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Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot study

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Dietetics, Universidad Central de Venezuela, Email gbauce@hotmail.com Received: December 05, 2017 | Published: August 20, 2018 Abstract Is a review of indicators to measure obesity in children and adolescents, such as the index of body mass (BMI), waist circumference (CC) and index weight - waist circumference (P/ CC), and compare the results. Sample: of 304 children between 6 and 18years of age, 128 of Caracas, 139 of Mérida and 37 of Valencia, of fourth educational institutions, Objective: to compare three indicators that measure overweight and obesity. Method: it is a descriptive, transversal study correlational; applied descriptive measures of association and correlation, the variables age, weight, height, waist circumference (WC), hip (C DAC) circumference, measured and calculated indicators: body mass mass index (BMI), waist to hip rate (ICC) and index Peso-circumference waist (P/CC). Results: According to CDC for BMI, 9.87% at risk of overweight, and 5.26% overweight; average of 65 CC, 92±7, 78cm, and percentile increases with age; average P/DC 0, 67±0, 11, higher in males and evidence sexual dimorphism from the age of 15. (R>0.70) correlations were obtained between weight-ccin.; weight c cad. BMI-weight; P/CC-age, height, weight and c cad. Conclusions: BMI remains a good indicator to assess overweight and obesity, DC complements the evaluation, but there is still no matching criteria for reference values; index P/CC, can be useful, since it discriminates by gender and correlated with age, weight, height, BMI, C hip. Keywords: children, teens, BMI, waist circumference, index weight-waist circumference. MOJ Biology and Medicine R
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Introduction
As already mentioned, in many studies before, the problem of
obesity in children and adolescents has been a concern for national
and international organizations, due to the fact that it has increased
considerably in recentyears, so much so that has called “public health
problem”, both in developed countries, and in underdeveloped countries.
The WHO, in its technical report 894, states that individuals who
have excess abdominal fat, have a risk to health, as a result of obesity;
also refers that there are additional tools to assess obesity, such as
underwater weight, magnetic resonance imaging, double watermark;
which have practical difculties for their use, coupled with high costs.1
In the same report, he reports that comorbidities of obesity include
coronary heart disease, high blood pressure and stroke, certain
types of cancer, non-insulin-dependent diabetes, diabetes mellitus,
gallbladder disease, dyslipidemia, osteoarthritis and gout, and lung
diseases, including sleep apnea.1
It must be taken into account that the body mass index (BMI),
which has been useful for the evaluation in adults, has recently been
recommended for the evaluation of children and adolescents. In the
same way, different groups of experts and international organizations
have set themselves the task of proposing reference standards of
the IMC for international use; among them the Centers for Disease
Control and Prevention (CDC) of the United States of America and the
Working Group on Obesity (IOTF) of the World Health Organization.2
With regard to waist circumference, the results obtained in
the studies that have been carried out in countries such as Brazil,
Spain, the United States, England and Italy show that, in children
and adolescents, waist circumference is a good indicator of central
obesity, with clinical and epidemiological utility.3 A cardiological
study conducted in Bogalusa, shows that in the case of children,
from 5 to 17years, the distribution of abdominal fat, measured by
waist circumference, is associated with abnormal concentrations of
triglycerides, low and high density lipoproteins and insulin.4 Likewise,
in a study conducted by Barreira et al, they found an association
between waist circumference and fat mass, as well as between waist
circumference and abdominal subcutaneous area and visceral adipose
tissue.5
In Venezuela, there is talk of children between 7 and 14years
old, with an incidence of 19.31% with overweight (above the 90th
percentile), and particularly in the Capital District, the gure is 23.26%.6
In a study of overweight and obesity in Venezuela, conducted by the
INN, they say that for the population of 7 to 12years, there are 17.57%
overweight and 9.87% of obesity nationwide; and for the group of 13
to 17years, they report a 12.03% of overweight and a 9.33% of obesity;
They also report that when the sample is discriminated in the group
of 7 to 17years, a higher prevalence of overweight and obesity was
observed in males, with gures of 15.32% and 10.63%, respectively.7
This increase in malnutrition has its possible causes in the so-called
demographic and nutritional transition, reected in changes in the diet
(high consumption of carbohydrates) and a decrease in individual
physical activity, which has been very accelerated in recentyears,
and It is also typical of developing regions, which has resulted in the
presence of malnutrition, obesity and overweight, a situation that also
leads to an increase in deaths from CVD, cancer, hypertension and
cerebrovascular diseases.7,8
Considerando que se ha incrementado la incidencia de sobrepeso
y obesidad en la población infantil de Venezuela en los últimos diez
años, se ha planteado la posibilidad de realizar un estudio en el cual
se incluyan otros índices, con el n de disponer de otros indicadores
para evaluar a esta población, en cuanto a sobrepeso y obesidad,
particularmente, si son indicadores mucho más fácil de calcular, y
conables.
MOJ Biol Med. 2018;3(3):120125. 120
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Three indicators for overweight and obesity: BMI,
CC and P/CC-index in children and adolescents:
Pilot study
Volume 3 Issue 3 - 2018
Gerardo Bauce
School of Nutrition and Dietetics, Universidad Central de
Venezuela, Venezuela
Correspondence: Gerardo Bauce, School of Nutrition and
Dietetics, Universidad Central de Venezuela,
Email gbauce@hotmail.com
Received: December 05, 2017 | Published: August 20, 2018
Abstract
Is a review of indicators to measure obesity in children and adolescents, such as the index
of body mass (BMI), waist circumference (CC) and index weight - waist circumference (P/
CC), and compare the results. Sample: of 304 children between 6 and 18years of age, 128 of
Caracas, 139 of Mérida and 37 of Valencia, of fourth educational institutions, Objective: to
compare three indicators that measure overweight and obesity. Method: it is a descriptive,
transversal study correlational; applied descriptive measures of association and correlation,
the variables age, weight, height, waist circumference (WC), hip (C DAC) circumference,
measured and calculated indicators: body mass mass index (BMI), waist to hip rate (ICC)
and index Peso-circumference waist (P/CC). Results: According to CDC for BMI, 9.87% at
risk of overweight, and 5.26% overweight; average of 65 CC, 92±7, 78cm, and percentile
increases with age; average P/DC 0, 67±0, 11, higher in males and evidence sexual
dimorphism from the age of 15. (R>0.70) correlations were obtained between weight-ccin.;
weight c cad. BMI-weight; P/CC-age, height, weight and c cad. Conclusions: BMI remains
a good indicator to assess overweight and obesity, DC complements the evaluation, but
there is still no matching criteria for reference values; index P/CC, can be useful, since it
discriminates by gender and correlated with age, weight, height, BMI, C hip.
Keywords: children, teens, BMI, waist circumference, index weight-waist circumference.
MOJ Biology and Medicine
Research Article Open Access
Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot
study 121
Copyright:
©2018 Bauce
Citation: Bauce G. Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot study. MOJ Biol Med.
2018;3(3):120125. DOI: 10.15406/mojbm.2018.03.00086
Materials and methods
A descriptive, cross-sectional and correlational study was carried
out, in which a group of schoolchildren selected by a randomized
procedure was used as a sample, from three cities: Caracas, Mérida
and Valencia, where schoolchildren from educational institutions of
each school were chosen. the cities, El Libertador de Caracas, 128
schoolchildren, Father Madariaga and Los Próceres in Mérida, 139
schoolchildren, and Los Maitines in Valencia, 37 schoolchildren,
who made up a sample of 304 children and adolescents, between
6 and 18years old, with the same number of them of each sex. The
variables age, weight, height, waist circumference, hip circumference
were measured, and the indicators were calculated: Body Mass Index
(BMI), Waist-Hip Index (BCI) and Weight-Circumference Waist
Index (IPCC). For the evaluation, the criterion suggested by the
WHO for the BMI9 was considered, based on the mean and deviation,
with the categories: overweight+1SD<BMI≤+2 SD, obesity
BMI>2DE; the CDC criteria for CC,10 based on the percentiles, with
categories cc<5% (Decit); 5%≤P/CC<85% (Normal); 85%≤P/
CC<95% (Overweight risk) and P/CC≥95% (Overweight), and
for the hip weight-waist index (P/CC), there are no references, as
it is a new index that is experiment in this pilot study. However,
the criterion suggested by the CDC for waist circumference was
used to classify this index, because it is based on the percentiles.
Descriptive and correlation statistics were determined, according to
the variables that were related.
Results
In Table 1 & Table 2, the averages of the anthropometric variables
of the students are presented, it can be seen that the averages are
higher for the male sex; Likewise, it can be observed that, very
interestingly, the averages decrease at 12years in males and at 17years
in females. In addition, all the variables behave in a similar way, since
they increase as the age advances. These differences become visible
when the graphic representation is observed, and it can be seen in
Figure 1, how the waist and hip circumferences behave, by sex, being
very similar during the rstyears and differentiating from the age of
18. In the same way, it is necessary to visualize the Figure 2, it is
observed that the waist/hip index, behaves in a similar way during
the rstyears, but then accentuates at 17years, evidencing the sexual
dimorphism. In the classication, according to the WHO criteria, of
the BMI, by sex, and there is a very high percentage (74.79%) of
schoolchildren classied as normal weight; 8.88% overweight and
4.14% with Obesity.
Table 1 Average of the variables size, weight, waist circumference, hip circumference. Schoolchildren from three cities of Venezuela
Sex nAge Size Weight Waist circumference Hip circumference
3 9 139,47±5,03 36,67±15,09 64,67±15,89 75,33±13,47
M 14 10 139,58±3,55 38,14±13,05 66,97±14,93 76,52±14,15
A 38 11 144,34±10,16 38,18±14,07 63,49±13,99 74,86±12,10
S 28 12 148,35±7,67 38,52±8,95 62,10±6,17 73,95±7,14
C 16 13 153,36±4,71 47,38±8,60 69,75±8,06 83,48±8,78
U 18 14 161,38±8,51 52,85±8,15 71,27±6,45 83,58±5,71
L 11 15 164,53±5,69 52,56±7,86 68,40±5,03 83,02±5,44
I 12 16 169,21±7,83 63,92±11,78 76,22±6,63 91,74±8,12
N 11 17 169,85±7,06 63,94±12,08 73,54±7,32 88,2±6,07
O 1 18 187,00±0,00 76,00±0,00 77,90±0,00 99,80±0,00
Total 153,36±12,31 46,25±13,47 67,63±8,66 80,01±9,67
3 9 135,10±6,43 31,50±12,29 60,37±10,23 72,47±12,70
28 10 140,19±8,46 37,73±9,61 62,10±6,85 76,84±9,22
F 33 11 147,27±7,15 38,44±7,16 61,75±5,85 78,74±6,45
E 38 12 150,25±5,84 42,29±7,35 63,28±5,39 81,15±7,08
M 14 13 152,93±2,67 46,87±6,59 65,53±7,39 85,90±5,22
E 9 14 154,00±4,99 45,11±5,93 64,63±4,48 82,12±5,91
N 11 15 156,87±4,96 52,45±9,23 69,34±7,28 90,46±7,48
I 9 16 155,56±6,17 55,33±5,76 71,11±3,92 91,79±4,42
N 4 17 152,80±3,84 50,50±7,22 69,95±8,35 87,05±5,65
O 1 18 161,20±0,00 58,50±0,00 70,60±0,00 95,00±0,00
Total 148,36±9,21 42,55±9,81 64,12±6,69 81,36±8,86
Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot
study 122
Copyright:
©2018 Bauce
Citation: Bauce G. Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot study. MOJ Biol Med.
2018;3(3):120125. DOI: 10.15406/mojbm.2018.03.00086
Table 2 Promedio de las variables índice cintura/cadera, IMC e índice peso/circunferencia de cintura. Escolares de tres ciudades de Venezuela
Sex nAge Waist / hip index IMC Weight / waist circumference
3 9 0,85±0,07 18,54±6,16 0,55±0,09
M 14 10 0,87±0,04 19,49±6,88 0,56±0,07
A 38 11 0,85±0,05 18,14±5,40 0,59±0,08
S 28 12 0,84±0,04 17,31± 2,46 0,61±0,09
C 16 13 0,84±0,03 20,14±3,61 0,68±0,07
U 18 14 0,85±0,05 20,24±2,35 0,74±0,08
L 11 15 0,82±0,03 19,32 ±1,87 0,77±0,07
I 12 16 0,83±0,03 22,29± 3,65 0,83±0,10
N 11 17 0,83±0,05 22,07± 3,41 0,86±0,10
O 1 18 0,78±0,00 21,73±0,00 0,98±0,00
Total 0,85±0,04 19,29±3,50 0,67±0,13
3 9 0,83±0,3 16,95±4,96 0,51± 0,11
28 10 0,81±0,04 18,99±3,42 0,60±0,09
F 33 11 0,78±0,05 17,62±2,38 0,63±0,09
E 38 12 0,78±0,03 18,66±2,56 0,66± 0,07
M 14 13 0,76±0,05 20,01±2,47 0,71±0,04
E 9 14 0,79±0,03 19,04±2,45 0,70±0,05
N 11 15 0,77±0,04 21,21±2,79 0,75±0,06
I 9 16 0,78±0,04 22,88±2,25 0,78±0,06
N 4 17 0,80±0,6 21,70±3,70 0,72±0,02
O 1 18 0,74±0,00 22,51±0,00 0,83±0,00
Total 0,79±0,04 19,13±3,14 0,66±0,10
Figure 1 Cirncunferencias de Cintura y Cadera, según sexo. Escolares de tres ciudades, Venezuela.
The school children were classied according to the BMI value,
according to the WHO, and the averages of the waist and hip
circumferences are considerably higher (81.78±5.69cm, 96.19±4,
98cm, respectively) for school children who are in the obesity category;
while the averages of the CC and Weight/CC index are slightly higher in
the obese group (0.85±0.06 and 0.79±0.11, respectively). In addition,
we have that the averages are statistically signicant (p<0.001), for
waist circumference, hip circumference and weight/C waist index.
With regard to waist circumference, the average is 65.92±7.89cm, for
the total sample, being 67.63±8.66 in males, higher than the average
of females (64, 12±6.69), which is statistically signicant (p<0.001).
When the waist circumference is evaluated, by means of the
Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot
study 123
Copyright:
©2018 Bauce
Citation: Bauce G. Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot study. MOJ Biol Med.
2018;3(3):120125. DOI: 10.15406/mojbm.2018.03.00086
percentiles suggested by the CDC, the value increases as the age
advances, in addition, the Differences are more accentuated in
the percentile values at 10, 12 and 17years, in the case of males
(Figure 3). Regarding the behavior of the percentiles, in the case
of females, the behavior is similar to that of males, with the
difference that the values are more distant at 17years (Figure 4).
We proceeded to classify the P/CC index, according to the criterion
suggested by the CDc for the CC, since it is the one that ts most
for this index, because it is based on the percentiles, and we have
that with the risk of overweight. 9.87% and overweight there are
5.26% of school children. The P/CC index resulted in an average
of 0.67±0.11, with average values of 0.6733±0.1275 for males and
0.6569±0.0989 for females, which are not statistically signicant
It was also observed that when the P/CC index is discriminated by sex,
it increases as age progresses, and evidences more notable differences
after 15years, in the male sex. As for the female sex, it increases as
the age increases, and the differences are evident up to 16years, and
at 17years, tend to approach. Very good correlations (r≥0.70) were
obtained between waist circumference with weight and with hip
circumference; hip circumference with weight, body mass index with
weight, waist circumference and hip circumference; the P/C Waist
and Age Index, the Size, the Weight and the C Hip. In addition to
the P/C Waist index, the distribution behaves approximately normal
(p<0.001); and the behavior of this index, is similar to the behavior of
the waist circumference and the hip circumference, as well as the hip
waist index. When considering the classication of BMI, according to
the WHO, and classifying schoolchildren according to the P/C Waist
index is ≥0.78, based on the 85th percentile, to consider that they are
at risk, and<0.78 to consider that it is not At risk, it was obtained
that 259 schoolchildren, who represent 85.20% have no risk, and 45
schoolchildren, who represent 14.80% are at risk.
Figure 2 Índices Cintura/Cadera y Peso/C Cintura, según sexo. Escolares de tres ciudades, Venezuela.
Figure 3 Percentiles de Circunferencia de Cintura por edad, sexo masculino. Escolares de tres ciudades de Venezuela.
Figure 4 Percentiles de Circunferencia de Cintura por edad, sexo femenino. Escolares de tres ciudades de Venezuela.
Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot
study 124
Copyright:
©2018 Bauce
Citation: Bauce G. Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot study. MOJ Biol Med.
2018;3(3):120125. DOI: 10.15406/mojbm.2018.03.00086
Discussion
It is known that today, overweight and obesity, has become a public
health problem in underdeveloped and developing countries,2 therefore;
Likewise, it is known that obesity in childhood and adolescence has
reached epidemic proportions in the Americas región.11 On the other
hand, it is necessary to agree with the results of the ENCA 2012,
cited by López-Blanco et al (2014), the Venezuelan diet is of low
quality, safety and innocuousness, which consolidates a known diet
pattern as obesogenic, which contributes to overweight and obesity.12
In view of the above, to evaluate both overweight and obesity in
children and adolescents, the present study was carried out, where the
BMI indicators, Circumference of the Waist, Hip Circumference, and
a new index that was obtained as the relationship between the Weight
and the Circumference of Waist, in order to compare them, and to
have reliable indicators to evaluate the obesity. First, we obtained,
for the aforementioned indicators, averages differentiated by sex, with
higher results in men, with the exception of the hip circumference,
these results; however, they are not signicant, except for the waist
circumference that is signicantly higher in children (p<0.0001), a
result that agrees with that obtained by Mederico et al. As for the
averages of the height by age, both in the case of males and females,
they are slightly lower than those obtained by Mederico et al, likewise
with weight averages, although these are slightly higher than 16,
17 and 18years, in this study.13 The average BMI of the sample is
19.23±3.29 (kg/m2) is, and for males it is 19.29±3.50 (kg/m2), while
for females it is 19 , 13±3.14 (kg/m2), which are not statistically
signicant, and in both sexes, are lower than those reported by
Cordero et al.,14 but the average in males is higher and in females less,
as reported by Cossio-Bolaños et al.15 The averages are considered
by age groups, according to sex, and only weight (p<0.01) and height
(p<0.001) for the group of 13 to 16years and waist circumference are
statistically signicant. (p<0.001) for the group of 10 to 12years; in
addition, the averages of the four variables, both in males and females,
are greater than those obtained by Benjumea et al.16 Additionally,
there is a 5.26% is classied as obese, a percentage lower than that
reported by NHANES, which for the period 2007-2008 is 16.9%, for
children and young people from 2 to 19years, who they are above the
95th percentile.17
Regarding the waist circumference, it is noteworthy that the
reference values differ according to the authors, so for example
Hirschler et al.,18 refers that the CC can be useful to predict metabolic
syndrome in children, considering a value>75th percentile ; in
which case, for the group studied there is a value of CC>70.65cm
and>72.38cm in males and females respectively, it would suggest
that 70 students are candidates to suffer from metabolic syndrome.
The average waist circumference by sex is 67.63±8.66 (cm) and
64.21±6.65 (cm) in males and females, respectively, lower than
those obtained by Mederico, and those reported by Cordero et al.,14
likewise, the average of the cc for the whole group is of 65.92±7.89
(cm), which is lower than that obtained by Hidalgo et al.,19 and also
when comparing the percentile values, the 25th and 50th percentiles are
similar, and the 75th percentile is slightly lower. On the other hand,
it was obtained that the averages of the cc by sex are statistically
signicant (p<0,001). When considering percentiles by age for waist
circumference, these increase with age in both sexes, coinciding
with the results obtained by Esquivel Lauzurique et al.,20 although
slightly higher in men, and differ signicantly (p<0.001) in the 85th,
90th and 95th percentiles. When considering by age groups with the
results obtained by Benjumea et al.,16 it is possible that the averages
of waist circumference obtained in this study are greater in both
sexes, although they are not statistically signicant among them. In
relation to the Weight/CC index, it has been classied based on the
average and the standard deviation established the catagories: Severe
decit (<0.44), Moderate decit (0.44≤p/CC<0.55), Normal (0.55≤P/
CC<0.78), overweight (0.78≤P/CC<0.90) and Obesity (≥0.90), with
the following percentages by category: 1.32%, 16.45%, 68.09%,
11.51% and 2.63%, respectively, corresponding to an approximately
normal distribution. When classifying the values of the P/CC index
by percentiles, we have that the 75th percentile is 0.74, if we take into
account the suggested by Hirscler et al (3) for the waist circumference,
and according to this criterion , schoolchildren are classied, in no
risk and risk, in such a way that those who have an index of 0.74 or
more are at risk; and there are only 32 esolares, who represent 10,
.53%, classied as risk, a percentage higher than that obtained by
applying the above criterion.
Conclusion
It has been shown that physical activity plays an important role in
the prevention of obesity and exercise levels high enough to counteract
excessive caloric intake are needed.10 The BMI is still a good indicator
to assess overweight and obesity in children and adolescents;
however, there is a tendency to use other indicators such as waist
circumference, which has allowed for a new element to evaluate the
school population and prevent metabolic syndrome;18 but nevertheless
there is no agreement as to the criterion to be used to classify in no
risk and risk; since there are several criteria, such as suggesting the
percentiles by age and sex.13 The P/C Waist index can be a useful
indicator to detect obesity, particularly due to its easy calculation and
behavior, since it has been proven that sexual dimorphism can be
veried when discriminating by age (Figure 2). In addition, for this
particular group, it was found to behave approximately as a normal
distribution (p<0.001), in addition it is highly correlated with weight,
height and hip circumference (r>0.80) and moderately with age and
BMI (p>0.69).
Acknowledgements
None.
Conict of interest
The author declares no conict of interest.
References
1. WHO. Obesity: Preventing and Managing the global epidemic. Technical
Report Series 894. 2000. 252 p.
2. Kaufer-Horwitz M, Toussaint G. Indicadores antropométricos para
evaluar sobrepeso y obesidad en pediatría. Bol Med Hosp Infant Mex.
2008;65:502–518.
3. Hirschler V, Delno AM, Clemente G, et al. ¿Es la circunferencia de
cintura un componente del síndrome metabólico en la infancia? Arch
argent pediatr. 2005;103(1):7–13.
4. Freedman DS, Serdula MK, Srinivasan SR, et al. Relation of
circumferences and skinfold thicknesses to lipid and insulin
concentrations in children and adolescents: the Bogalusa Heart Study.
American Journal of Clinical Nutrition. 1999;69(2):308–317.
5. Barreira TV, Broyles ST, Gupta AK, et al. Relationship of Anthropometric
Indices to Abdominal and Total Body Fat in Youth: Sex and Race
Differences. Obesity (Silver Spring). 2014;22(5):1345–1350.
Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot
study 125
Copyright:
©2018 Bauce
Citation: Bauce G. Three indicators for overweight and obesity: BMI, CC and P/CC-index in children and adolescents: Pilot study. MOJ Biol Med.
2018;3(3):120125. DOI: 10.15406/mojbm.2018.03.00086
6. Briceño-Iragorry L, Valero B G, Briceño LA. Obesidad ¿Es una realidad
en Venezuela? Epidemiología Pandemia del siglo XXI. Ponencia de la
Academia Nacional de Medicina Venezuela 2012. In: Muci-Mendoza R,
Briceño-Iragorry, editors. Colección Razetti. 2012. 120(2):128–134.
7. INN. Sobrepeso y Obesidad en Venezuela (Prevalencia y Factores
condicionantes). Colección Lecciones Institucionales. Ediciones Gente
de Maíz. Caracas, 2010.
8. Uauy R, Albalá C, Kaín J. Obesity trends in Latin America: Transiting
from under-to overweight. J Nutr. 2001;131(3):893S–899S.
9. USAID. Tablas de IMC y tablas de IMC para la edad, de niños(as) y
adolescentes de 5 a 18 años de edad y tablas de IMC para adultos(as)
no embarazadas, no lactantes ≥ 19 años de edad. Food and Nutrition
Technical Assistance. 2013.
10. CDC. Anthropometric Reference Data for Children and Adults: United
States, 2011–2014. Data from the National Health and Nutrition
Examination Survey. U.S. Department of health and human services.
11. OMS. Plan de acción para la prevención de la obesidad en la niñez y la
adolescencia. 53o Consejo Directivo de la OPS y 66a Sesión del Comité
Regional de la OMS. 2014.
12. LOPEZ DE BLANCO Mercedes, Landaeta-Jimenez Maritza, Herrera
Cuenca Marianella, et al. La doble carga de desnutrición y obesidad en
Venezuela. An Venez Nutr [online]. 2014;27(1):77–87.
13. Mederico M, Paolia M, Zerpa Y, et al. Valores de referencia de la
circunferencia de la cintura e índice de la cintura/cadera en escolares
y adolescentes de Mérida, Venezuela: comparación con referencias
internacionales. Endocrinol Nutr. 2013;60(5):235–242.
14. Cordero MR, Rodríguez A, Hernández C, et al. Biomarcadores
cardiometabólicos e indicadores antropométricos de adiposidad en
adolescentes escolares. VITAE. Academia Biomédica Digital. Facultad
de Medicina. Universidad Central de Venezuela; 2015. 62:1–10.
15. Marco Antonio Cossio-Bolaño MA, Abella CP, Arruda M. Valoración de
la adiposidad corporal de escolares en Arequipa, Perú. Revista Peruana
de Medicina Experimental y Salud Pública. 2012:29(4).
16. Benjumea R María V, Molina de S Dora I, Arbeláez B Patricia E, et al.
Circunferencia de la cintura en niños y escolares manizaleños de 1 a 16
años. Rev Col Cardiol. 2008;15(1):23–34.
17. Disease Control and Prevention (CDC). Understanding Nutrition:
Primer Module on Overweight and Obesity. 2011. 3 p.
18. Hirschler V, Maccallini G, Calcagno M, et al. Waist circumference
identies primary school children with metabolic syndrome
abnormalities. Diabetes Technol Ther. 2007;9(2):149–157.
19. Hidalgo Glida, Flores-Torres Jessica, Rodríguez-Morales Alfonso J, et
al. Determinación de puntos de corte para la circunferencia de cintura
a través de curvas ROC en población pediátrica de tres regiones
de Venezuela evaluada en el SENACREDH. Arch Venez Puer Ped
[Internet]. 2011;74(3):95–99.
20. Esquivel Lauzurique Mercedes, Rubén Quesada Mercedes, González
Fernández Ciro, et al. Curvas de crecimiento de la circunferencia de
la cintura en niños y adolescentes habaneros. Rev Cubana Pediatr.
2011;83(1):44–55.
... Para el IPCC, por tratarse de un nuevo indicador, se consideró mejor clasificar al grupo, según el promedio y la desviación estándar, sugerido por Bauce, que en el caso de niños y adolescentes, está basado en los percentiles y la media y la desviación, y las categorías IPCC: < 5 % (Déficit); 5 %≤ IPCC<85 % (Normal); 85 % ≤IPCC< 95% (Riesgo de sobrepeso) e IPCC≥ 95 % (Sobrepeso) (14)(15) . ...
... El CDC, en su Vital and Health Statistics (17) , publica unas referencias antropométricas para niños y adultos, en las cuales para el IMC, por edad y sexo, refieren valores promedios a los 6 años hasta los 14,5 años (15,9 kg De igual forma estos promedios del IMC 20,9 ± 3,9 kg/m 2 (M) y 20,9 ± 3,9 kg/m 2 (F) son similares a los referidos por Bauce (14) , los cuales son 19,29 ± 3,50 kg/m 2 y 19,13 ± 3,14 kg/m 2 , respectivamente. ...
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El objetivo es comparar dos fórmulas de cálculo del Índice de Masa Corporal (IMC) y relacionarlo con otros indicadores como la Circunferencia de Cintura (CC), Índice Cintura-Talla (ICT), Índice Peso-Circunferencia de Cintura (IPCC) y etnia. MÉTODOS: Estudio descriptivo, transversal, prospectivo y correlacional. Una muestra de 480 niños y adolescentes, de 6 a 15 años, de dos instituciones educativas de Caracas, Municipio Libertador, seleccionados al azar de los grados y secciones previamente elegidas, se solicitó consentimiento informado a sus representantes. Variables: etnia, sexo, peso, talla, IMC, CC, ICT, % GC e IPCC. Se determinó promedio, desviación, porcentajes, comparación de medias y porcentajes y correlaciones. RESULTADOS: Promedios del IMC-Oxford ligeramente mayores a los del IMC-Quetelet, por edad. Al clasificar según Normopeso, Sobrepeso y Obesidad, promedios de los dos IMC son significativos; promedios de todas las variables, no significativos por sexo, excepto para el % GC (p<0,000), este aumenta considerablemente con la edad. La clasificación de la CC 15,0 % Riesgo sobrepeso y 5,0 % Obesidad; el % GC clasifica 19,5 % en Exceso, mayor en el sexo femenino, hay un alto porcentaje en Déficit (65,8 %). Correlaciona IMC-Q con IPCC (r=0,84), IMC-O con IPCC (r=0,70) e IMC-Q con IMC-O (r= 0,97). Los indicadores CC, ICT e IPCC, se comportan similarmente en los tres grupos de clasificación de los IMC; y en las tres etnias según los percentiles, y los valores de la CC siempre mayores a los del IPCC. CONCLUSIÓN: el IMC-Oxford puede ser utilizado como una nueva opción para evaluar Sobrepeso y Obesidad, en grupos de niños y adolescentes. The objective is to compare two Body Mass Index (BMI) calculation formulas and relate it to other indicators such as Waist Circumference (CC), Waist-Size Index (ICT), Weight-Waist Circumference Index (IPCC), and ethnicity. METHODS: Descriptive, cross-cutting, prospective and correlative study. A sample of 480 children and adolescents, aged 6 to 15, from two educational institutions in Caracas, Libertador Municipality, randomly selected from the degrees and sections previously chosen, requested informed consent from their representatives. Variables: ethnicity, gender, weight, size, BMI, WC, ICT, BFP and WWCI. Average, deviation, percentages, comparison of means and percentages and correlations were determined. RESULTS: BMI-Oxford averages slightly higher than BMI-Quetelet, by age. When classifying by Normoweight, Overweight and Obesity, averages of the two BMI are significant; averages of all variables, not significant by sex, except for % GC (p<0.000), this increases considerably with age. CC rating 15.0 % Overweight risk and 5.0 % Obesity; % GC ranks 19.5 % in Excess, higher in the female sex, there is a high percentage in Deficit (65,8 %). It maps IMC-Q to WWCI (r-0.84), IMC-O with WWCI (r-0.70), and IMC-Q with IMC-O (r-0.97). The CC, WTS and WWCI indicators behave similarly in the three BMI classification groups; and in the three ethnicities according to the percentiles, and the VALUES of the WC always higher than those of the WWCI. CONCLUSION: BMI-Oxford can be used as a new option to evaluate Overweight and Obesity, in groups of children and adolescents.
... The Weight-Waist Circumference Index, by the formula used by Bauce and proposed as a new indicator of overweight and obesity [15,16]. ...
... The Weight-Waist Circumference Index, by the formula used by Bauce and proposed as a new indicator of overweight and obesity [15,16]. ...
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Objective: The objective is to compare anthropometric indicators of overweight and obesity in children and adolescents. Method: descriptive, cross-sectional, prospective and correlational study, using a sample of 484 children and adolescents, aged between 6 and 15 years, from two educational institutions in Caracas. The variables are Sex, Age, Weight, Height, BMI, Waist-Height Index (WHI), Waist Weight-Circumference Index (WWCI) and Body Fat Percentage (BFP), using the Deurenberg formula. Mean, percentages, correlations were obtained and means and percentages were compared using Student's t-test. Results: similar sex means for all indicators; discriminated by age group, they behave the same in the group of 6 to 11 years, and in the group of 12 or more years, all the averages are higher in the male sex; are significant (p<0,000). Moderate to high correlations were obtained between Age-Weight (0.69); Age-Size and Size-WWCI (0.74-0.76); Weight-WWCI, Weight-Height, Weight-BMI and BMI-WWCI greater than 0.84. The WHI indicator ranks 85.5% in Non-risk and 14.5% in Risk; the WWCI, classifies 84.9% in Non-risk and 15.1% in Risk. Conclusions: The indicators classify a high percentage in Normal; the BMI/Age/WHO ranks the highest percentage in Excess, followed by the Waist Weight-Circumference Index (WWCI) and the Waist-Height Index WHI; the BMI/Age/ FTE indicator classifies a lower percentage in Deficit, in two sexes; there is a high correlation between BMI and BFP, it is suggested to use BFI as a complementary indicator of BMI, to evaluate overweight and obesity in children and adolescents.
... Las fórmulas utilizadas para obtener los indicadores son las siguientes: Para el IMC se tomó en cuenta la fórmula de Quetelet (6) : IMC = Peso (kg) / Talla (m) 2 Y la fórmula sugerida por Nick Trefethen de la Universidad de Oxford (5) : IMC = 1,3*Peso (kg) / Talla (m) 2,5 La Circunferencia de Cintura (CC), se midió de acuerdo con lo establecido en la antropometría, esto es, la medición se realizó en el punto medio entre el reborde costal inferior y la cresta ilíaca. (7) Para el Índice Cintura-Talla (ICT) se empleó la fórmula (8) : ICT = CC (cm) / Talla (cm) Para el IPCC se consideró el criterio sugerido y aplicado por Bauce, el cual es calculado mediante la siguiente fórmula (9,10) : Criterios utilizados para la clasificación y evaluación del sobrepeso y la obesidad Para el IMC, se siguió el criterio de la OMS los valores de IMC < 18,5 (Déficit); 18,5≤ IMC < 25,0 (Normal); 25,0 ≤ IMC < 30,0 (Sobrepeso); IMC ≥ 30,0 (Obesidad) (1,3) . Para la CC el criterio es Según la recomendación de las Guías Clínicas para la Obesidad del Instituto Nacional de Salud de los EEUU, se considera como punto de corte para los hombres valores mayores a 102 cm y para las mujeres, mayores a 88 cm el cual coincide con el asumido por SEEDO (12,13) . ...
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Descriptive, prospective, transversal and correlational study, whose objective is to relate two formulas for calculating BMI, with other indicators, in a group of adults. METHODS: The sample is of 137 adult patients who attended consultation at the University Hospital of Caracas. The variables are: age, weight, size, BMI-Q, BMI-O, WC, WSI, WCWP and BFP. Averages, deviations, percentages and z-tests and Mann Whitney were obtained to compare averages and Median. RESULTS: Similar BMI-Q averages in both sexes, and older BMI-O in female sex. The two formulas for calculating BMI result in the highest percentage with BMI-O, higher overweight percentage with BMI-Q and significant (p<0.000) and percentages of Healthy Weight and Obesity equal. Equal averages, per group, of BFP for the two BMI formulas, and increase from Healthy Weight to Obesity. The Coefficient of Variation reveals more homogeneity in BMI-O (18.41% vs 25.21%). BMI-Q correlates with weight (0.91), WC (0.92) and WSI (0.93); IMC-O with weight (0.97), WC (0.83) and WCWI (0.90). Whitney's test reveals that averages by sex are significant (p<0,000), as are IPCC averages per sex (p<0.000). In addition, the BMI Oxford, WC, WSI and WCWI indicators have sensitivity of 92,3%, 92.3% and 92.3%, respectively. CONCLUSION: The BMI Oxford for its somewhat complicated calculation formula is not recommended to evaluate overweight and obesity, in adults.
... El Índice Peso-Circunferencia de Cintura (IPCC), utilizado por Bauce, y se calculó mediante la fórmula siguiente (8,11,12) : ...
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Evaluation of the Waist Weight-Circumference Index (WWCI) using Logistic Regression. Descriptive, prospective and cross-sectional study shows 1095 adults and older adults, aged between 20 and 96 years. Methods: variables: age, weight, size, Waist Circumference (WC), BMI, Waist-Size Index (WSI). Results: Similar BMI in both sexes; higher WC and WSI averages in a ≥ age of 65; major WWCI in group 20-59 years; WWCI risk rate (54.1%) higher in WC (44.7%) WSI (78.2%). WWSI significantly associated with BMI, WC and WSI (p<0.000); positive predictive value 0.92 and negative predictive value 0.70, indicate discriminatory capacity; Relative Risk, 1.92; Wald test statistic indicates statistical significance for the coefficients of risk probability equations; area under the ROC curve is 0.803 and 0.903 (P<0.000), high sensitivity and specificity. Conclusion: WWCI can be considered to evaluate overweight and obesity in adults, given its high discriminatory capacity.
... Este indicador tiene la particularidad de tomar en consideración, tanto la masa corporal, expresada en kilogramos, como la distribución de grasa abdominal, expresadas en centímetros, es decir, sin elevar alguna de ellas al cuadrado, lo que podría llevar a una medida mucho más objetiva del riesgo que tiene una persona de enfermedad cardiovascular (14) , por otra parte, se sabe que a partir de los 40 años, el organismo comienza a perder masa muscular que puede afectar las dos medidas involucradas en este índice; así mismo el valor de referencia se consideró el promedio de todo el grupo, esto es, IPCC < 0,71 para no riesgo e IPCC ≥ 0,71 para riesgo por grupo etáreo. ...
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Introduction: Anthropometric measurements are useful for evaluating nutritional status, they are easy to obtain when applied to ambulatory elderly populations. Objective: to anthropometrically evaluate a group of older adults; For this, the variables: age, weight, height, waist circumference (CC), calf circumference (PP) were measured and BMI, ICT, IPCC and% GC were calculated. Methods: A group of older adults was selected, who attended the consultation in a private clinic, in the Caracas metropolitan area, during the months of June and October 2015. e indicators BMI, CC, PP, ICT, IPCC and% GC were determined. To classify, according to the categories of each, adults, and assess their nutritional status. Results: e results indicate age 71.9 ± 7.9 years, weight 67.1 ± 13.9, height 157.6 ± 9.2 cm, CC 93.7 ± 12.2, PP 33.7 ± 4.1, BMI 26.9 ± 4.7, ICT 0.60 ± 0.08, IPCC 0.71 ± 0.10 and% GC 40.4 ± 7.7. Malnutrition according to the PP 42.3% (M) and 15.6% (F); Overweight according to BMI 69.1% (M) and 62.9% (F); obesity 30.8% (M) and 37.1% (F). According to the CC, high risk and very high risk, 42.1% (M) and 20.6% (F), and 58.9% (M) and 77.4% (F), respectively. ICT reveals obesity 20.7% (M) and 62.2% (F); IPCC risk 78.2% (M) and 49.6% (F); % GC obesity 95.5% (M) and 98.3% (F). High correlations between CC-ICT, Weight-BMI, Weight-CC, Weight-IPCC (r ≥ 0.80 and p <0.001). Conclusion: the indicators are very useful to assess nutritional status, and having several of them, allows to complement the nutritional evaluation in the elderly. Keywords: older adults, Anthropometry, Anthropometric Indicators, Nutritional assessmentl.
... Este indicador tiene la particularidad de tomar en consideración, tanto la masa corporal, expresada en kilogramos, como la distribución de grasa abdominal, expresadas en centímetros, es decir, sin elevar alguna de ellas al cuadrado, lo que podría llevar a una medida mucho más objetiva del riesgo que tiene una persona de enfermedad cardiovascular (14) , por otra parte, se sabe que a partir de los 40 años, el organismo comienza a perder masa muscular que puede afectar las dos medidas involucradas en este índice; así mismo el valor de referencia se consideró el promedio de todo el grupo, esto es, IPCC < 0,71 para no riesgo e IPCC ≥ 0,71 para riesgo por grupo etáreo. ...
... Este indicador tiene la particularidad de tomar en consideración, tanto la masa corporal, expresada en kilogramos, como la distribución de grasa abdominal, expresadas en centímetros, es decir, sin elevar alguna de ellas al cuadrado, lo que podría llevar a una medida mucho más objetiva del riesgo que tiene una persona de enfermedad cardiovascular (14) , por otra parte, se sabe que a partir de los 40 años, el organismo comienza a perder masa muscular que puede afectar las dos medidas involucradas en este índice; así mismo el valor de referencia se consideró el promedio de todo el grupo, esto es, IPCC < 0,71 para no riesgo e IPCC ≥ 0,71 para riesgo por grupo etáreo. ...
Article
Full-text available
Introduction: Anthropometric measurements are useful for evaluating nutritional status, they are easy to obtain when applied to ambulatory elderly populations. Objective: to anthropometrically evaluate a group of older adults; For this, the variables: age, weight, height, waist circumference (CC), calf circumference (PP) were measured and BMI, ICT, IPCC and% GC were calculated. Methods: A group of older adults was selected, who attended the consultation in a private clinic, in the Caracas metropolitan area, during the months of June and October 2015. e indicators BMI, CC, PP, ICT, IPCC and% GC were determined. To classify, according to the categories of each, adults, and assess their nutritional status. Results: e results indicate age 71.9 ± 7.9 years, weight 67.1 ± 13.9, height 157.6 ± 9.2 cm, CC 93.7 ± 12.2, PP 33.7 ± 4.1, BMI 26.9 ± 4.7, ICT 0.60 ± 0.08, IPCC 0.71 ± 0.10 and% GC 40.4 ± 7.7. Malnutrition according to the PP 42.3% (M) and 15.6% (F); Overweight according to BMI 69.1% (M) and 62.9% (F); obesity 30.8% (M) and 37.1% (F). According to the CC, high risk and very high risk, 42.1% (M) and 20.6% (F), and 58.9% (M) and 77.4% (F), respectively. ICT reveals obesity 20.7% (M) and 62.2% (F); IPCC risk 78.2% (M) and 49.6% (F); % GC obesity 95.5% (M) and 98.3% (F). High correlations between CC-ICT, Weight-BMI, Weight-CC, Weight-IPCC (r ≥ 0.80 and p <0.001). Conclusion: the indicators are very useful to assess nutritional status, and having several of them, allows to complement the nutritional evaluation in the elderly. Keywords: older adults, Anthropometry, Anthropometric Indicators, Nutritional assessmentl.
... Para el ICT, la referencia para niños y adolescentes, es de 0,51 en niños y 0,50 en niñas, para obesidad, y de 0,47-0,48 para sobrepeso; para adultos, un valor de 0,56 tanto para hombres, como para mujeres. (9,12) ; sin embargo, por tratarse de validar el indicador IPCC, se consideró mejor clasificar a cada grupo, según el promedio y la desviación de cada uno; así para niños y adolescentes se tiene Déficit (ICT<0,43); Normal Para evaluar el Índice Peso-Circunferencia de Cintura (IPCC), por ser un indicador nuevo, se asumió como valor de referencia el Percentil 85, el cual está próximo al valor de la media y se clasificó según las siguientes categorías: Déficit (IPCC < 0,44); Normal (0,44≤ IPCC < 0,80); Sobrepeso (0,80 ≤ IPCC < 0,98) y Obesidad (IPCC ≥ 0,98) (6) . ...
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Introducción: En este estudio se compara el Índice de Peso-Circunferencia de Cintura (IPCC), con los indicadores Índice de Masa Corporal (IMC), Índice Cintura-Talla (ICT) y Porcentaje de Grasa Corporal (%GC), en tres grupos de sujetos para determinar que tan eficiente resulta en el diagnósticoo de sobrepeso y obesidad y proponerlo como complemento de los otros indicadores mencionados. Métodos: estudio exploratorio, descriptivo, prospectivo y correlacional en una muestra probabilística de 655 sujetos, dividida en tres sub muestras: 455 niños y adolescentes, 97 universitarios y 103 adultos. Variables: edad, sexo, peso, talla, circunferencia de cintura (CC), Índice de Masa Corporal (IMC), Índice Cintura Talla (ICT) e Índice de Peso-Circunferencia de Cintura (IPCC), Porcentaje de Grasa Corporal (%GC). Medidas estadísticas: descriptivas, asociación, correlación, comparación de promedios y regresión logística. Resultados: IMC revela, sobrepeso y obesidad mayor en adultos; CC e ICT mayor riesgo en adultos; %GC reporta obesidad en 6,8% niños, 17,9% universitarios y 64,8% adultos. IPCC se comporta normalmente, aumenta con la edad, 15,6% en niños y adolescentes, 14,4% universitarios y 14,6% adultos, en riesgo. Promedios del IPCC por sexo, en niños y adolescentes, no significativos; correlaciona con peso, talla e IMC (r>0,70). Regresión logística evidencia verosimilitud significativa (p<0,001), regresiones mayores a 0,90 y bondad de ajuste significativas (p<0,000). Conclusiones: Considerar el IPCC conjuntamente con otros indicadores para evaluar sobrepeso y obesidad.
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Overweight and obesity in children and adolescents are public health problems in developed and developing countries. Its presence at such an early age is a risk factor for obesity and coronary risk in adulthood, hence the importance of prevention, detection and treatment on time. In order to diagnose overweight and obesity, anthropometric indicators linked to adiposity are needed. The body mass index (BMI) has proven useful for the evaluation of obesity in adults and more recently it has been recommended for the assessment of children and adolescents. Different groups of experts and international agencies including the Center for Disease Control (CDC) in the USA and the International Obesity Task Force (IOTF) from the World Health Organization have proposed BMI reference standards for international use. In this review article, the standards of reference are presented and discussed. There seems to be consensus that the different international criteria currently available are useful and can be used interchangeably in the assessment of overweight and obesity in childhood and adolescence; however, data must be interpreted with caution and the possible advantages and limitations of each criterion must be considered.
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Objetivo. Determinar en niños, la asociación entre la circunferencia de la cintura (CC) y diferentes componentes del síndrome metabólico, incluyendo obesidad, índice de masa corporal (IMC), insulinorresistencia (HOMA-IR), proinsulina, perfil lipídico y tensión arterial (TA).Población, material y métodos. Se evaluaron las medidas antropométricas de 2.182 estudiantes (1.126 masculinos) de 6 a 13 años de edad. Se aleatorizaron 68 niños: 28 con sobrepeso (SP) y 40 obesos (OB) que se aparearon según el sexo y la edad con 16 niños de peso normal (No-OB) en los que se realizaron evaluaciones posteriores. En estos niños se determinó, además del índice de masa corporal (IMC) y la CC, la TA y el estadio de Tanner. Se realizó una prueba de tolerancia oral a la glucosa (PTOG) y se determinó el perfil lipídico, la insulinemia y la proinsulinemia en este subgrupo. Los niños se clasificaron como no-OB (IMC < percentilo 85), SP (IMC entre percentilos 85 y 94) y OB (IMC> percentilo 95).Resultados. La CC presentó una asociación significativa y univariada con la talla (r= 0,73), el IMC (r= 0,96), el estadio de Tanner (r= 0,67), la edad (r= 0,56), la TA sistólica (r= 0,64), la TA diastólica (r= 0,61), el HDL (r= 0,45), triglicéridos (r= 0,28), proinsulina (r= 0,59) y HOMA-IR (r= 0,59). El análisis de regresión logística que utilizó a la CC> percentilo 90° como variable dependiente, mostró que el HDL (exponencial beta= 0,93, IC 95% 0,88-0,98, P= 0,01) y HOMA-IR (exponente beta= 1,997, IC 95%1,174-3,396) fueron factores de riesgo independientes para la CC, luego de ajustarlos por la edad y el estadio de Tanner, sexo, talla, TA y triglicéridos. La regresión lineal múltiple con la HOMA-IR como variable dependiente mostró que la CC (coeficiente beta= 0,066 IC 95%: 0,007- 0,125; P= 0,0°29), edad (-0,389 IC 95%-0,611-/-0,167; P= 0,001) y estadio de Tanner (0,734 IC 95% 0,175/1,29; P= 0,011) fueron variables predictoras significativas e independientes para insulinorresistencia.Conclusiones. La CC es un predictor del síndrome de insulinorresistencia en niños y podría incluirse en la práctica clínica como una herramienta simple para identificar niños con riesgo de presentar en el futuro enfermedad cardiovascular (ECV) y diabetes tipo 2.
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INTRODUCTION. In past decades, the excess weight and obesity have increased in Cuban children and adolescents, thus, are necessaries simple tools allowing analyzing in health practice the characteristics and evolution of obesity. By this reason, we decide to develop growth curves of waist circumference in Havanan children and adolescents, a dimension showing a high correlation with the intra-abdominal fatty mass and consequently, with an atherogenic lipid profile. METHODS. Authors estimated the percentile values according to the age groups and the sex, using the potency transformation method type Box-Cox (BCPE) in 4 360 children and adolescents aged between 7,5 and 19,0 included in the sample of cross-sectional studies of growth and development conducted in La Habana in 1998 and 2005. RESULTS. The waist circumference increased in a significant way with age in both sexes. Boys showed figures higher than that of girls and the values obtained trend to be lower than those reported in other studies. CONCLUSIONS. These curves could be used provisionally with clinical and epidemiologic objectives until be available national references to identify the schoolboys and adolescents with a risk to develop disorders related to visceral adiposity.
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This study was designed to assess whether waist circumference can predict metabolic syndrome abnormalities in primary schoolchildren. Of 5,103 children (2,526 males) 4-13 years old who underwent anthropometric measurements, 530 had more extensive testing. Body mass index (BMI), waist circumference, and blood pressure were determined in all subjects. The subgroup had Tanner stage, glucose, lipid profile, and insulin assays. The BMI of the 5,103 children was used to calculate our z scores. To determine which marker was a better predictor for metabolic syndrome, a receiver operating characteristic (ROC) curve was generated for BMI and waist circumference, with metabolic syndrome as the dichotomous variable. Over 530 children (8.7 +/- 2.4 years) 6% (n = 32) were obese (BMI >95(th) percentile; z BMI = 2.55), 13.6% (n = 72) were overweight (OW) (85(th) < BMI < 95(th) percentile; z BMI = 1.45), and 80.4% (n = 426) were non-OW (BMI <85(th) percentile; z BMI = - 0.14). Fifty-eight percent [95% confidence interval (CI) 53, 6], 22.8% (95% CI 19, 27), 15.5% (95% CI 12, 19), and 4.1% (95% CI 2, 6) were Tanner stage I, II, III, and IV, respectively. Metabolic syndrome was present in 9.4% overall, 6% of the non-OW, 22.2% of the OW, and 31% in the obese group (P < 0.01). The differences between ROC areas were not significant (0.009) (95% CI -0.035 to 0.053; P = 0.679) for BMI and waist circumference. The optimal threshold for waist circumference percentile was 71.3 with a sensitivity and specificity of 58.9 (95% CI 48.4, 68.9) and 63.1 (95% CI 58.4, 67.7), respectively. Waist circumference and BMI predict metabolic syndrome abnormalities in children. Waist circumference > or =75(th) percentile could be the optimal threshold to predict metabolic syndrome in children.
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Although body fat patterning has been related to adverse health outcomes in adults, its importance in children and adolescents is less certain. We examined the relation of circumference (waist and hip) and skinfold-thickness (subscapular and triceps) measurements to lipid and insulin concentrations among 2996 children and adolescents aged 5-17 y. This was a community-based, cross-sectional study conducted in 1992-1994. A central or abdominal distribution of body fat was related to adverse concentrations of triacylglycerol, LDL cholesterol, HDL cholesterol, and insulin; these associations were independent of race, sex, age, weight, and height. These associations were observed whether fat patterning was characterized by using 1) waist circumference alone (after adjustment for weight and height), 2) waist-to-hip ratio, or 3) principal components analysis. Compared with a child at the 10th percentile of waist circumference, a child at the 90th percentile was estimated to have, on average, higher concentrations of LDL cholesterol (0.17 mmol/L), triacylglycerol (0.11 mmol/L), and insulin (6 pmol/L) and lower concentrations of HDL cholesterol (-0.07 mmol/L). These differences, which were independent of weight and height, were significant at the 0.001 level and were consistent across race-sex groups. These findings emphasize the importance of obtaining information on body fat distribution, waist circumference in particular, in children. Waist circumference, which is relatively easy to measure, may help to identify children likely to have adverse concentrations of lipids and insulin.
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Latin America is undergoing a rapid demographic and nutritional transition. A recent WHO/PAHO survey on obesity in the region revealed an increasing trend in obesity as countries emerge from poverty, especially in urban areas. In contrast, in middle income countries, obesity tends to decline as income increases; this is especially so in women. Dietary changes and increasing inactivity are considered the crucial contributory factors that explain this rise. The end result is a progressive rise in overweight and obesity, especially in low income groups who improve their income and buy high fat/high carbohydrate energy-dense foods. Intake of these foods increases to the detriment of grains, fruits and vegetables. Most aboriginal populations of the Americas have changed their diet and physical activity patterns to fit an industrialized country model. They now derive most of their diet from Western foods and live sedentary and physically inactive lives. Under these circumstances they develop high rates of obesity, insulin resistance and type 2 diabetes. Supplementary feeding programs are common in the region; the number of beneficiaries significantly exceeds the malnourished. Weight-for-age definition of undernutrition without assessment of length will overestimate the dimension of malnutrition and neglect the identification of stunted overweight children. Providing food to low income stunted populations may be beneficial for some, although it may be detrimental for others, inducing obesity especially in urban areas. Defining the right combination of foods/nutrients, education and lifestyle interventions that are required to optimize nutrition and health is a present imperative.
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