Patterns of body size and adiposity among UK Children of South Asian, black African-Caribbean and white European origin: Child Heart and Health Study in England (CHASE Study)

Division of Community Health Sciences, St George's, University of London, London, UK.
International Journal of Epidemiology (Impact Factor: 9.18). 11/2010; 40(1):33-44. DOI: 10.1093/ije/dyq180
Source: PubMed


The objective of this study was to examine adiposity patterns in UK South Asian, black African-Caribbean and white European children using a range of adiposity markers. A cross-sectional survey in London, Birmingham and Leicester primary schools was conducted. Weight, height, waist circumference, skinfold thickness values (biceps, triceps, subscapular and suprailiac) were measured. Fat mass was derived from bioimpedance; optimally height-standardized indices were derived for all adiposity markers. Ethnic origin was based on parental self-report. Multilevel models were used to obtain adjusted means and ethnic differences adjusted for gender, age, month, observer and school (fitted as a random effect). A total of 5887 children aged 9-10 years participated (response rate 68%), including 1345 white Europeans, 1523 South Asians and 1570 black African-Caribbeans.
Compared with white Europeans, South Asians had a higher sum of all skinfolds and fat mass percentage, and their body mass index (BMI) was lower. South Asians were slightly shorter but use of optimally height-standardized indices did not materially affect these comparisons. At any given fat mass, BMI was lower in South Asians than white Europeans. In similar comparisons, black African-Caribbeans had a lower sum of all skinfolds but a higher fat mass percentage, and their BMI was higher. Black African-Caribbeans were markedly taller. Use of optimally height-standardized indices yielded markedly different findings; sum of skinfolds index was markedly lower, whereas fat mass index and weight-for-height index were similar. At any given fat mass, BMI was similar in black African-Caribbeans and white Europeans.
UK South Asian children have higher adiposity levels and black African-Caribbeans have similar or lower adiposity levels when compared with white Europeans. However, these differences are not well represented by comparisons based on BMI, which systematically underestimates adiposity in South Asians, and in black African-Caribbeans it overestimates adiposity because of its association with height.

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    • "The BIA is safe, non-invasive, rapid, relatively inexpensive, and suitable for large-scale epidemiologic studies. The BIA also was used for the measurement of body composition in other studies in school-aged children [30] [31]. 7. The information on the socioeconomic status of the children was not obtained in this study. "
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    • "Data among South Asian children are limited from North America. In the UK, school-aged, South Asian children have lower levels of physical activity compared with White Caucasian children [35] and have demonstrated higher caloric and total fat intake [48] and increased adiposity, compared with White Caucasian children [49]. Reducing sedentary behaviors such as screen time has been associated with improving obesity [50]. "
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    • "We hypothesized that metabolic sensitivity to adiposity would be greater in South Asians than white Europeans. Several adiposity markers were assessed, including measures based on skinfold thickness and bioimpedance, which provide robust measures of adiposity in this multiethnic population (19), as well as BMI and waist circumference. We have also included data on leptin, an adipokine with circulating levels that are strongly correlated with total body fat percentage (20). "
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