Harmonization of anthropometric measurements for a multicenter nutrition survey in Spanish adolescents

Reference Values of Physical Performance in Handball Players Aged 13-19 Years: Taking into Account Their Biological Maturity

Biological maturity status significantly influences success in handball, impacting an athlete's performance and overall development. This study aimed to examine the anthropometric and physical performance variables concerning age and maturity status, establishing reference values for physical performance among Tunisian players. A total of 560 handball players (309 males and 251 females aged 13-19 years) were categorized based on maturity status: early (n = 98), average (n = 262), and late (n = 200), determined through Mirwald and colleagues' equations. Anthropometric, physical fitness, and physiological data were collected for reference value creation. Our findings revealed significantly higher anthropometric parameters (p = 0.003) in late-maturing athletes compared to their early-maturing counterparts. Post-pubertal athletes showed significantly superior (p = 0.002) jumping ability, change of direction, and aerobic performance compared to their pre-pubertal peers. Additionally, male athletes outperformed females in both fitness (p = 0.001) and aerobic (p = 0.001) performance. A notable age-by-maturity interaction emerged for most performance outcomes (η2 ranging from 0.011 to 0.084), highlighting increased sex-specific differences as athletes progressed in age. Percentile values are provided for males and females, offering valuable insights for coaches and sports scientists to design personalized training programs. Understanding a player's performance relative to these percentiles allows trainers to tailor workouts, addressing specific strengths and weaknesses for enhanced development and competitiveness.

Submandibular Skinfold Thickness Cut-off Values in Relation to Body Mass Index and Percentage Body Fat Among Chilean Adolescents

The present study evaluates submandibular skinfold (SMS) cutoff values to estimate excess weight for BMI and percentage body fat (%BF) among Chilean adolescents. The results show an optimal area under the cutoff curve value of 83% among girls and 91% in boys to estimate SMS concerning %BF and BMI. The SMS cutoff value estimating obesity by %BF was 10 mm among girls and 9 mm among boys, 10 mm among girls, and 7 mm among boys by BMI. Our results showed that SMS is significantly associated with anthropometric parameters for obesity.

Cardiorespiratory fitness and development of childhood cardiovascular risk: The EXAMIN YOUTH follow-up study

Background: Obesity- and hypertension-related cardiovascular (CV) risk has been shown to originate in childhood. Higher body mass index (BMI) and blood pressure (BP) have been associated with increased large artery stiffness and a lower microvascular arteriolar-to-venular diameter ratio (AVR) in children. This study aimed to investigate the association of cardiorespiratory fitness (CRF) with development of BMI, BP and vascular health during childhood. Methods: In our prospective cohort study, 1,171 children aged 6-8 years were screened for CRF, BMI, BP, retinal vessel diameters and pulse wave velocity using standardized protocols. Endurance capacity was assessed by 20 m shuttle run test. After 4 years, all parameters were assessed in 664 children using the same protocols. Results: Children with a higher CRF at baseline developed a significantly lower BMI (β [95% CI] -0.09 [-0.11 to -0.06] kg/m2, p < 0.001), a lower systolic BP (β [95% CI] -0.09 [-0.15 to -0.03] mmHg, p = 0.004) and a higher AVR (β [95% CI] 0.0004 [0.00004 to 0.0007] units, p = 0.027) after 4 years. The indirect association of CRF with development of retinal arteriolar diameters was mediated by changes in BMI. Conclusion: Our results identify CRF as a key modulator for the risk trajectories of BMI, BP and microvascular health in children. Obesity-related CV risk has been shown to track into adulthood, and achieving higher CRF levels in children may help counteract the development of CV risk and disease not only in pediatric populations, but may also help reduce the burden of CVD in adulthood. Registration: http://www.clinicaltrials.gov/ (NCT02853747).

Effects of a Long-Term Adapted Judo Program on the Health-Related Physical Fitness of Children with ASD

Physical fitness is one of the most important physical and mental health aspects for children with Autism Spectrum Disorder (ASD). This study aimed to test the effects of a long-term adapted judo program on the health-related physical fitness of children with ASD. The participants were recruited from various associations of families and schools for children with special needs. Twenty-one children were assigned to an experimental group and nineteen to a control group. The experimental group participated in a six-month adapted judo program consisting of 90 min of practice each week. Health-related physical fitness was measured using the indicators obtained from the ALPHA-fitness battery, the estimated VO₂max and the waist/height ratio^0.5. Changes within and between groups were analyzed using linear mixed models for repeated measures designs and test-retest reliability of tests requiring a maximum score using the Intraclass Correlation Coefficient (ICC). A judo program tailored for children with ASD can improve the cardio-metabolic health and cardiorespiratory fitness of its participants. The problems involved with administering physical aptitude tests that involve maximum effort or performance in children with ASD cast serious doubts on the reproducibility of their results.

Comparison of Glycosylated Haemoglobin, Blood Pressure, and Anthropometric Measurements Depending on Gender and Bodyweight State in Adolescents

Background/Objective: The greatest anthropometric and physiological changes occur during adolescence. Assessment of growth patterns is necessary to prevent future health risks. Aims: To describe the values of glycosylated haemoglobin (HbA1c), systolic (SBP) and diastolic (DBP) blood pressure, triceps skinfold, and abdominal circumference according to gender and age (between 12 and 17 years), as well as explore the differences between body weight conditions. Methods: A descriptive cross-sectional study was carried out, including 4130 adolescents between 12 and 17 years old. SBP and DBP, HbA1c, triceps skinfold, and abdominal circumference were evaluated. Results: Significant differences were observed between males and females for HbA1c (p < 0.001), SBP (p < 0.001), triceps curl (p < 0.001), and abdominal circumference (p < 0.001), independently of the age group. Regardless of gender and age groups, significant differences were observed between overweight/obese and normal-weight adolescents in SBP (p < 0.001), DBP (p < 0.001 to 0.009), triceps skinfold (p < 0.001), and abdominal perimeter (p < 0.001). Conclusions: Our findings revealed higher SBP, DBP, triceps skinfold, and abdominal circumference in overweight/obese adolescents compared to normal-weight adolescents in both genders.

Determinants of Longitudinal Changes in Cardiometabolic Risk in Adolescents with Overweight/Obesity: The EVASYON Study

We investigated which determinants (socioeconomic, early life factors, body composition changes, fitness changes and/or physical activity changes) best predicted longitudinal outcomes in cardiometabolic risk profile (Z-score change) in adolescents with OW/OB who underwent a 13-month multidisciplinary lifestyle intervention. A total of 165 adolescents (13–16 y; 46% boys) from the EVASYON study were included. Socioeconomic variables and early life factors were obtained from the medical records. Body composition was assessed using anthropometry. Fitness and physical activity were measured with field-based tests and questionnaires. Cardiometabolic risk factors (fasting glucose, HDL cholesterol, triglycerides, blood pressure and waist circumference) were derived from standard methods in the hospital. Body weight changes, sex and mother’s education were selected in the stepwise process as the most important determinants of changes in cardiometabolic risk profile (R² = 0.26, p = 0.002; R² = 0.14, p = 0.013; and R² = 0.14, p = 0.017, respectively). Both boys and girls showed a lower cardiometabolic risk score with the reduction in body weight (r = 0.535, p = 0.009 and r = 0.506, p = 0.005, respectively). There was no interaction between sex and body weight change (p = 0.614). In conclusion, the simple measure of changes in body weight should be considered to track changes in cardiometabolic risk profile in adolescents with OW/OB.

Specific physical performances among male elite youth soccer players: effect of maturity status

BACKGROUND

There is a lack of studies that investigated the relationship between anthropometric profile, biological maturity and specific soccer performances. Therefore, the aims of the present study were to establish normative data of anthropometric and specific physical performances and to determine the impact age and somatic maturation on young soccer players (U13-U19, n=487).

METHODS

Measurements include anthropometric variables to determine the age of peak height velocity (PHV), leg muscle volume (LMV) and soccer specific test (SST); Squat jump (SJ), Counter Movement jump (CMJ), sprint 10 meter (T<inf>10m</inf>), sprint 20 meter (T<inf>20m</inf>), sprint 30 meter (T<inf>30m</inf>) and intermittent-endurance tests.

RESULTS

Reference values showed a significant difference between anthropometric variables, LMV and SST according to PHV categories. (M)ANOVA analysis showed a significant age using maturity interaction effect of all anthropometric variables. A significant result was reported in the majority of SST performances for the age, the T<inf>10m</inf> and for T<inf>20m</inf> performances. The full model of multiple regressions and the multiple equations was used to determine the best predictors of physical performances according to anthropometric variables.

CONCLUSIONS

This study provides normative data for anthropometric characteristics and physical performances according to chronological age (U13-U19) and maturity groups of young soccer players.

Ten Days of Curcumin Supplementation Attenuates Subjective Soreness and Maintains Muscular Power Following Plyometric Exercise

Curcumin has become a popular product used to decrease inflammation and enhance recovery from exercise.

PURPOSE

To determine the effects of curcumin supplementation on delayed onset muscle soreness and muscle power following plyometric exercise.

METHODS

Participants (n = 22; five females, 17 males) consumed either curcumin (500 mg) or placebo twice daily for 10 days (6 days pre, day of and 3 days post exercise). Participants completed 5 x 20 drop jumps on day 7. Blood sampling and recovery tests were assessed at pre-supplementation, 24-hours and immediately pre-exercise, and immediately post-, 24, 48 and 72-hours post-exercise. Blood markers included serum creatine kinase (CK) and erythrocyte sedimentation rate (ESR), while soreness was measured during a squat and post vertical jump.

RESULTS

Both groups experienced muscle damage post-exercise with elevated CK (403 ± 390 ul; p < 0.01), soreness with squatting (38 ± 29 mm; p < 0.01), and vertical jump (36 ± 30 mm; p < 0.01). Soreness was greater in placebo vs. curcumin 48 h and 72 h post-exercise (p < 0.01); however, CK was not significantly different between groups (p = 0.28) despite being >200 IU·L^-1 greater 24 hr post exercise in placebo vs. curcumin. ESR was significantly greater immediately post-exercise (6.3 ± 5.6 vs. 3.4 ± 2.6 mm/hr; p = 0.03), however these were within the normal range for this test and not significantly different between groups (p = 0.25). Vertical jump decreased over time in the placebo, but not curcumin group (19.8 ± 4.8 vs. 21.4 ± 3.2 in; p = 0.01).

CONCLUSION

These data suggest curcumin reduces soreness and maintains muscular power following plyometric exercise.

Field-Based Health-Related Physical Fitness Tests in Children and Adolescents: A Systematic Review

Physical fitness (PF) is a multi-component construct and a biomarker of health. Worse PF is related to vulnerability and predicts worse academic achievements. Thus, assessing PF is important to monitor health in youth. This systematic review aimed to identify and inform physical education, health professionals and entities about existing PF batteries and field-tests that can be used in school settings. A comprehensive literature search was carried out in five electronic databases (Academic Search Complete, Education Resources Information Center, PubMed, Scopus, and Web of Science) to identify PF battery protocols that can be carried out in the school setting. Overall, 24 PF batteries were identified. Regarding the PF components assessed, only cardiorespiratory fitness and upper body strength were contemplated in all batteries. Middle-body strength and lower body strength were presented in most batteries (21 and 19 of 24, respectively). Agility (16 of 24) and body composition (16 of 24) were also considered in several batteries, although to a lesser extent. Flexibility (14 of 24) and speed (12 of 24) were the PF components less represented in the batteries. Among the 24 identified PF batteries, 81 PF tests assessing the different PF components were encountered. The advances in the PF field-based assessment in school settings and health in youth resulted in the amplification of the number of existing batteries. Considering the connection between PF and health and the opportunity that the school setting provides to assess fitness in children and adolescents, there is a need for standardization and a consensus of PF assessments in this specific setting.

Assessment of body mass index in a pediatric population aged 7-17 from Ukraine according to various international criteria-A cross-sectional study

Childhood obesity is one of the most serious public health problems. The prevalence of obesity among children is increasing and may negatively affect their immediate health, but it can also lead to obesity in adulthood. The aim of the study was to compare BMI cut-off points by examining three main international references: the World Health Organization (WHO), the International Task Force Obesity (IOTF) and the US Center for Disease Control and Prevention (CDC). Ultimately, the study group consisted of 18,144 children and adolescents aged 6.5–17.5 years. Body mass was measured on medical scales with an accuracy of ± 100 g and height measurement was taken using a height meter with an accuracy of ± 0.1 cm three times. Underweight, overweight and obesity were calculated according to WHO, IOTF and CDC BMI international references. There were differences in the incidence of underweight between the classifications: 16.8% according to IATF, 5.3% according to WHO and 9.9% according to CDC. There were also differences in the incidence of overweight and obesity between the classifications: 13% according to IOTF, 19.7% according to WHO and 14.1% according to CDC. In the CDC and WHO studies, a significantly higher prevalence of childhood obesity (4.0% and 4.7%, respectively) was observed compared with IOTF (2.1%). The prevalence of overweight and obesity in this study was higher among boys compared to girls. However, estimates of prevalence of overweight and obesity differ in methods and reference cut-off points. Higher prevalence was obtained in IOTF classification, followed by the WHO and CDC classification.

Validity of Slaughter Equations and Bioelectrical Impedance Against Dual-Energy X-Ray Absorptiometry in Children

OBJECTIVE

This study aimed to 1) analyze the criterion validity of the Slaughter equations (Slg-Eq) and bioelectrical impedance analysis (BIA) to estimate body fat percentage (BFP) and fat mass index (FMI) at different degrees of obesity in children compared with dual-energy x-ray absorptiometry (DXA) and 2) determine their agreement over time.

METHODS

Ninety-two children with overweight or obesity (10.0 [SD 1.2] years; 34.8% girls) participated in this 20-week study. Anthropometric, BIA, and DXA measurements were performed.

RESULTS

Both Slg-Eq and BIA methods underestimated BFP and FMI against DXA, and the bias was markedly larger with BIA (mean absolute percentage error = 11% for Slg-Eq vs. 18%-21% for BIA); a larger underestimation was observed in girls compared with boys for Slg-Eq (P ≤ 0.001), and the observed underestimation in adiposity was reduced as weight status increased. Systematic errors were kept constant over time, so no large differences between methods were observed in the change in adiposity.

CONCLUSIONS

At the group level, Slg-Eq provides a more valid estimation of BFP and FMI than BIA. At the individual level, Slg-Eq shows larger estimation errors. The validity of these methods might differ in sex and weight status. Nevertheless, both methods seem to be valid for monitoring changes in adiposity.

Intra- and inter- observer reliability of anthropometric measurements and blood pressure in primary schoolchildren and adults: the Feel4Diabetes-study

BACKGROUND

Feel4Diabetes was a large-scale, multicenter lifestyle intervention aiming to prevent type 2 diabetes among families from vulnerable population groups in six European countries (Belgium, Bulgaria, Finland, Greece, Hungary and Spain). The current study aimed to describe the process that was followed to harmonize and standardize the measurement of anthropometric (weight, height and waist circumference) and blood pressure (systolic and diastolic) indices, as well as to assess the intra- and inter- observer reliability of these measurements.

METHODS

A central training workshop was conducted prior to the baseline measurements of the Feel4Diabetes-intervention. One researcher from each intervention country, as well as 12 adults and 12 children (for the anthropometric measurements) and 21 adults (for the blood pressure measurements) participated in this workshop. Technical Error of Measurement (TEM) and reliability (%R) were calculated to assess the reliability of the indices which were assessed to evaluate the outcome of the Feel4Diabetes-intervention. The Feel4Diabetes-intervention is registered at https://clinicaltrials.gov/ (NCT02393872).

RESULTS

Intra-observer reliability was found to be higher than 99.5% for all anthropometric measurements in both children and adults. Inter-observer reliability was found to be higher than 98% regarding the anthropometric measurements, while for blood pressure measurements %R was 76.62 and 91.38% for systolic and diastolic blood pressure measurements, respectively.

CONCLUSION

The central training of the Fee4Diabetes-intervention ensured that the data collected for the outcome evaluation of the Feel4Diabetes-intervention in the six European countries at three different time points (baseline, follow-up 1 and follow-up 2) were valid and comparable.

Nutritional assessment of Oraons of West Bengal: a comparison between biochemical and anthropometric methods

Comprehensive nutritional assessment is the basis of nutritional diagnosis and necessary to identify the individual or the population at a risk of dietary deficiencies. However, there is no specific and confirmatory method to measure nutritional status. Present study tried to find out the efficacy of two nutritional assessment method (1) biochemical test like Total serum protein (TSP) and (2) anthropological measurements like body mass index (BMI) and mid-upper-arm-circumference (MUAC). Later, three methods were tested and compared for the strength of assessing the nutritional status. Study was conducted among 198 adult Oraon, 84 male, 114 female individuals of Madarihat and Falakata police station area, Alipurduar district, West Bengal. Selected blood parameters such as total serum protein (TSP), serum albumin and haemoglobin and anthropometric measurements (height, weight, mid-upper arm circumference, waist circumference, hip circumference, calf circumference, biceps skinfold, triceps skinfold, and calf skinfold) were obtained following standard instruments and protocols. Nutritional status of all individuals was assessed by TSP, BMI and MUAC classification methods. Comparison between/among three classification methods (TSP, BMI and MUAC) was done and discriminant function analysis was adopted to find out the percentage of correct classification by each methods. It was found that prevalence of undernutrition using TSP classification was 38.1% male and 43.0% female; using BMI was 34.5% male and 53.5% female; using MUAC was 45.2% male and 64.9% female. Discriminant function analysis showed that BMI (97.0%) had the highest capability of correct classification followed by MUAC (84.80%) and TSP (63.60%). Results indicate that however, TSP is an objective way of nutritional assessment, but BMI had the highest capability of correct classification of nutritional status. It may be pointed out that the evaluation with TSP was expensive and invasive whereas BMI is non-expensive and completely a non-invasive way of evaluation. Therefore, BMI may widely be used for nutritional assessment.

Feasibility and Reliability of Physical Fitness Tests among Colombian Preschool Children

The aim of the study was to assess the feasibility and reliability of physical fitness field tests used in the "Fuprecol kids" study among Colombian preschool children aged 3-5 years. A total of 90 preschoolers aged 3-5 years participated in the study. Weight, height, waist circumference, cardiorespiratory fitness (CRF), musculoskeletal fitness (handgrip strength and standing broad jump), speed-agility (4 × 10 m shuttle run), and flexibility (sit and reach test) components were tested twice (two weeks apart). The feasibility of the tests (preschoolers able to complete the test) ranged from 96% in the CRF test to 100% in the musculoskeletal fitness, speed-agility, and flexibility tests. Overall, the %TEMs were 0.625% for the weight, 0.378% for the height, 1.035% for the body mass index, and 0.547 % for the waist circumference. In addition, all tests were substantial reliable, for CRF (in stages and laps, concordance correlation coefficient = 0.944 and 0.941, respectively) in both sexes and flexibility (concordance correlation coefficient = 0.949) in girls. There were no significant differences in fitness test-retest mean differences in the boys (P > 0.05), except in CRF (laps P = 0.017). In girls, there were differences in CRF (stages (P = 0.017) and laps (P= 0.013)), and flexibility (P = 0.002) variables. The results from this study indicate that the "Fuprecol kids" battery of tests, administered by physical education teachers, was reliable and feasible for measuring components of physical fitness in preschoolers in a school setting in Colombia.

Collaborative active learning: bioimpedance and anthropometry in higher education

Research in the health sciences devotes much attention to overweight and obesity and, consequently, to body composition. In recent years, traditional body measures have been questioned as efficient variables in health sciences due to the fact that they cannot give information about body fat mass. Our aim is to teach how to analyze body composition through anthropometry and bioelectrical impedance analysis to our "Physiology of Vegetative and Reproductive Functions" students, who are studying for their degree in Biology. We proposed project-oriented-learning to promote collaborative interactions among students. Fifty-two students voluntarily formed five groups; they worked with the concepts of basal metabolic rate and body composition from a theoretical point of view and later transformed these concepts into a practical perspective by preparing a manuscript in groups with objectives proposed by our teaching team. In this research, we show a collaborative educational scenario for university students in which students are tutored from a constructivist perspective to promote social interactions, resulting in new knowledge acquisition.

Diet quality index as a predictor of treatment efficacy in overweight and obese adolescents: The EVASYON study

BACKGROUND & AIM

A diet quality index (DQI) is a tool that provides an overall score of an individual's dietary intake when assessing compliance with food-based dietary guidelines. A number of DQIs have emerged, albeit their associations with health-related outcomes are debated. The aim of the present study was to assess whether adherence to dietary intervention, and the overall quality of the diet, can predict body composition changes.

METHODS

To this purpose, overweight/obese adolescents (n = 117, aged: 13-16 years; 51 males, 66 females) were recruited into a multi-component (diet, physical activity and psychological support) family-based group treatment programme. We measured the adolescents' compliance and body composition at baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up. Also, at baseline, after 6 months, and at the end of follow-up we calculated the DQI.

RESULTS

Global compliance with the dietary intervention was 37.4% during the intensive phase, and 14.3% during the extensive phase. Physical activity compliance was 94.1% at 2-months and 34.7% at 13months and psychological support compliance were growing over the intervention period (10.3% intensive phase and 45.3% during extensive phase). Adolescents complying with the meal frequency criteria at the end of the extensive phase had greater reductions in FMI z-scores than those did not complying (Cohen's d = 0.53). A statistically significant association was observed with the diet quality index. DQI-A variation explained 98.1% of BMI z-score changes and 95.1% of FMI changes.

CONCLUSIONS

We conclude that assessment of changes in diet quality could be a useful tool in predicting body composition changes in obese adolescents involved in a diet and physical activity intervention programme backed-up by psychological and family support.

The prediction of in-hospital mortality by mid-upper arm circumference: a prospective observational study of the association between mid-upper arm circumference and the outcome of acutely ill medical patients admitted to a resource-poor hospital in sub-Saharan Africa

There are few reports of the association of nutritional status with in-hospital mortality of acutely ill medical patients in sub-Saharan Africa. This is a prospective observational study comparing the predictive value of mid-upper arm circumference (MUAC) of 899 acutely ill medical patients admitted to a resource-poor sub-Saharan hospital with mental alertness, mobility and vital signs. Mid-upper arm circumference ranged from 15 cm to 42 cm, and 12 (24%) of the 50 patients with a MUAC less than 20 cm died (OR 4.84, 95% CI 2.23-10.37). Of the 237 patients with a MUAC more than 28 cm only six (2.5%) died (OR 0.27, 95% CI 0.10-0.67). On logistic regression, the National Early Warning Score (NEWS), alertness, mobility and MUAC were independent predictors of in-hospital mortality. Mid-upper arm circumference is an independent predictor of the in-hospital mortality of acutely ill medical patients in a resource-poor hospital in sub-Saharan Africa.

Changes in nutritional state and dysphagia in stroke patients monitored during a 14-d period in a Burkina Faso hospital setting

INTRODUCTION

Dysphagia and undernourishment are common in cerebrovascular accident (stroke) patients in developed countries. Despite the dietary transition, there is little information available in Africa on this topic. This study aims to assess the prevalence of undernourishment and dysphagia in stroke patients in two Burkina Faso teaching hospitals at a starting point (D0), on the eighth day, and on the 14th (D14) and to specify factors related to undernourishment at day 14.

METHODOLOGY

The nutritional state of the patients was assessed using body mass index, triceps skinfold thickness, and mid-upper arm circumference. Dysphagia was identified using the Practical Aspiration Screening Schema.

RESULTS

A total of 222 patients were included in the study. From D0 to D14, the prevalence of undernourishment increased from 25.2% to 31.0% and the prevalence of dysphagia decreased from 37.4% to 15.8%. All nutritional criteria worsened. In a multivariate analysis, undernourishment was more present at D14 for women (odds ratio [OR] = 7.01; 95% confidence interval [CI]: 1.51-32.56, P = 0.01) and was less present if weight (OR = 0.69; 95% CI: 0.60-0.79, P = 0.0001) or triceps skinfold thickness (OR = 0.85; 95% CI: 0.74-0.99, P = 0.03) were high at D0.

CONCLUSION

The prevalence of undernourishment was high at D0 and increased during the monitoring period. It would be advisable to monitor patients' weight and triceps skinfold thickness, to optimize care for women and patients with low weight or triceps skinfold thickness at D0, to monitor dysphagia, and to inform patients, families, and relevant staff of nutritional concerns after a cerebrovascular accident.

Associations of maternal obesity and excessive weight gain during pregnancy with subcutaneous fat mass in infancy

BACKGROUND

Not much is known about the associations of maternal obesity and excessive gestational weight gain with body fat in infancy.

OBJECTIVE

To examine the associations of maternal pre-pregnancy body mass index and gestational weight gain with infant subcutaneous fat.

METHODS

In a population-based prospective cohort study among 845 mothers and their infants, we obtained maternal pre-pregnancy body mass index and measured maternal weight during pregnancy. At 1.5, 6 and 24months, we estimated infant total subcutaneous fat (sum of biceps, triceps, suprailiacal and subscapular skinfold thicknesses) and central-to-total subcutaneous fat ratio (sum of suprailiacal and subscapular skinfold thicknesses/total subcutaneous fat).

RESULTS

Maternal body mass index was positively associated with higher infant body mass index from 6months onwards. Maternal body mass index was not associated with infant subcutaneous fat measures at 1.5 or 6months. A 1-standard deviation scores (SDS) higher maternal body mass index was associated with a 0.09 (95% Confidence Interval 0.01, 0.17) SDS higher infant total subcutaneous fat at 24months, but not with central-to-total subcutaneous fat ratio. No associations were present for maternal total or period-specific gestational weight gain with infant fat.

CONCLUSION

Maternal body mass index was positively associated with infant body mass index and total subcutaneous fat in late infancy. Maternal total and period-specific gestational weight gain were not associated with infant body fat mass measures.

A review of the physiological and psychological health and wellbeing of naval service personnel and the modalities used for monitoring

Naval cohorts rely heavily on personnel to ensure the efficient running of naval organisations. As such, the wellbeing of personnel is essential. In an occupational setting, naval service personnel experience a variety of physiological and psychological stressors. Most naval services arrange annual physical fitness and body composition tests to ensure the physical readiness of personnel. However, these tests only evaluate a small amount of physiological capabilities. Components such as aerobic and strength capabilities are assessed, however, other components of physical fitness such as speed, agility, anaerobic capacity and flexibility are not. In addition to the physical capabilities, personnel are impacted by fatigue, nutrition and psychological stressors such as copping in stressful situations or dealing with time away from family and friends. This review will discuss the physiological and psychological factors that affect personnel's wellbeing. In addition to this, it will also evaluate the methods that are used to assess both physiological and psychological wellbeing.

Design, Response Rates, and Population Characteristics of a Cross-Sectional Study in Zanzibar, Tanzania

Background

Data on nutritional status and correlates of noncommunicable diseases are scarce for resource-poor settings in sub-Saharan countries. With the scope of a project, “Access to Food and Nutrition Status of the Zanzibari Population,” data for investigating public health questions were collected using proven measurement and laboratory standards.

Objective

The present study aims at providing a descriptive overview of recruitment approaches, standardization, quality control measures, and data collection, with special attention to the design, responses, and participant characteristics of the overall project.

Methods

A cross-sectional study across 80 randomly selected Shehias (wards) was conducted in 2013 in Unguja Island, Zanzibar. Examinations included all members living in 1 household, face-to-face interviews and anthropometric measurements (weight, height, mid-upper arm circumference, waist and hip circumference, and body composition) were assessed for all household members, blood pressure was taken from participants older than 2 years, and biosamples (urine and blood) from eligible household members were collected. Data collected from the core sample included sociodemographic data, nutritional status, and medical history (hypertension). Physical activity data was collected from a subsample of children between 3 and 16 years of age.

Results

A total of 1314 participants (mean age 23.6 ± 18.9 years, 54.54% female) completed all anthropometric measurements and were included in the analysis. Out of which, 98.40% (1293/1314) completed the household member’s questionnaire, 93.32% (1229/1314) participants older than 2 years completed blood pressure measurements, and 64.31% (845/1314) blood samples were collected from participants older than 5 years. Underweight prevalence for the total study population was 36.53% (480/1314) with the highest prevalence in children under 14 years. Overweight and obesity was highest among females with the prevalence of 7.61% (100/1314) and 6.62% (87/1314), respectively; obesity was rare among male participants.

Conclusions

The study provides valuable data to investigate the interplay of socioeconomic, demographic, environmental, physiological, and behavioral factors in the development of diet-related disorders in a representative sample of the Zanzibari population.

Relevance of Morning and Evening Energy and Macronutrient Intake during Childhood for Body Composition in Early Adolescence

(1) Background: This study investigated the relevance of morning and evening energy and macronutrient intake during childhood for body composition in early adolescence; (2) Methods: Analyses were based on data from 372 DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed study) participants. Explorative life-course plots were performed to examine whether morning or evening energy and macronutrient intake at 3/4 years, 5/6 years, or 7/8 years is critical for fat mass index (FMI [kg/m²]) and fat free mass index (FFMI [kg/m²]) in early adolescence (10/11 years). Subsequently, exposures in periods identified as consistently critical were examined in depth using adjusted regression models; (3) Results: Life-course plots identified morning fat and carbohydrate (CHO) intake at 3/4 years and 7/8 years as well as changes in these intakes between 3/4 years and 7/8 years as potentially critical for FMI at 10/11 years. Adjusted regression models corroborated higher FMI values at 10/11 years among those who had consumed less fat (p = 0.01) and more CHO (p = 0.01) in the morning at 7/8 years as well as among those who had decreased their morning fat intake (p = 0.02) and increased their morning CHO intake (p = 0.05) between 3/4 years and 7/8 years; (4) Conclusion: During childhood, adherence to a low fat, high CHO intake in the morning may have unfavorable consequences for FMI in early adolescence.

Associations of Infant Subcutaneous Fat Mass with Total and Abdominal Fat Mass at School-Age: The Generation R Study

BACKGROUND

Skinfold thickness enables the measurement of overall and regional subcutaneous fatness in infancy and may be associated with total and abdominal body fat in later childhood. We examined the associations of subcutaneous fat in infancy with total and abdominal fat at school-age.

METHODS

In a population-based prospective cohort study among 821 children, we calculated total subcutaneous fat (sum of biceps, triceps, suprailiacal, and subscapular skinfold thicknesses) and central-to-total subcutaneous fat ratio (sum of suprailiacal and subscapular skinfold thicknesses/total subcutaneous fat) at 1.5 and 24 months. At 6 years, we measured fat mass index (total fat/height(3) ), central-to-total fat ratio (trunk fat/total fat), and android-to-gynoid fat ratio (android fat/gynoid fat) by dual-energy X-ray absorptiometry and preperitoneal fat mass area by abdominal ultrasound.

RESULTS

Central-to-total subcutaneous fat ratio at 1.5 months was positively associated with fat mass index and central-to-total fat ratio at 6 years, whereas both total and central-to-total subcutaneous fat ratio at 24 months were positively associated with all childhood adiposity measures. A 1-standard-deviation scores higher total subcutaneous fat at 24 months was associated with an increased risk of childhood overweight (odds ratio 1.70, 95% confidence interval 1.36, 2.12). These associations were weaker than those for body mass index and stronger among girls than boys.

CONCLUSIONS

Subcutaneous fat in infancy is positively associated with total and abdominal fat at school-age. Our results also suggest that skinfold thicknesses add little value to estimate later body fat, as compared with body mass index.

Reliability of 3D laser-based anthropometry and comparison with classical anthropometry

Anthropometric quantities are widely used in epidemiologic research as possible confounders, risk factors, or outcomes. 3D laser-based body scans (BS) allow evaluation of dozens of quantities in short time with minimal physical contact between observers and probands. The aim of this study was to compare BS with classical manual anthropometric (CA) assessments with respect to feasibility, reliability, and validity. We performed a study on 108 individuals with multiple measurements of BS and CA to estimate intra- and inter-rater reliabilities for both. We suggested BS equivalents of CA measurements and determined validity of BS considering CA the gold standard. Throughout the study, the overall concordance correlation coefficient (OCCC) was chosen as indicator of agreement. BS was slightly more time consuming but better accepted than CA. For CA, OCCCs for intra- and inter-rater reliability were greater than 0.8 for all nine quantities studied. For BS, 9 of 154 quantities showed reliabilities below 0.7. BS proxies for CA measurements showed good agreement (minimum OCCC > 0.77) after offset correction. Thigh length showed higher reliability in BS while upper arm length showed higher reliability in CA. Except for these issues, reliabilities of CA measurements and their BS equivalents were comparable.

Waist circumference distribution in Colombian schoolchildren and adolescents: The FUPRECOL Study

OBJECTIVE

This study was intended to establish the percentile distribution of waist circumference in schoolchildren from Bogota, Colombia, participating in the FUPRECOL Study.

METHODS

A cross-sectional study conducted in 3,005 children and 2,916 adolescents aged 9 to 17.9 years. Height, weight, waist circumference, hip circumference, and self-assessed sexual maturity status were recorded. Percentiles (3(rd), 10(th), 25(th), 50(th), 75(th), 90(th), and 97(th)) and smoothed sex- and age-specific curves were calculated, and the waist circumference values found were compared to international references from other ethnic populations.

RESULTS

Fifty-seven percent of the overall population (n=5,921) were females (mean age, 12.7±2.3 years). In most age groups, waist circumference was greater in boys as compared to girls. The increase between the 50(th) and 97(th) percentiles by age was 15.7cm in boys aged 9 to 9.9 years and 16.0cm in girls aged 11-11.9 years. Comparison of our study results, by age group and sex, to international references showed that our 50(th) percentile was lower than reported in Peru and the UK except for studies in India, Venezuela (Merida), US, and Spain was higher.

CONCLUSIONS

Age- and sex-specific percentiles of waist circumference obtained from children and adolescents from Bogota, Colombia, are reported. They may be used as a reference both for nutritional assessment and for predicting cardiovascular risks at early ages.

Design, Implementation, and Evaluation of the Adolescents and Surveillance System for the Obesity Prevention Project

The Adolescents Surveillance System for Obesity prevention (ASSO) Project aimed at developing standardized and web-based tools for collecting data on adolescents' obesity and its potential determinants. This has been implemented and piloted in the local area of Palermo city, Italy. The aim of the present study is to provide an overview of the Project's design, implementation, and evaluation, highlighting all the aspects for a potential scale-up of the surveillance system on the whole national territory and abroad, as a sustainable and effective source of data.The overall structure and management, the ASSO-toolkit, the ASSO-NutFit software, and all developed and used procedures for recruiting, training, and data collecting/analyzing are addressed. An interim evaluation has been performed through a feasibility study; a final Project evaluation has been performed reporting the Strengths, Weaknesses, Opportunities, and Threats (SWOT) and the attributes that a surveillance system should have.This article provides a detailed overview of the Project and highlights that ASSO can be considered a valid, logical, coherent, efficient, and sustainable surveillance system that is consistent with countries' needs and priorities.The system developed by the ASSO Project provides high-quality data and complies with several characteristics typical of a suitable surveillance system. It has a potential of being adopted within the National Health Service and other countries' Health Services for monitoring adolescents' obesity and its determinants, such as food intakes, behaviors, physical activity, and fitness profiles.

Subcutaneous fat mass in infancy and cardiovascular risk factors at school-age: The generation R study

OBJECTIVE

To examine the associations of infant subcutaneous fat with cardiovascular risk factors at school-age.

METHODS

In a population-based prospective cohort study among 808 children, total subcutaneous fat (sum of biceps, triceps, suprailiacal, and subscapular skinfold thicknesses) and central-to-total subcutaneous fat ratio (sum of suprailiacal and subscapular skinfold thicknesses/total subcutaneous fat) at 1.5 and 24 months were estimated. At 6 years, body mass index, blood pressure, cholesterol, triglycerides, and insulin levels were measured.

RESULTS

Infant subcutaneous fat measures were not associated with childhood blood pressure, triglycerides, or insulin levels. A 1-standard-deviation score (SDS) higher total subcutaneous fat at 1.5 months was, independently of body mass index, associated with lower low-density lipoprotein (LDL)-cholesterol levels at 6 years. In contrast, a 1-SDS higher total subcutaneous fat at 24 months was associated with higher total-cholesterol [difference 0.13 (95% confidence interval (CI) 0.03, 0.23) SDS] and LDL-cholesterol levels [difference 0.12 (95% CI 0.02, 0.21) SDS] at 6 years. There were no associations of central-to-total subcutaneous fat ratio with childhood cholesterol levels.

CONCLUSIONS

These results suggest that infant total subcutaneous fat is weakly associated with cholesterol levels at school-age. Further studies are needed to assess the long-term cardiometabolic consequences of infant body fat.

Reliability of Health-Related Physical Fitness Tests among Colombian Children and Adolescents: The FUPRECOL Study

Substantial evidence indicates that youth physical fitness levels are an important marker of lifestyle and cardio-metabolic health profiles and predict future risk of chronic diseases. The reliability physical fitness tests have not been explored in Latino-American youth population. This study’s aim was to examine the reliability of health-related physical fitness tests that were used in the Colombian health promotion “Fuprecol study”. Participants were 229 Colombian youth (boys n = 124 and girls n = 105) aged 9 to 17.9 years old. Five components of health-related physical fitness were measured: 1) morphological component: height, weight, body mass index (BMI), waist circumference, triceps skinfold, subscapular skinfold, and body fat (%) via impedance; 2) musculoskeletal component: handgrip and standing long jump test; 3) motor component: speed/agility test (4x10 m shuttle run); 4) flexibility component (hamstring and lumbar extensibility, sit-and-reach test); 5) cardiorespiratory component: 20-meter shuttle-run test (SRT) to estimate maximal oxygen consumption. The tests were performed two times, 1 week apart on the same day of the week, except for the SRT which was performed only once. Intra-observer technical errors of measurement (TEMs) and inter-rater (reliability) were assessed in the morphological component. Reliability for the Musculoskeletal, motor and cardiorespiratory fitness components was examined using Bland–Altman tests. For the morphological component, TEMs were small and reliability was greater than 95% of all cases. For the musculoskeletal, motor, flexibility and cardiorespiratory components, we found adequate reliability patterns in terms of systematic errors (bias) and random error (95% limits of agreement). When the fitness assessments were performed twice, the systematic error was nearly 0 for all tests, except for the sit and reach (mean difference: -1.03% [95% CI = -4.35% to -2.28%]. The results from this study indicate that the “Fuprecol study” health-related physical fitness battery, administered by physical education teachers, was reliable for measuring health-related components of fitness in children and adolescents aged 9–17.9 years old in a school setting in Colombia.

Anthropometric measurement standardization in the US-affiliated pacific: Report from the Children's Healthy Living Program

OBJECTIVES

Anthropometric standardization is essential to obtain reliable and comparable data from different geographical regions. The purpose of this study is to describe anthropometric standardization procedures and findings from the Children's Healthy Living (CHL) Program, a study on childhood obesity in 11 jurisdictions in the US-Affiliated Pacific Region, including Alaska and Hawai'i.

METHODS

Zerfas criteria were used to compare the measurement components (height, waist, and weight) between each trainee and a single expert anthropometrist. In addition, intra- and inter-rater technical error of measurement (TEM), coefficient of reliability, and average bias relative to the expert were computed.

RESULTS

From September 2012 to December 2014, 79 trainees participated in at least 1 of 29 standardization sessions. A total of 49 trainees passed either standard or alternate Zerfas criteria and were qualified to assess all three measurements in the field. Standard Zerfas criteria were difficult to achieve: only 2 of 79 trainees passed at their first training session. Intra-rater TEM estimates for the 49 trainees compared well with the expert anthropometrist. Average biases were within acceptable limits of deviation from the expert. Coefficient of reliability was above 99% for all three anthropometric components.

CONCLUSIONS

Standardization based on comparison with a single expert ensured the comparability of measurements from the 49 trainees who passed the criteria. The anthropometric standardization process and protocols followed by CHL resulted in 49 standardized field anthropometrists and have helped build capacity in the health workforce in the Pacific Region. Am. J. Hum. Biol. 28:364-371, 2016. © 2015 Wiley Periodicals, Inc.

Behavioral predictors of attrition in adolescents participating in a multidisciplinary obesity treatment program: EVASYON study

The aims of this study were to identify the cognitive and behavioral predictors of dropping out and to estimate the attrition rate during different phases of an intervention program to treat overweight and obesity in adolescents. Overweight/obese adolescents (n=156, aged: 13-16 years; 71 male and 85 female subjects) were included in a multicomponent (diet, physical activity and psychological support) family-based group treatment program. At baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up, we measured adolescents' cognitive and behavioral dimensions, together with the parents' perception of their child's behavior. Of the 156 adolescents selected, 112 completed the full program (drop-out rate of 28.2%). The risk of dropping out during the extensive phase increased by 20% for each unit increase in the adolescent's social insecurity score (odds ratio=1.20, 95% confidence interval=1.07-1.34, P=0.002). The adolescents who had a high interoceptive awareness showed a significant decrease of 13.0% in the probability of dropping out (odds ratio=0.87, 95% confidence interval=0.77-0.99, P=0.040). Adolescents' social insecurity was the main predictor of drop-out in a multicomponent family-group-based obesity treatment program. To reduce attrition rates in these programs, the individual's social insecurity level needs to be reduced, whereas the family's awareness of eating-related behavior needs adjustment.

Television viewing time and risk of eating disorders in Spanish adolescents: AVENA and AFINOS studies

BACKGROUND

Effective preventive interventions for both eating disorders and obesity in adolescence should be focused on shared risk factors. We analyzed the association between television (TV) viewing time and the risk of eating disorders, as well as the potential role of obesity in this association.

METHODS

The sample consisted of a total of 3458 Spanish adolescents, aged 13-18.5 years, from the Food and Assessment of the Nutritional Status of Adolescents (AVENA) and Physical Activity as a Preventive Measure of the Development of Overweight, Obesity, Allergies, Infections, and Cardiovascular Risk Factors in Adolescents (AFINOS) studies. Adolescents' TV time was assessed by self-report. Body mass index was calculated and the adolescents were classified into non-overweight and overweight-obesity. The risk of eating disorders was evaluated using the SCOFF questionnaire.

RESULTS

Adolescents who watched TV >1 h/day had a higher risk for eating disorders, compared with those adolescents who watch TV <1 h/day. Also, overweight-obese adolescents had a higher risk for eating disorders than those who were non-overweight. Analyses across groups of TV viewing time and weight status showed similar trends, so that the higher the time spent in TV viewing, the higher the risk of eating disorders, regardless of weight status.

CONCLUSIONS

TV viewing time might be a focal point for prevention of both eating disorders and obesity in adolescence.

Reliability of Mid-Upper Arm Circumference Measurements taken by Community Health Nurses

Mid upper arm circumference-based diagnosis of severe acute malnutrition is seen as very attractive because it is assumed to be simple to use in measuring the arm and also requires a single cut-off without having to compute an index or compare to a reference population. The circumference of the left upper arm measured at the mid-point between the tip of the shoulder and the tip of the elbow is referred to as mid upper arm circumference (MUAC). MUAC was originally used in emergency settings where huge populations had to be screened within a short time. However, in the past few years the development of community therapeutic care of acute malnutrition implied a need for a diagnostic tool. The general objective of the study was to assess the inter- and intra-observer variability in MUAC measurements of under-five children by community health nurses in selected communities of the Northern Region in Ghana. A community-based cohort study was conducted on a convenience sample of 120 community health nurses and nursing students from selected communities in the Northern region of Ghana. Each CHN measured MUAC for four unique children on three consecutive days to assess intra-observer variability. To assess inter-observer variability, 50 independent nursing students took MUAC measures of four children on the same day. Bland Altman plots showed a high degree of agreement of MUAC measures taken repeatedly for three days by the same observers and ICC= 0.993. MUAC measures among observers (inter-observer) and ICC =0.042 showed a considerable level of variability among different observers. This study showed that MUAC is reliable when repeated measures are taken on children by the same observers, but using different observers for the same children showed a high level of variability.

Anthropometry and body composition of adolescents in cracow, poland

Background and Objective

The aim of the present study was to determine the level of adiposity and obesity in Polish adolescents and compare the results with earlier studies conducted in this population as well as those carried out in other populations.

Methods

The study group consisted of 456 boys and 514 girls aged 14-18 years living in Cracow chosen from randomly selected secondary schools. Weight, height, waist, and hip circumference (WC, HC) as well as triceps, biceps, subscapular, and suprailiac skinfold thickness (SFT) were measured. Body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), subscapular/triceps skinfold ratio (STR), and percentage body fat were computed. The prevalence of overweight and obesity based on Polish children growth reference were calculated and age-dependent and gender-specific smoothed percentile curves for BMI and ROC curves were generated.

Results

Weight, height, WC, HC (up 16yr), WHtR (up 15yr), and WHR were considerably higher in males than females. Weight, height, and HC increased with age; WHtR remained the same. The prevalence of overweight and obesity were 10.2% (boys 10.3%; girls 10.1%) and 4.2% (boys 5.3%; girls 3.3%). ROC analysis revealed that WHtR was the best tool for detection of obesity (AUC of 0.982±0.007) in males, whereas the sum of four SFTs (AUC: 0.968±0.011) and WHtR (AUC: 0.963±0.012) were the best predictors of obesity in females.

Conclusions

The level of adiposity in Cracow adolescents increased during the last decade. However, it is still lower than in other well-developed societies struggling with obesity epidemics.

Cognition and the risk of eating disorders in Spanish adolescents: the AVENA and AFINOS studies

Eating disorders (ED) can arise from a combination of biological and psychological factors. Some studies suggest that intellectual factors might be important in the development of ED, although the evidence is still scarce. The aim of this study was to examine the association between cognition measurements (cognitive performance and academic achievement) and the risk of developing ED in adolescents considering their weight status. The sample consisted of 3,307 adolescents (1,756 girls), aged 13-18.5 years, who participated in the AVENA (n = 1,430; 783 girls) and AFINOS (n = 1,877; 973 girls) studies. Cognitive performance was measured by the TEA test in the AVENA study, and academic achievement was self-reported in the AFINOS study. ED risk was evaluated in both studies by using the SCOFF questionnaire. Body mass index was calculated to classify adolescents as non-overweight or overweight (including obesity). Overweight adolescents showed a higher risk of developing ED than non-overweight ones in both studies. In the AVENA study, overweight boys with low performance in reasoning ability showed increased risk of ED (p = 0.05). In the AFINOS study, overweight boys with low academic performance in physical education and non-overweight girls with low academic achievement in all the areas analyzed showed higher risk of ED than their peers (all p < 0.05).

CONCLUSION

No association between cognitive performance and ED risk was found in adolescents, while academic achievement was associated with ED risk, especially in non-overweight girls. The non-cognitive traits that accompany academic achievement could influence the likelihood of developing ED in these girls.

[Measurements of location of body fat distribution: an assessment of colinearity with body mass, adiposity and stature in female adolescents]

OBJECTIVE

: To verify the correlation between body fat location measurements with the body mass index (BMI), body fat percentage (BF%) and height, according to the nutritional status in female adolescents.

METHODS

: A controlled cross-sectional study was carried out with 113 adolescents (G1: 38 with normal weight, but with high body fat level, G2: 40 with normal weight and G3: 35 overweight) from public schools in Viçosa-MG, Brazil. The following measures were assessed: weight, height, waist circumference (WC), umbilical circumference (UC), hip circumference (HC), thigh circumference, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-thigh ratio (WTR), conicity index (CI), sagittal abdominal diameter (SAD), coronal diameter (CD), central (CS) and peripheral skinfolds (PS). The BF% was assessed by tetrapolar electric bioimpedance.

RESULTS

: The increase in central fat, represented by WC, UC, WHtR, SAD, CD and CS, and the increase in peripheral fat indicated by HC and thigh circumference were proportional to the increase in BMI and BF%. WC and especially the UC showed the strongest correlations with adiposity. Weak correlation between WHR, WTR, CI and CS/PS with adiposity were observed. The height showed correlation with almost all the fat location measures, being fair or weak with waist measurements.

CONCLUSIONS

: The results indicate colinearity between body mass and total adiposity with central and peripheral adipose tissue. We recommend the use of UC for assessing nutritional status of adolescents, as it showed the highest capacity to predict adiposity in each group, and also showed fair or weak correlation with height.

Overweight and Obesity Based on Four Reference Systems in 18,382 Paediatric Patients with Type 1 Diabetes from Germany and Austria

AIM

To evaluate the prevalence of overweight and obesity in paediatric type 1 diabetes (T1D) subjects, based on four commonly used reference populations.

METHODS

Using WHO, IOTF, AGA (German pediatric obesity), and KiGGS (German Health Interview and Examination Survey for Children and Adolescents) reference populations, prevalence of overweight (≥90th percentile) and obesity (≥97th percentile) and time trend between 2000 (n = 9,461) and 2013 (n = 18,382) were determined in 2-18-year-old T1D patients documented in the German/Austrian DPV database.

RESULTS

In 2000, the overweight prevalence was the highest according to IOTF (22.3%), followed by WHO (20.8%), AGA (15.5%), and KiGGS (9.4%). The respective rates in 2013 were IOTF (24.8%), WHO (22.9%), AGA (18.2%), and KiGGS (11.7%). Obesity prevalence in 2000 was the highest according to WHO (7.9%), followed by AGA (4.5%), IOTF (3.1%), and KiGGS (1.8%). In 2013, the respective rates were WHO (9.6%), AGA (6.2%), IOTF (4.5%), and KiGGS (2.6%). Overall, the prevalence of overweight and obesity increased from 2000 to 2006 (p < 0.001) but showed stabilization thereafter in girls and overweight in boys.

CONCLUSION

Overweight and obesity prevalence in T1D subjects differs significantly if it is assessed by four separate reference populations. More detailed assessment of each child is required to determine obesity-related risks.

Optimal treatment of replicate measurements in anthropometric studies

BACKGROUND

Anthropometric studies often include replicates of each measurement to decrease error. The optimal method to combine these measurements is uncertain.

AIM

To identify the optimal method to combine replicate measures for analysis.

METHODS

The authors carried out 10 000 Monte Carlo simulations to explore the effect of six approaches to combine replicate measurements in a hypothetical two-group intervention study (n = 100 per arm) in which the outcome, infant length at age 1 year, was measured two or three times. One group had a true value with a normal distribution N (mean = 76, SD = 2.4 cm). Statistical power was estimated to detect a 1 cm difference between the groups, based on a t-test.

RESULTS

Under a realistic scenario with a measurement error distribution N (0, 0.8), highest power was reached by use of the mean and the median of pairwise averages. However, when a portion of the data (≥2%) were contaminated by greater error (e.g. due to data entry), the median of three measurements outperformed all other methods while the mean had the lowest performance.

CONCLUSION

Obtaining three rather than two measures and using the median of the three replicates is a safe and robust approach to combine participants' raw data values for use in subsequent analyses.

Reliability of anthropometric measurements in European preschool children: the ToyBox-study

The ToyBox-study aims to develop and test an innovative and evidence-based obesity prevention programme for preschoolers in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. In multicentre studies, anthropometric measurements using standardized procedures that minimize errors in the data collection are essential to maximize reliability of measurements. The aim of this paper is to describe the standardization process and reliability (intra- and inter-observer) of height, weight and waist circumference (WC) measurements in preschoolers. All technical procedures and devices were standardized and centralized training was given to the fieldworkers. At least seven children per country participated in the intra- and inter-observer reliability testing. Intra-observer technical error ranged from 0.00 to 0.03 kg for weight and from 0.07 to 0.20 cm for height, with the overall reliability being above 99%. A second training was organized for WC due to low reliability observed in the first training. Intra-observer technical error for WC ranged from 0.12 to 0.71 cm during the first training and from 0.05 to 1.11 cm during the second training, and reliability above 92% was achieved. Epidemiological surveys need standardized procedures and training of researchers to reduce measurement error. In the ToyBox-study, very good intra- and-inter-observer agreement was achieved for all anthropometric measurements performed.

Anthropometric indices to assess body-fat changes during a multidisciplinary obesity treatment in adolescents: EVASYON Study

BACKGROUND & AIMS

The main objectives of weight loss interventions in children and adolescents are to decrease fat mass while maintaining fat-free mass. Several methods are available to assess childhood and adolescence obesity, such as weight and height, bioelectrical impedance, skin-fold thickness measurements and other laboratory methods. The aim was to assess simple anthropometric indices as predictors of body-fat changes, using dual-energy X-ray absorptiometry measurements as reference method.

METHODS

Multi-intervention approach (diet, physical activity and psychological support in a family-group-based treatment) was implemented with a one-year follow-up in 13-to-16-year-old overweight or obese Spanish adolescents. A total of 83 adolescents were recruited from Granada and Zaragoza, males (n = 43) (31.6 kg/m(2)) and females (n = 40) (32.0 kg/m(2)). We measured body composition with anthropometry and dual-energy X-ray absorptiometry. All measurements were made at baseline, and after 2 and 13 months. Random coefficient regression model was used to calculate the proportion of body composition changes during follow-up that would be explained by simple body composition indices based on anthropometric measures.

RESULTS

After controlling for age and Tanner stage, body mass index explained 76.5% of body composition changes in males and 90.1% in females, while fat mass index (assessed by skin-folds) explained 78.9% of body composition changes in males and 84.0% of body composition changes in females.

CONCLUSIONS

In conclusion, we found that BMI was a good indicator of body fat composition changes in children and adolescents, although FMI assessed by anthropometry was also a good indicator.

Characteristics of extracurricular physical activity and cognitive performance in adolescents. The AVENA study

The aim of this report was to examine the associations between some characteristics (i.e., structure and number) of extracurricular physical activity (EPA) and cognitive performance in adolescents. A total of 1662 adolescents (880 girls; 13.0-18.5 years) from 5 Spanish cities (Granada, Madrid, Murcia, Santander and Zaragoza) were included in this study. Structure (organised and non-organised) and number of EPAs, and participation at vigorous intensity during EPA were self-reported. Cognitive performance (verbal, numeric and reasoning abilities, and an overall score) was measured with the "SRA-Test of Educational Ability". Results showed that vigorous EPA was positively associated with all cognitive variables. Adolescents who practiced an organised EPA had higher scores in 3 of the 4 cognitive variables than those who practiced a non-organised EPA (all P < 0.05). Likewise, the group who participated in more than one EPA had higher cognitive performance in all variables than the group who participated in only one EPA (all P < 0.05). Regardless of potential confounder variables, including vigorous EPA, both structure and number of EPAs were each other independently associated with cognitive performance. Therefore, structure and number of EPAs may positively influence cognitive performance in adolescents. Participating in multiple, organised EPA may have benefits for cognitive performance.

Physical fitness, overweight and the risk of eating disorders in adolescents. The AVENA and AFINOS studies

What is already known about this subject Eating disorders are among the public health issues facing adolescents. An excess of body fat has been associated with an increased risk of these disorders. The association of physical fitness with eating disorders has not yet been analysed in adolescents. What this study adds This study confirms that the overweight and obesity increase the risk of developing eating disorders. The present study shows that there is an inverse association between physical fitness levels and the risk of eating disorders. This study suggests that physical fitness might attenuate the influence of overweight on the development of eating disorders in adolescents.

BACKGROUND

Eating disorders together with the overweight and obesity are important health concerns in adolescents.

OBJECTIVE

To analyse the individual and combined influence of overweight and physical fitness on the risk of developing eating disorders in Spanish adolescents.

METHODS

The sample consisted of 3571 adolescents (1864 females), aged 13 to 18.5 years, from Spain who participated in the AVENA and AFINOS studies. The risk of eating disorders was evaluated using the SCOFF questionnaire. Body mass index was calculated and the adolescents were classified into two groups: overweight (including obesity) and non-overweight according to Cole's cut-off points. Cardiorespiratory fitness in the AVENA Study was assessed by the 20-m shuttle-run test and the overall physical fitness level was self-reported in the AFINOS Study.

RESULTS

Overweight adolescents had a higher risk of developing eating disorders than non-overweight adolescents (odds ratio [OR] = 4.91, 95% confidence interval [CI]: 3.63-6.61 in the AVENA Study and OR = 2.45, 95% CI: 1.83-3.22 in the AFINOS Study). Also, adolescents with medium and low levels of physical fitness had a higher risk of developing eating disorders (OR = 1.51, 95% CI: 1.05-2.16, and OR = 2.25, 95% CI: 1.60-3.19, respectively, in the AVENA Study, and OR = 1.73, 95% CI: 1.37-2.17, and OR = 4.11 95% CI: 2.98-5.65, respectively, in the AFINOS Study) than adolescents with high levels of physical fitness. In both studies, the combined influence of overweight and physical fitness showed that adolescents with lower levels of physical fitness had an increased risk of developing eating disorders in both non-overweight and overweight groups.

CONCLUSIONS

Physical fitness might attenuate the influence of overweight on the development of eating disorders in adolescents.

Prospective association of protein intake during puberty with body composition in young adulthood

OBJECTIVE

To examine the association of habitual animal and plant protein intake during the potentially critical period of puberty with body composition in young adulthood.

DESIGN AND METHODS

Multivariable regression analyses were performed on data from 140 female and 122 male participants of the DONALD Study with ≥2 3-day weighed dietary records during puberty (girls 9-14 years; boys 10-15 years) and anthropometric measurements in young adulthood (18-25 years). Fat-free mass index (FFMI) and fat mass index (FMI) were estimated from four skinfolds.

RESULTS

In women, a higher pubertal animal protein consumption was independently related to higher levels of FFMI (ptrend = 0.001), but not to FMI (ptrend = 0.5). Adjusted means of FFMI in energy-adjusted tertiles of animal protein intake were 15.3 (95% confidence interval: 15.0, 15.5), 15.4 (15.1, 15.7), 16.2 (15.9, 16.6) kg/m(2) . In men, a higher animal protein intake was related to a higher FFMI (ptrend = 0.04) and a lower FMI (ptrend = 0.001) only after adjusting FFMI for current FMI levels and vice versa. Plant protein was not associated with body composition among either sex.

CONCLUSIONS

Our results show that a higher pubertal animal protein consumption may yield a higher fat-free mass in young adulthood.

Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise

The purpose of this study was to determine the effect of cryotherapy on the inflammatory response to muscle-damaging exercise using a randomized trial. Twenty recreationally active males completed a 40-min run at a -10 % grade to induce muscle damage. Ten of the subjects were immersed in a 5 °C ice bath for 20 min and the other ten served as controls. Knee extensor peak torque, soreness rating, and thigh circumference were obtained pre- and post-run, and 1, 6, 24, 48, and 72 h post-run. Blood samples were obtained pre- and post-run, and 1, 6 and 24 h post-run for assay of plasma chemokine ligand 2 (CCL2). Peak torque decreased from 270 ± 57 Nm at baseline to 253 ± 65 Nm post-run and increased to 295 ± 68 Nm by 72 h post-run with no differences between groups (p = 0.491). Soreness rating increased from 3.6 ± 6.0 mm out of 100 mm at baseline to 47.4 ± 28.2 mm post-run and remained elevated at all time points with no differences between groups (p = 0.696). CCL2 concentrations increased from 116 ± 31 pg mL(-1) at baseline to 293 ± 109 pg mL(-1) at 6 h post-run (control) and from 100 ± 27 pg mL(-1) at baseline to 208 ± 71 pg mL(-1) at 6 h post-run (cryotherapy). The difference between groups was not significant (p = 0.116), but there was a trend for lower CCL2 in the cryotherapy group at 6 h (p = 0.102), though this measure was highly variable. In conclusion, 20 min of cryotherapy was ineffective in attenuating the strength decrement and soreness seen after muscle-damaging exercise, but may have mitigated the rise in plasma CCL2 concentration. These results do not support the use of cryotherapy during recovery.

[Association of muscle strength with early markers of cardiovascular risk in sedentary adults]

OBJECTIVE

To assess the association between muscle strength and early cardiovascular risk (CVR) markers in sedentary adults.

MATERIALS AND METHODS

A total of 176 sedentary subjects aged 18-30 years were enrolled. Body mass index and fat percentage were calculated, and waist circumference, grip strength by dynamometry, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and maximal oxygen uptake by VO2max were measured as CVR markers. A multivariate logistic regression analysis was used to assess associations between muscle strength and CVR markers.

RESULTS

Inverse correlations were found between muscle strength and adiposity (r=-.317; P=.001), waist circumference (r=-.309; P=.001), systolic blood pressure (r=-.401; P=.001), and mean arterial pressure (r=-.256; P=.001). Subjects with lower levels of muscle strength had a 5.79-fold (95% CI 1.57 to 9.34; P=.008) risk of having higher adiposity levels (≥25%) and a 9.67-fold (95% CI=3.86 to 19.22; P<.001) risk of having lower physical capacity values for VO2max (≤31.5mL/kg/min(-1)).

CONCLUSIONS

In sedentary adults, muscle strength is associated to early manifestations of CVR. It is suggested that muscle strength testing is added to routine measurement of VO2max and traditional risk factors for prevention and treatment of cardiovascular risk.

Increase in prevalence of adiposity between the ages of 7 and 11 years reflects lower remission rates during this period

What is already known about this subject? A considerable increase in the prevalence of overweight during the primary school years (7-11 years) has been reported. What this study adds? This reflects lower remission rates of excess body fat (i.e. the proportion of shifts from excess to normal body fat) between the ages of 7 and 11 years as compared with nearly balanced incidence and remission rates of excess body fat between the ages of 3 and 7 years.

OBJECTIVE

This study aimed to compare the age-specific balance between incidence and remission of excess body fat between the ages of 3-7 and 7-11 years using the data from a longitudinal study.

DESIGN

Longitudinal analysis based on the data from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study, an ongoing, open cohort study in healthy children, conducted in Dortmund, Germany. Excess body fat was defined by the sum of triceps and subscapular skin-fold measurements above the 90th reference percentile of the new German standard; overweight was defined using different national and international standards. The main outcome parameters were incidence and remission rates of excess body fat (n = 496) and overweight (n = 518) between the ages of 3 and 7 years and between the ages of 7 and 11 years.

RESULTS

The incidence rates of excess skin-fold thickness between the ages of 3 and 7 years (4.2 [2.4, 6.2]%) and between the ages of 7 and 11 years (4.3 [2.6, 6.2]%) were almost identical. By contrast, remission rates were significantly lower during the age period of 7-11 years (primary school age) than during the age period of 3-7 years (pre-school age): 37.5 (21.9, 53.1%) compared with 72.3 (59.6, 85.1%).

CONCLUSIONS

These data point to the low remission of excess body fat as an important driving force for the increasing prevalence of excess body fat in children between the ages of 7 and 11 years. Public health initiatives in children should encompass both primary prevention and interventions targeted at children already overweight at school entry.