Combined influence of body mass index and waist circumference on coronary artery disease risk factors among children and adolescents.
ABSTRACT In adult populations, it is recognized widely that waist circumference (WC) predicts health risk beyond that predicted by BMI alone; current recommendations for adults are that a combination of BMI and WC be used to classify obesity-related health risk. For children and adolescents, however, little is known about the combined influence of BMI and WC on health outcomes. The objectives of this study were to determine whether BMI and WC predict coronary artery disease (CAD) risk factors independently for children and adolescents and to assess the clinical utility of using WC in combination with BMI to identify CAD risk.
Subjects included 2597 black and white, 5- to 18-year-old, male and female youths. Outcome measures included 7 CAD risk factors. In the first analysis step, BMI and WC were used as continuous variables to predict CAD risk factors. In the second analysis step, participants were placed into normal-weight, overweight, and obese BMI categories and, within each BMI category, CAD risk factors were compared for groups with low and high WC values.
When BMI and WC were included in the same regression model to predict CAD risk factors, the added variance above that predicted by BMI or WC alone was minimal, which indicated that BMI and WC did not have independent effects on the risk factors. For example, for systolic blood pressure, BMI alone explained 7.3% of the variance, WC alone explained 7.7% of the variance, and the combination of BMI and WC explained 8.1% of the variance. When BMI and WC values were categorized with a threshold approach, WC provided information on CAD risk beyond that provided by BMI alone, particularly when the categories were used to predict elevated CAD risk factor levels. For instance, in the overweight BMI category, the high-WC group was approximately 2 times more likely to have high triglyceride levels, high insulin levels, and the metabolic syndrome, compared with the low-WC group.
These findings provide some evidence that a combination of BMI and WC should be used in clinical settings to evaluate the presence of elevated health risk among children and adolescents.
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ABSTRACT: To describe the percentile values for body mass index (BMI), waist circumference (WC) and waist-to-height (WHtR) of children from Colombo, Brazil, and compare them with data of children from other countries. This was a cross-sectional study with a random sample of 2,035 children aged 6-11 years. Age-and sex-specific smoothed percentiles curves for BMI, WC and WHtR were created using the LMS method. Values of 10(th), 50(th) and 90(th) percentiles from Brazilian children were compared with data from other countries. There was a trend of increasing BMI and WC with age in both sexes. WHtR remained constant with advancing age in boys and girls. Comparison of the growth pattern among countries showed clear differences. Southern Brazil boys and girls had elevated 90(th) percentile values for BMI, which was similar to German children and higher than the North American and World Health Organization percentile values. However, children from this study had intermediate values for WC and WHtR in comparison to children from other countries. Elevated BMI values were observed among southern Brazilian children, but WC and WHtR percentile values were lower in southern Brazilian children than in children from other countries. Interventions at different levels should be made to avoid a probable increase of nutritional disorders (especially general obesity) in the next years. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.
Revista Paulista de Pediatria 12/2014; 32(4):333-341. DOI:10.1016/j.rpped.2014.04.002
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ABSTRACT: African American adolescents experience higher rates of obesity and have an increased risk of obesity-related diseases than do White American adolescents. Despite culturally sensitive obesity preventive interventions, obesity rates are increasing within the African American adolescent population. Current obesity interventions do not usually address the heterogeneity (e.g., socioeconomic status [SES], gender, and residential status differences) within the African American adolescent community that can affect the efficacy of these interventions. To examine the gender, SES, and residential status differences related to obesity and weight behaviors in African American adolescents. A descriptive correlational study was conducted with 15- to 17-year-old African American adolescents (n = 145) from community clinics, youth organizations, churches, and social networks in metropolitan and inner-city Detroit. Data were collected through use of survey methods and analyzed with use of descriptive statistics, independent sample t tests, and multiple regression equations. Female adolescents consumed foods higher in fat and calories (t = -2.36, p = .019) and had more body fat (t = -9.37, p = .000) than did males. Adolescents of lower SES consumed food higher in fat and calories (t = -2.23, p = .027) and had higher body mass (t = -2.57, p = .011) than did adolescents of higher SES. Inner-city African American adolescents had higher levels of physical activity (t = -2.39, p = .018) and higher body mass (t = 2.24, p = .027) than did suburban African American adolescent counterparts. Gender, SES, and residential status were statistically significant predictors of eating behaviors, physical activity, body mass index, and body fat. The initial findings from the study will assist in better understanding the obesity epidemic that affects African American adolescents in disparate proportions. Further examination of the study variables is essential to serve as a basis for developmentally appropriate and culturally relevant targeted interventions with this population. Health care providers and obesity researchers who work with youth can use the initial findings from this study to advocate for healthy lifestyles while reducing the obesity disparity within the African American adolescent population. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.Journal of Pediatric Health Care 01/2015; DOI:10.1016/j.pedhc.2014.11.005 · 1.97 Impact Factor