Development and tracking of central patterns of subcutaneous fat of rural South African youth: Ellisras longitudinal study

Tracking of anthropometric characteristics from childhood to adolescence: an 8-year follow-up findings from the Czech ELSPAC study

BACKGROUND

Although evidence suggests that obesity track well from childhood to adolescence, most of the research has been done in Western and high-income countries. Moreover, most of the studies have tracked body-mass index, as a proxy of nutritional status, while tracking characteristics of circumferences and skinfold thicknesses have been less studies. Therefore, the main purpose of the study was to explore tracking characteristics of complete anthropometric data from childhood to adolescence.

METHODS

This sub-study was part of the Czech ELSPAC study. In the present 8-year longitudinal study, we collected information from pediatrician's medical records at the ages of 8 y (n = 888), 11 y (n = 1065), 13 y (n = 811) and 15 y (n = 974), including circumferences (head, chest, waist, hips, and arm), indices (body-mass index, waist-to-hip ratio and waist-to-height ratio) and skinfold thicknesses (biceps, triceps, subscapula, suprailiaca, thigh and the sum of 5 skinfolds). Participants were recruited from the two selected regions of the Czech Republic (Brno and Znojmo). Linear generalized estimating equations were conducted to analyze tracking patterns over an 8-year follow-up period for all anthropometric measurements.

RESULTS

Tracking coefficients were moderate to strong, ranging from 0.40 to 0.62 for circumferences, 0.41 to 0.74 for indices and 0.72 to 0.86 for skinfolds. According to body-mass index and waist circumference standards, overweight/obese children and children with abdominal obesity at the age of 8 y were 11.31 (95% CI = 8.41 to 15.22, p < 0.001) and 10.73 (95% CI = 7.93 to 14.52, p < 0.001) more likely to remain overweight/obese and to have abdominal obesity at the age of 15 y.

CONCLUSIONS

Findings show moderate to strong tracking of anthropometric characteristics, i.e. circumferences track moderately well, while strong tracking for indices and skinfold thicknesses is observed. Moreover, strong tracking of general overweight/obesity and abdominal obesity between ages 8 y and 15 y indicates that the detection of these risk factors at the beginning of primary school should be advocated.

Genesis, Procedures, Attrition Rate and Major Reasons for Missing Measurement Session by the Study Participants in the Ellisras Longitudinal Study

The noncommunicable diseases’ (NCDs) profile is changing rapidly from one country to another. A well-formulated cohort study in Africa could answer major questions relating to the changing profile of NCDs risk in Africa. The aim of the present study was to outline the genesis, procedures, attrition rate and major reasons for study participants to miss measurement sessions in the Ellisras Longitudinal Study (ELS). Method: The ELS followed multiple longitudinal designs comprising repeated measurements in more than one cohort with overlapping ages. Age cohort and time of measurement effects could be identified. A cluster random sampling method was used to sample 2255 participants (1201 males and 1054 females), aged 2 to 10.9 years at baseline (November 1996). Information on lifestyle (tobacco and smoking, alcohol intake, physical activity and socioeconomic status) and biological risk factors for NCD and educational achievements were collected over time. The participants were followed 17 times over the past 25 years with measurements (blood pressure and anthropometry) collected twice during the first consecutive 8 years to account for growth dynamics and other health-related variables. The attrition rate for ELS sample for boys (14%–27.3%) was significantly (p < 0.05) higher than girls (7.9%–18.6%) from May 1999 to November 2003. There was a significant (p < 0.05) increase (25.3%–70.3%) in attrition rate from November 2009 to December 2015. The ELS participant migration to urban areas provided a unique opportunity to investigate the effect of urban life on these rural young adults given the previous data collected on the same subjects at a younger age (3–10 years at baseline in 1996). Conclusion: A well-formulated ELS study in Africa could answer major questions relating to the changing magnitude of NCDs risk factor profiles in Africa.

The Relationship Between Strength Measurements and Anthropometric Indicators (BMI and Skinfold Thickness) in Ellisras Rural Adolescents Aged 9–15 Years: Ellisras Longitudinal Study

Purpose. Handgrip strength and arm hang have been recognized as predictors of muscle strength and presented as biomarkers for important health outcomes and overall fitness of an individual. The aim of the study was to investigate the relationship between arm hang and handgrip strength with BMI and skinfold thickness.

Method. The total of 769 children (391 boys and 378 girls) aged 9-15 years underwent a series of anthropometric and strength measurements with the use of standard procedures. Linear regression was applied to assess the relationship of arm hang and handgrip strengths with body mass index and skinfold thickness.

Results. The prevalence of undernutrition and low strength measurements was high (1.7-85%) while the prevalence of overweight and obesity was low (1.5-4.2%) in the Ellisras children aged 9-15 years. Boys showed a significantly higher (p < 0.05) mean arm hang (9.6-13.1 kg) than girls (4.0-5.1 kg) aged 11-15 years. There was a significant (p < 0.05) association between low strength and underweight among Ellisras rural children when unadjusted (OR = 0.650; 95% CI = 0.487-0.867) and adjusted (OR = 0.650; 95% CI = 0.489-0.868) for age and gender.

Conclusions. The prevalence of undernutrition and poor strength was high. An association was observed between arm hang and anthropometric indicators while handgrip showed no significant association with anthropometric indicators. Further studies are needed to investigate the association between strength and undernutrition over time.

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.

Tracking of weight status and body fatness in Italian children

The prevalence of weight disorders among school-aged children is an increasing phenomenon and it is of great importance to identify the characteristics of individuals at risk of gaining or retaining weight. This study aimed to examine the prevalence of weight disorders and their tracking over a 3-year period in a sample of Italian children. Body mass, body height and selected skinfold thicknesses were assessed in 355 children at the age of 7 and 10 years. Tracking of body mass index (BMI), inverted BMI (iBMI) and skinfold-based body fat were analyzed and the relationships between changes in BMI and body fat were examined. Children presenting with overweight or obesity at 7 years old showed a trend toward lower weight categories at 10 years old. Conversely, a trend to become overweight was observed among normal weight boys, and a trend to become underweight was observed among normal weight girls. BMI, iBMI and body fat showed good levels of tracking, with high correlations between measurements performed at 7 and 10 years of age. Furthermore, BMI and iBMI changes were correlated to body fatness changes. The present study shows the importance of carefully following children's development over time because weight disorders may appear even in previously normal weight children.

Body adipose distribution among patients with type 2 diabetes mellitus

SUMMARY

Both diabetes mellitus (DM) and obesity are prevalent in adults. The relationship between DM and body adipose tissue (AT) distribution is complex and although it has been investigated extensively, the subject remains controversial. Although a causal association between DM and obesity and AT distribution cannot be established on the basis of existing data, it is possible to conclude from many studies that gene, serum sex steroids level, daily physical activity and food supply can be the risk of obesity and AT redistribution factor among type 2 DM patients (T2DM). Obesity and AT redistribution of T2DM patients can increase the risk of insulin resistant (IR), cardiovascular disease and many other disorders. Even though obesity and AT redistribution screening or prophylactic treatment in all patients with T2DM is not being recommended at present, such patient populations should be given general guidelines regarding exercise, food intake control, and even medicinal treatment. The extent of diagnostic and therapeutic interventions should be based on the individual's risk profile.: