Preliminary data on the association between waist circumference and insulin resistance in children without a previous diagnosis.
ABSTRACT The aim of the present work was to study the association between different anthropometric parameters and insulin resistance (IR) in Spanish schoolchildren without a previous diagnosis. A total of 443 Spanish schoolchildren (9-11 years of age) were studied in this cross-sectional study. The anthropometric measurements collected were weight, height, body circumferences and skinfolds. Body mass index (BMI), waist/hip ratio, percentage body fat and fat-free body mass were determined. Overnight-fasted blood lipids, insulin and glucose levels were analysed, and estimation of IR, taking into account the homeostasis model assessment (HOMA), was calculated. The children with IR had higher serum triglycerides and insulin levels, were heavier and taller, and had a higher BMI, a larger waist circumference, a larger hip circumference, a larger waist/hip ratio and thicker bicipital and tricipital skinfolds than those who did not have IR. Age, sex, BMI and waist circumference explained 32.0% of the variance in the HOMA values; only sex, triglycerides and waist circumference independently influenced this variable. A 1-cm increase in waist circumference was associated with approximately a 3.8% increase in the mean HOMA value. The children with a waist circumference of over the p90 for their age and sex were at greater risk of showing IR as measured by the HOMA: odds ratio = 6.94 (2.01-23.91; P < 0.001). In conclusion, according to these results, waist circumference is the best anthropometric parameter associated with IR in children, and those with a waist circumference of over the p90 for their age and sex would appear to be at particular risk.
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ABSTRACT: The purpose of this study was to examine the prevalence of obesity over time in the same individuals comparing body mass index (BMI), waist circumference (WC) and waist to height ratio (WHtR). Five year longitudinal repeated measures study (2005-2010). Children were aged 11-12 (Y7) years at baseline and measurements were repeated at age 13-14 (Y9) years and 15-16 (Y11) years. WC and BMI measurements were carried out by the same person over the five years and raw values were expressed as standard deviation scores (sBMI and sWC) against the growth reference used for British children. Mean sWC measurements were higher than mean sBMI measurements for both sexes and at all assessment occasions and sWC measurements were consistently high in girls compared to boys. Y7 sWC = 0.792 [95% confidence interval (CI) 0.675-0.908], Y9 sWC = 0.818 (95%CI 0.709-0.928), Y11 sWC = 0.943 (95%CI 0.827-1.06) for boys; Y7 sWC = 0.843 (0.697-0.989), Y9 sWC = 1.52 (95%CI 1.38-0.67), Y11 sWC = 1.89 (95%CI 1.79-2.04) for girls. Y7 sBMI = 0.445 (95%CI 0.315-0.575), Y9 sBMI = 0.314 (95%CI 0.189-0.438), Y11 sBMI = 0.196 (95%CI 0.054-0.337) for boys; Y7 sBMI = 0.353 (0.227-0.479), Y9 sBMI = 0.343 (95%CI 0.208-0.478), Y11 sBMI = 0.256 (95%CI 0.102-0.409) for girls. The estimated prevalence of obesity defined by BMI decreased in boys (18%, 12% and 10% in Y 7, 9 and 11 respectively) and girls (14%, 15% and 11% in Y 7, 9 and 11). In contrast, the prevalence estimated by WC increased sharply (boys; 13%, 19% and 23%; girls, 20%, 46% and 60%). Central adiposity, measured by WC is increasing alongside a stabilization in BMI. Children appear to be getting fatter and the additional adiposity is being stored centrally which is not detected by BMI. These substantial increases in WC are a serious concern, especially in girls.Public health 11/2013; · 1.26 Impact Factor
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ABSTRACT: This paper updates a British Nutrition Foundation (BNF) Briefing Paper on this topic, published in 2011. Healthy eating and being physically active are particularly important for children and adolescents. This is because their nutrition and lifestyle influence their wellbeing, growth and development. There remains considerable room for improvement in the diets of British schoolchildren, according to findings of the government's National Diet and Nutrition Surveys (NDNS), but some improvements have been made in the past decade. Although intakes of saturated fatty acids and non-milk extrinsic sugars have decreased in recent years, on average, they are still above recommended upper levels. Average contribution of fat to total energy intake has dropped below the recommended upper level of 35%, but fibre intakes remain low. With regard to micronutrients, many teenage girls are consuming low amounts of iron, but there is also evidence of low intakes of vitamin A, riboflavin, calcium, magnesium, potassium, selenium, iodine and zinc. New data on micronutrient status is now available for 11–18 year-olds, and reveals low levels of vitamin D, riboflavin and iron (mainly in girls). Low vitamin D intake and status is a particular problem in some ethnic minority groups, especially South Asian children. There is also some evidence of socio-economic inequalities; for example, children from families with higher incomes tend to have higher intakes of fruits and vegetables compared with children from families with lower incomes. This paper also discusses how dietary patterns can influence the micronutrient intake and status of schoolchildren, as well as the risk of overweight and obesity. Since publication of the Briefing Paper in 2011, new physical activity guidelines have been published and, for the first time, these are UK-wide guidelines. Also for the first time, UK-wide data on physical activity levels in schoolchildren are available (for 7-year-old children). Physical activity levels vary little between the UK regions, with the exception of Northern Ireland where fewer children meet the UK recommendations than in other regions. The data highlight significant differences between boys and girls (with girls generally being less active) and significant differences between ethnic groups. In particular, children from the Bangladeshi, Indian and Pakistani ethnic groups are less likely to meet the recommended levels of physical activity compared with other children. Obesity remains a major problem among British schoolchildren and there is a stark socio-economic gradient, with levels of obesity being highest in the most socially deprived children. This paper also discusses various health issues in children, including iron deficiency anaemia, oral health, bone development, food allergy and intolerance, and cognitive function in children, updating the previous paper with the latest statistics and evidence. The findings of the NDNS serve to emphasise the importance of a whole school approach to good nutrition embracing the school curriculum as well as the food and drink available in schools (as highlighted in the recently published School Food Plan). School food provision has seen many changes over recent years, with school food standards now in place in all UK regions, most recently Wales. Various evaluations of the impact of school food standards, mainly in England, have highlighted improvements in the diets of schoolchildren, not only in the school setting but in their diets overall. However, there remains room for improvement. This paper also briefly describes a selection of initiatives and organisations of relevance to child nutrition.Nutrition Bulletin 02/2014;
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ABSTRACT: Objective:It has been suggested that childhood obesity is inversely associated with deprivation, such that the prevalence is higher in more deprived groups. However, comparatively few studies actually use an area-level measure of deprivation, limiting the scope to assess trends in the association with obesity for this indicator. Furthermore, most assume a linear relationship. Therefore, the aim of this study was to investigate associations between area-level deprivation and three measures of adiposity in children: body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR).Design:This is a cross-sectional study in which data were collected on three occasions a year apart (2005-2007).Subjects:Data were available for 13 333 children, typically aged 11-12 years, from 37 schools and 542 lower super-output areas (LSOAs).Measures:Stature, mass and WC. Obesity was defined as a BMI and WC exceeding the 95th centile according to British reference data. WHtR exceeding 0.5 defined obesity. The Index of Multiple Deprivation affecting children (IDACI) was used to determine area-level deprivation.Results:Considerable differences in the prevalence of obesity exist between the three different measures. However, for all measures of adiposity the highest probability of being classified as obese is in the middle of the IDACI range. This relationship is more marked in girls, such that the probability of being obese for girls living in areas at the two extremes of deprivation is around half that at the peak, occurring in the middle.Conclusion:These data confirm the high prevalence of obesity in children and suggest that the relationship between obesity and residential area-level deprivation is not linear. This is contrary to the 'deprivation theory' and questions the current understanding and interpretation of the relationship between obesity and deprivation in children. These results could help make informed decisions at the local level.International Journal of Obesity advance online publication, 12 February 2013; doi:10.1038/ijo.2013.2.International journal of obesity (2005) 02/2013; · 5.22 Impact Factor