Abstract
BackgroundEvidence indicates that central adiposity has increased to a higher degree than general adiposity in children and adolescents in recent decades. However, waist circumference is not a routine measurement in clinical practice.ObjectiveThis study aimed to determine the prevalence of abdominal obesity based on waist circumferences (WC) and waist to height ratio (WHtR) in Spanish children and adolescents aged 6 to 17 years. Further, the prevalence of abdominal obesity (AO) among normal and overweight individuals was analyzed.DesignData were obtained from a study conducted from 1998 to 2000 in a representative national sample of 1521 children and adolescents aged 6 to 17 years (50.0% female) in Spain. WC and WHtR measurements were obtained in addition to BMI. AO was defined as WHtR ≥0.50 (WHtR-AO), sex and age specific WC≥90th percentile (WC-AO1), and sex and age specific WC cut-off values associated with high trunk fat measured by by dual-energy X-ray absorptiometry (WC-AO2).ResultsIOTF- based overweight and obsity prevalence was 21.5% and 6.6% in children and 17.4% and 5.2% in adolescents, respectively. Abdominal obesity (AO) was defined as WHtR≥0.50 (WHtR-AO), sex- and age-specific WC≥90th percentile (WC-AO1), and sex- and age-specific WC cut-off values associated with high trunk fat measured by dual-energy X-ray absorptiometry (WC-AO2). The respective prevalence of WHtR-AO, WC-AO1, and WC-AO2 was 21.3% (24.6% boys; 17.9% girls), 9.4% (9.1% boys; 9.7% girls), and 26.8% (30.6% boys;22.9% girls) in children and 14.3% (20.0% boys; 8.7% girls), 9.6% (9.8% boys; 9.5% girls), and 21.1% (28.8% boys; 13.7% girls) in adolescents.ConclusionThe prevalence of AO in Spanish children and adolescents is of concern. The high proportion of AO observed in young patients who are normal weight or overweight indicates a need to include waist circumference measurements in routine clinical practice.
Highlights
The childhood obesity epidemic is one of the greatest current challenges for health policy
Abdominal obesity (AO) was defined as waist to height ratio (WHtR)$0.50 (WHtR-abdominal obesity (AO)), sex- and age-specific waist circumference (WC)$90th percentile (WC-AO1), and sex- and age-specific WC cut-off values associated with high trunk fat measured by dual-energy X-ray absorptiometry (WC-AO2)
Prevalence of WHtR-abdominal obesity was higher than general obesity based on IOTF definition
Summary
The childhood obesity epidemic is one of the greatest current challenges for health policy. The prevalence of abdominal obesity varied from 3.8% to 33.2% in the countries studied This wide range is due in part to actual population differences and in part to differences in surrogate measures of abdominal adiposity and the cut-off points used to define abdominal obesity. Data from the Bogolusa Heart Study showed a high cardiometabolic risk among normal and overweight children with abdominal obesity compared to overweight children without excessive abdominal fat accumulation [5]. National and international guidelines recommend the use of percentile cut-off points of weight and height based on country-specific growth charts to identify children and adolescents at cardiometabolic risk [6,7]. Waist circumference is not a routine measurement in clinical practice
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