Waist Circumference Standard Deviation Score Research Articles

Determinants and Predictors of Body Fat in Indian Children and Adolescents.

To study determinants and predictors of body fat in Indian children and adolescents. In this cross-sectional study, 5175 children and adolescents [3014 boys, age 12.8 (3) y, 5-18 y] participated. Determinants and predictors of body fat were assessed using partial correlation (corrected for age, and gender) and linear regression. Fat percentage correlated negatively with the duration of physical activity (r = -0.091, p < 0.01) and sleep (r = -0.044, p = 0.01) and positively with parental body mass index (BMI) (r = 0.202, p < 0.01 for father and r = 0.235, p < 0.01 for mother), and birth weight (r = 0.050, p < 0.01). On linear regression, fat percentage was positively associated with parental BMI and birth weight, and negatively with physical activity and sleep duration. All adiposity markers [BMI standard deviation score (SDS) (r = 0.863, p < 0.01), weight SDS (r = 0.827, p < 0.01) waist to height ratio (r = 0.819, p < 0.01), waist circumference SDS (r = 0.765, p < 0.01) wrist circumference (r = 0.21, p < 0.01), and neck circumference (r = 0.19, p < 0.01)] correlated significantly with fat percentage, showing highest correlation with BMI SDS. Reduced sleep and physical activity are the key modifiable risk factors for adiposity. BMI SDS is the best clinical surrogate of body fat in Indian children and adolescents. There is a need to explore the impact of lifestyle interventions targeting sleep and physical activity on adiposity.

Anthropometric Markers and Iron Status of 6-12-Year-Old Thai Children: Associations and Predictors.

Introduction Obesity may be associated with poor iron status. The objective of this study was to investigate the association between different indices of iron status and anthropometric measurements in Thai children. Materials and Methods Anthropometry (weight, height, waist circumference (WC), and body composition assessed by bioelectrical impedance analysis) and iron indices were measured in 336 Thai children aged 6–12 years. Iron deficiency (ID) was defined using two or more of the following: (1) %transferrin saturation (%Tsat) < 16%; (2) serum ferritin (SF) < 15 μg/mL; and (3) soluble transferrin receptor (sTfR) > 5 mg/L. Iron deficiency anaemia (IDA) was defined as haemoglobin < WHO age cutoff combined with ID. Overweight and obesity were defined as body mass index (BMI) standard deviation score (SDS) ≥ +1 SDS or +2 SDS, respectively (WHO growth reference). Results BMI SDS was significantly positively correlated with sTfR and SF (sTfR, r: 0.209, p < 0.001; SF, r: 0.214, p < 0.001) and negatively correlated with %Tsat (r: −0.132, p = 0.013). Correlations between WC SDS and %fat mass and each iron marker were similar. The percentage with low SF was significantly lower than that using other individual markers. ID prevalence was not significantly different between normal-weight and overweight/obesity groups although a significantly higher proportion of overweight/obese children had sTfR >5 mg/L. Puberty and menarche were significant predictors of ID (puberty adjusted OR: 2.20, 95% CI: 0.43, 11.25; menarche adjusted OR: 6.11, 95% CI: 1.21, 30.94). Conclusion Greater adiposity was associated with poorer iron status. However, SF may not be a good indicator of iron status in Thai children, particularly in those who are overweight/obese, whereas sTfR merits further investigation.

Lifestyle intervention for children and adolescents with severe obesity - results after one year.

Lifestyle interventions for children and adolescents with severe obesity show moderate short-term effects on weight reduction internationally. We evaluated treatment results at two Norwegian specialist outpatient clinics. We performed a retrospective analysis of data from children and adolescents between 3 and 18 years of age collected in 2012-2016. Children and adolescents with severe obesity who attended their one-year follow-up were included. We included in the analyses the following body weight measures: percentage overweight as defined by the International Obesity Task Force cut-off (% IOTF-25); BMI standard deviation score; waist circumference standard deviation score; and body fat percentage at the start of treatment and at one-year follow-up. Of 568 children and adolescents who started treatment, 416 (73%) attended the one-year check-up. A total of 271 (65%) patients achieved a reduction in %IOTF-25, while 228patients (55%) reduced their BMI standard deviation score. There was a statistically significant mean reduction of all four registered body weight measurements. Altogether 54 of 325 children (17%) changed category from severe obesity to obesity, 8 (2%) went from severe obesity to overweight, and 8 of 91 children (9%) changed category from obesity to overweight or normal weight. The proportion of participants with a reduction of more than 5% in %IOTF-25 was 43% (177/416), and a reduction in BMI standard deviation score of more than 0.25 was observed in 23% (95/416) of participants. Girls responded on average more poorly to the intervention than boys. There was no clinically significant difference in results between the treatment centres. After one year of treatment of children and adolescents with severe obesity in two specialist healthcare centres, we found a moderate mean reduction in weight, waist circumference and body fat percentage, but with large interindividual variation.

Cluster randomised controlled trial and economic and process evaluation to determine the effectiveness and cost-effectiveness of a novel intervention [Healthy Lifestyles Programme (HeLP)] to prevent obesity in school children

BackgroundApproximately one-third of children in England leave primary school overweight or obese. There is little evidence of effective obesity prevention programmes for children in this age group.ObjectiveTo determine the effectiveness and cost-effectiveness of a school-based healthy lifestyles programme in preventing obesity in children aged 9–10 years.DesignA cluster randomised controlled trial with an economic and process evaluation.SettingThirty-two primary schools in south-west England.ParticipantsChildren in Year 5 (aged 9–10 years) at recruitment and in Year 7 (aged 11–12 years) at 24 months’ post-baseline follow-up.InterventionThe Healthy Lifestyles Programme (HeLP) ran during the spring and summer terms of Year 5 into the autumn term of Year 6 and included four phases: (1) building a receptive environment, (2) a drama-based healthy lifestyles week, (3) one-to-one goal setting and (4) reinforcement activities.Main outcome measuresThe primary outcome measure was body mass index (BMI) standard deviation score (SDS) at 24 months post baseline measures (12 months post intervention). The secondary outcomes comprised waist circumference SDS, percentage body fat SDS, proportion of children overweight and obese at 18 and 24 months, accelerometer-assessed physical activity and food intake at 18 months, and cost-effectiveness.ResultsWe recruited 32 schools and 1324 children. We had a rate of 94% follow-up for the primary outcome. No difference in BMI SDS was found at 24 months [mean difference –0.02, 95% confidence interval (CI) –0.09 to 0.05] or at 18 months (mean difference –0.02, 95% CI –0.08 to 0.05) between children in the intervention schools and children in the control schools. No difference was found between the intervention and control groups in waist circumference SDS, percentage body fat SDS or physical activity levels. Self-reported dietary behaviours showed that, at 18 months, children in the intervention schools consumed fewer energy-dense snacks and had fewer negative food markers than children in the control schools. The intervention effect on negative food markers was fully mediated by ‘knowledge’ and three composite variables: ‘confidence and motivation’, ‘family approval/behaviours and child attitudes’ and ‘behaviours and strategies’. The intervention effect on energy-dense snacks was partially mediated by ‘knowledge’ and the same composite variables apart from ‘behaviours and strategies’. The cost of implementing the intervention was approximately £210 per child. The intervention was not cost-effective compared with control. The programme was delivered with high fidelity, and it engaged children, schools and families across the socioeconomic spectrum.LimitationsThe rate of response to the parent questionnaire in the process evaluation was low. Although the schools in the HeLP study included a range of levels of socioeconomic deprivation, class sizes and rural and urban settings, the number of children for whom English was an additional language was considerably lower than the national average.ConclusionsHeLP is not effective or cost-effective in preventing overweight or obesity in children aged 9–10 years.Future workOur very high levels of follow-up and fidelity of intervention delivery lead us to conclude that it is unlikely that school-based programmes targeting a single age group can ever be sufficiently intense to affect weight status. New approaches are needed that affect the school, the family and the wider environment to prevent childhood obesity.Trial registrationCurrent Controlled Trials ISRCTN15811706.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 6, No. 1. See the NIHR Journals Library website for further project information.

Irisin is a biomarker for metabolic syndrome in prepubertal children.

The aim of the present study was to evaluate the association of irisin with obesity and metabolic syndrome (MetS) in Korean prepubertal children. A total of 96 children and adolescents aged 6 to 10 years (56 males) were included in this study. Subjects were divided into 3 groups: normal weight (n = 54), overweight (n = 16), and obese (n = 26). In the subgroup analyses, overweight/obese children were further divided based on their MetS status (with MetS vs. without MetS). Children with obesity tended to exhibit a lower mean irisin concentration compared to those with normal weight (p = 0.028). Using Pearson's correlation coefficient to compare all the children in the study, there was a significant inverse correlation between irisin and body mass index (BMI) standard deviation scores (SDS) (r = -0.210, p = 0.041), waist circumference SDS (r = -0.203, p = 0.049), and glucose (r = -0.296, p = 0.004). In the subgroup analyses of overweight/obese children, irisin exhibited a significant inverse correlation with glucose (r = -0.507, p = 0.001) and triglycerides (r = -0.331, p = 0.033). Children with MetS exhibited lower irisin concentrations than those without MetS (14.70 ng/mL vs. 22.02 ng/mL, p = 0.001), and these associations were significant after adjusting for age, gender, and BMI SDS (14.51 ng/mL vs. 22.06 ng/mL, p = 0.002). The irisin level of 15.43 ng/mL was determined to be a possible cutoff to distinguish children with metabolic syndrome from overweight/obese children, with a sensitivity of 75% and a specificity of 94% (p < 0.001). Our results suggest that decreased irisin levels may be associated with MetS in prepubertal children and that irisin might be a biomarker for MetS in prepubertal children.

Serum galectin-1 levels are positively correlated with body fat and negatively with fasting glucose in obese children

Galectin-1, a recently identified peptide, is primarily released from the adipose tissue. Although galectin-1 was shown to have an anti-inflammatory effect, its specific function is not clearly understood. We aimed to evaluate the relationship of serum galectin-1 levels with clinical and laboratory parameters in childhood obesity. A total of 45 obese children (mean age: 12.1±3.1years) and 35 normal-weight children (mean age: 11.8±2.2years) were enrolled. Clinical [body mass index (BMI), waist circumference (WC), percentage of body fat and blood pressure] and biochemical [glucose, insulin, lipids, galectin-1, high-sensitive C-reactive protein (hsCRP) and leptin levels] parameters were assessed. Serum galectin-1, hsCRP and leptin levels were significantly higher in obese children than those in normal-weight children (12.4 vs 10.2ng/mL, p<0.001; 3.28 vs 0.63mg/L, p<0.001; 8.3 vs 1.2ng/mL, p<0.001, respectively). In obese children, galectin-1 levels correlated negatively with fasting glucose (r=−0.346, p=0.020) and positively with fat mass (r=0.326, p=0.026) and WC standard deviation score (SDS) (r=0.451, p=0.002). The multivariate regression analysis demonstrated that serum galectin-1 levels were significantly associated with fasting glucose and WC SDS. This study showed that obese children had significantly higher galectin-1 levels in proportion to fat mass in obese cases than those in healthy children, which may be interpreted as a compensatory increase in an attempt to improve glucose metabolism.

Height-obesity relationship in school children in Sub-Saharan Africa: results of a cross-sectional study in Cameroon.

BackgroundIn developed nations, taller children exhibit a greater propensity to overweight/obesity. This study investigates whether this height-adiposity relationship holds true for Cameroon children using two parameters of adiposity including body mass index (BMI) and waist circumference (WC).MethodsIn 557 children (287 boys and 270 girls, mean age 9.0 ± 1.8 years) from the North West Region of Cameroon height, weight and WC were measured and BMI calculated. Variables were converted to standard deviation scores (SDS). Participants were divided into quartiles of height SDS, then mean of age and sex-standardized body fat parameters compared across quartiles. The frequency of excess adiposity was calculated within each quartile. Correlation and regression analysis were used to assess height-adiposity relationships.ResultsMultiple comparisons indicated a significant increase in mean BMI (−0.08 to 0.65) and WC (−0.11 to 0.87) SDSs with increasing quartiles of height SDS. Frequency of overweight/obesity and abdominal overweight/obesity was highest among children with highest height SDS (30.2 – 33.1%) and lowest in their shortest peers (0.7 – 5.0%). There was a linear relationship between height SDS and BMI SDS (R2 = 0.087, p < 0.001); height SDS and WC SDS (R2 = 0.356, p < 0.001) among both boys and girls.ConclusionsThis study shows that in Cameroon just as in developed economies a higher height SDS is associated with a higher frequency of overweight/obesity. This is independent of the parameter used to evaluate overweight/obesity (BMI SDS or WC SDS).

Interrelationships between anthropometric variables and overweight in childhood and adolescence.

ObjectivesTo answer the questions: how does body mass index (BMI) correlate to five overweight related anthropometric variables during different ages in childhood, and which anthropometric variables contribute most to variation in BMI during childhood?MethodsData on BMI, height (H), sitting height (SH), waist circumference (WC), waist to height ratio (WHtR), waist to sitting height ratio (WSHtR), subscapular skinfold (SSF), and triceps skinfold (TSF), from 4,576 Norwegian children 4.00–15.99 years of age, were transformed to standard deviation scores (SDS) and studied using correlation and multiple regression analyses.ResultsThe correlations between BMI SDS and the standardized anthropometric variables were in general strong and positive. For all variables, the correlations were weakest in the youngest age group and highest between 7 and 12 years. WC SDS and WHtR SDS were most strongly correlated with BMI SDS through all ages and in both sexes. A model with seven anthropometric variables adjusted for age and sex explained 81.4% of the variation in BMI SDS. When adjusted for all other variables, WC SDS contributed most to the variation in BMI SDS (b = 0.467, CI [0.372, 0.562]). Age group, but not sex, contributed significantly to variation in BMI SDS.ConclusionThe interrelationships between BMI SDS and five standardized overweight related anthropometric variables were dependent on age, being weakest in the youngest age group. Independent of sex and age, WC SDS was in this study superior to other anthropometric variables in contributing to variation in BMI SDS during childhood. Am. J. Hum. Biol. 26:502–510, 2014. © 2014 The Authors American Journal of Human Biology Published by Wiley Periodicals, Inc.

Appetite for Prevention

Appetite for Prevention

Acknowledgements

Short leg length (LL) and childhood obesity have been independently associated with a higher risk for adult disease. However, the contribution of relative LL to overweight and obesity in children remains an under-researched area. To utilize data from a large cross-sectional anthropometric survey to assess the association of LL to height ratio (LLHR, leg length/height) with measures of overweight and obesity in British children. Children were analysed from the bottom and top body mass index (BMI) standard deviation score (SDS) quartiles (3825 children, boys=1686) or waist circumference (WC) SDS quartiles (3824 children, boys=1687). The top quartile was defined as the 'high' BMI or WC SDS group and the lower bottom quartile as the 'low' BMI or WC SDS group. Height and LL were expressed as SDSs using current references and LLHR was calculated. Children in the 'high' groups were taller with longer legs but had a lower LLHR across most ages. The magnitude of the difference was greater for BMI than WC in both genders. Altered body dimensions appear to be linked to measures of overweight and obesity in children but longitudinal studies are needed to confirm this suggestion.

Association of leg length with overweight and obesity in children aged 5–15 years: A cross-sectional study

Background: Short leg length (LL) and childhood obesity have been independently associated with a higher risk for adult disease. However, the contribution of relative LL to overweight and obesity in children remains an under-researched area.Aim: To utilize data from a large cross-sectional anthropometric survey to assess the association of LL to height ratio (LLHR, leg length/height) with measures of overweight and obesity in British children.Methods: Children were analysed from the bottom and top body mass index (BMI) standard deviation score (SDS) quartiles (3825 children, boys=1686) or waist circumference (WC) SDS quartiles (3824 children, boys=1687). The top quartile was defined as the ‘high’ BMI or WC SDS group and the lower bottom quartile as the ‘low’ BMI or WC SDS group. Height and LL were expressed as SDSs using current references and LLHR was calculated.Results: Children in the ‘high’ groups were taller with longer legs but had a lower LLHR across most ages. The magnitude of the difference was greater for BMI than WC in both genders.Conclusion: Altered body dimensions appear to be linked to measures of overweight and obesity in children but longitudinal studies are needed to confirm this suggestion.

Assessment of obesity status in outpatients from three disease states

To assess obesity status in patients with cystic fibrosis (CF), human immunodeficiency virus (HIV) and various metabolic disorders (MD), through comparison against a) UK reference data and b) contemporary healthy children. Weight, height, waist circumference (WC), and triceps (TRI) and sub-scapular (SUBS) skinfold thickness were measured in a total of 57 healthy, 49 HIV, 68 MD and 49 CF children. Using published reference data, standard deviation scores (SDS) were calculated. CF patients had weight, height and BMI SDS significantly below zero. MD patients had height SDS significantly below, and BMI SDS significantly above, zero. Healthy children had BMI SDS significantly above zero. In all three patient groups and healthy children, TRI and WC SDS were significantly above zero. SUBS SDS was also significantly above zero in patients with MD and HIV. WC SDS was greater in patients than in healthy children, but only significantly so for the MD children. In all three patient groups, even those associated with reduced stature or reduced weight, indices of fatness were significantly increased relative to reference data. The tendency to central fatness was evident in healthy children, but was more extreme in patients, especially those with MD.