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Indian Pediatr 2013;50: 889 |
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Waist Circumference: Diagnostic Tool for
Health Risk in Children
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Daniel Ter Goon
Centre for Biokinetics, Recreations and Sport Sciences,
University of Venda, Private Bag X5050, Thohyoyandou,
South Africa, 0950.
Email:
[email protected]
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Using waist circumference (WC) as a screening measure for
identifying children at health risk is rare in South African
children; therefore this study identified children with a WC
above the 90th percentile. The WC of 1136 school children
(548 boys) aged 9-13 years in Central Pretoria, South
Africa, were measured using standard procedures. The
percentiles of WC based on those from the National Health
and Nutrition Examination Survey (NHANES) III [1] was
arbitrarily used to screen for those at risk factors of
central obesity.
Waist circumference (WC) is a commonly
used measure of central obesity [2] because it is a good
predictor of abdominal fat and is more closely related to
the development of cardiovascular diseases (CVD) and type 2
diabetes (T2D) mellitus [3].
However, it is observable that unlike
body mass index (BMI), WC measurement is seldom taken in
most South African schools, nor does its prognostic role
have been widely used in screening for health risk factors
in children, especially in developing countries. This might
be largely attributed to the non-availability of commonly
defined criteria of WC in children, compared to BMI.
Screening for WC in children might provide useful
information in terms of public health policy, in designing
strategies to reverse adverse WC trends among children. The
analysis in the present identifies 20.6% of the children
with a WC above the 90th percentile judged to be centrally
obese (Table I).
TABLE I Proportion of Children With A Waist Circumference Above 90th Percentile*
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Boys (n = 548) |
Girls (n = 588)
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Total (n = 1136) |
Waist circumference below the 90th centile |
438 (38.6) |
464 (40.8) |
902 (79.4) |
Waist circumference above the 90th centile |
110 (9.7) |
124 (10.9) |
234 (20..6) |
*Excess WC defined using NHANES III criteria. |
This data, though cross-sectional and
descriptive, is a pointer to the likely presence of CVD risk
factors among the sample children. This is alarming and
calls for serious attention. Evidence for predictive
validity of childhood WC as an indicator of risk for adult
morbidity is provided by a recent study from the Fels
Longitudinal Study [4].
The inclusion of WC in the screening
protocol to estimate the prevalence of central adiposity in
school-age children should be a prime priority. Such
information would provide an indicator of the future health
of the children, and would aid in instituting appropriate
remedial strategies for those at risk factors of central
obesity.
References
1. Fernandez Jr, Redden, DT, Pietrobelli
A, Allison DB. Waist circumference percentiles in nationally
representative samples of African-American,
European-American, and Mexican-American children and
adolescents. J Paediatr. 2004;145: 439-44.
2. Kelishadi R, Gouya MM, Ardalan G,
Hosseini M, Motaghian M, Delavari A, et al. First
reference curves of waist circumferences in an Asian
population of youths: Caspian Study. J Trop Paediatr.
2007;53:158-64.
3. Eissa M, Dai S, Mihalopoulos NL, Day
RS, Harrist RB, Labarthe DR. Trajectories of fat mass index,
fat free-mass index, and waist circumference in children. Am
J Prev Med. 2009;37:S34-S9.
4. Sun SS, Liang R, Huang TT, Daniels SR, Arslanian S,
Liu K, et al. Childhood obesity predicts adult
metabolic syndrome: the Fels Longitudinal Study. J Pediatr.
2008;152:191-200.
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