1,2]. The mentioned standards and their application do not result in an adequate assessment of overweight and obesity because only the Height-for-age (HA) and Weight-for-age (WA) anthropometric indices are included in the Bulgarian standards, while the international criteria Weight-for-Height and Body Mass Index have not been used. The aim of the present study is to perform a comparative analysis of the nutritional status of children and adolescents in Bulgaria assessed by an anthropometric indicator (Body Mass Index) following the WHO Growth Reference5 2007 and the International Obesity Task Force standard[6] (IOTF) 2000
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