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Ferretti RDL, Maia-Lemos PDS, Guedes KJT, Caran EMM. Neck Circumference for Identification of Excess Adiposity in Adolescents with Cancer: A Better Parameter for Use in Clinical Practice? J Adolesc Young Adult Oncol 2024; 13:316-322. [PMID: 37878304 DOI: 10.1089/jayao.2022.0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Purpose: Excess weight in adolescents with cancer during treatment does affect cancer outcomes. Neck circumference (NC), an easygoing anthropometric measure, may present greater metabolic risk, and is associated with excess adiposity. The aim of this study was to identify the prevalence of elevated NC in adolescents with cancer and associated factors. Methods: Cross-sectional study with adolescents aged 10-19 years, under antineoplastic treatment, evaluated from 2015 to 2017, at a Pediatric Oncology Institute's outpatient clinic. Anthropometric parameters were collected, besides diagnosis, sex, and age. The classification of elevated NC was carried out considering cutoff values for adolescents, according to sex and age group. A binary logistic regression was used to determine relationships between NC and associated factors. Results: Among 496 eligible cases, most were male (n = 299, 60.3%). A total of 31.9% of cases had high NC. There is significant and moderate correlation between skinfold thickness (TS) and NC (ρ = 0.6; p = 0.000), and a significant but weak correlation between TS and body mass index (ρ = 0.267; p = 0.000). The adjusted analysis for sex, age group, and type of tumor showed that females are more likely to belong to the high NC category, to have excess adiposity. The age group between 10 and 12 years was the most associated with this outcome (2.795 [0.979-7.977]; p < 0.05). TS is also associated with high NC (1.114 [1.050-1.182]; p < 0.05). Conclusion: It was concluded that there is high prevalence of elevated NC and higher risks for this outcome considering type of tumor, sex, age group, besides being an easy and simple measure for use in clinical practice.
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Affiliation(s)
- Roberta de Lucena Ferretti
- Department of Pediatrics, Support Group for Children and Adolescents with Cancer (GRAACC), Federal University of Sao Paulo, Sao Paulo, Brazil
- Department of Nursing and Nutrition, University of Taubate, Taubate, Brazil
| | - Priscila Dos Santos Maia-Lemos
- Department of Pediatrics, Support Group for Children and Adolescents with Cancer (GRAACC), Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Karen Jaloretto Teixeira Guedes
- Department of Pediatrics, Support Group for Children and Adolescents with Cancer (GRAACC), Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Eliana Maria Monteiro Caran
- Department of Pediatrics, Support Group for Children and Adolescents with Cancer (GRAACC), Federal University of Sao Paulo, Sao Paulo, Brazil
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Souza Alves Jr CA, Augustemak DE Lima LR, Franco Moreno YM, Santos Silva DA. Anthropometric indicators as discriminators of high body fat in children and adolescents with HIV: comparison with reference methods. Minerva Pediatr (Torino) 2023; 75:828-835. [PMID: 32418403 DOI: 10.23736/s2724-5276.20.05720-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND Body fat assessment is needed in individuals with HIV. The objective was to identify the discriminatory capacity of the abdominal skinfold (ASF) tricipital skinfold (TSF), subscapular fold (SSF), calf skinfold (CSF), body adiposity index (BAI), body mass index, conicity index (IC), mid-upper arm circumference (MUAC), waist circumference (WC), perimeter of neck (PN) and waist-to-height ratio (WHtR) for high body fat in children and adolescents with HIV, compared Dual energy X-ray absorptiometry (DXA) and air displacement plethysmography (ADP). METHODS Descriptive study, cross - sectional study, with 65 children and adolescents with HIV by vertical transmission. Body fat was measured by DXA and ADP. Measures were measured by international standardization. The diagnostic properties for high body fat were assessed by area under the ROC curve (AUC). RESULTS For boys, having DXA as a reference for fat, ASF (AUC: 0.920), TSF (AUC: 0.792), SSF (AUC: 0.766), CSF (AUC: 0.866), BAI satisfactory discriminatory capacity. With ADP as the reference method, ASF (AUC: 0.920), TSF (AUC: 0.921), SSF (AUC: 0.766), CSF (AUC: 0.901), BAI (AUC: 0.756) and BMI (AUC: 0.699) presented satisfactory results. For girls, having DXA as a reference for fat, ASF (AUC: 0.838), TSF (AUC: 0.842), SSF (AUC: 0.840), CSF (AUC: 0.887), BAI (AUC: 0.846), and BMI (AUC: 0.859) presented satisfactory discriminatory capacity. Assuming ADP as a reference for fat, ASF (AUC [AUC: 0.799], TSF [AUC: 0.825], SSF [AUC: 0.767], CSF [AUC: 0.897], BAI 0.788), were satisfactory. CONCLUSIONS The ASF, TSF, SSF, CSF, BAI and BMI anthropometric indicators may be suggested as the most suitable for the detection of high body fat in children and adolescents with HIV.
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Affiliation(s)
- Carlos A Souza Alves Jr
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil -
| | | | - Yara M Franco Moreno
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Diego A Santos Silva
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil
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Oliveira IKF, Teixeira NDSCCDA, Rêgo BDMP, Aires IO, Torres Rodrigues RR, Araújo REDS, Lima CHR, Sousa RRD, Carvalho CMRGD, Costa DL, Santos MMD, Paz SMRSD, Paiva ADA. Neck circumference as a predictor of cardiometabolic risk and truncal obesity in people living with HIV. NUTR HOSP 2023; 40:1000-1008. [PMID: 37334822 DOI: 10.20960/nh.04402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Introduction Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV). Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using a structured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (WC), neck (NC), arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 %CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with WC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance. Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men.
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Alirezaei T, Soori H, Irilouzadian R, Najafimehr H. Novel Anthropometric Indices as Screening Tools for Obesity: A Study on Healthy Iranians. J Nutr Metab 2023; 2023:6612411. [PMID: 37822568 PMCID: PMC10564568 DOI: 10.1155/2023/6612411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/09/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023] Open
Abstract
Background and Aims Upper body fat distribution is more related to cardiometabolic diseases than central obesity. Neck circumference (NC) and neck-to-height ratio (NHtR) are two indicators of upper body obesity that are affordable, easy to obtain, highly reproducible, and more practical in the crowded health centers than the classic anthropometric indices. Methods 18-65-year-old individuals with no past medical history were included. After obtaining written informed consent, they were screened for hypertension, high blood glucose, and other abnormal laboratory results. Data were analyzed using SPSS and Mann-Whitney U test, Chi square test, Spearman's correlation coefficient, and ROC curve. Results In our 2,812 participants, NC had the lowest area under the curve (AUC) in both male and female obese and overweight subjects. NHtR and hip circumference (HC) had the highest AUC in men and women with obesity, respectively. The highest sensitivity for overweight men and women belonged to waist circumference (WC) and waist-to-height ratio (WHtR), respectively, and for both males and females with obesity, NHtR had the highest sensitivity. The cutoff point of NHtR had the same value for males and females. HC and NHtR had the highest positive likelihood ratio (PLR) for obesity in men. In addition, HC and WC had the highest PLR for obesity in women. Conclusion In this study, we revealed that NC had the lowest and NHtR and HC had the highest predictive value for obesity. Furthermore, for both males and females with obesity, NHtR had the highest sensitivity. HC had the highest PLR for obesity in both genders. Our results warrant prospective studies to evaluate the role of NHtR and other novel anthropometric indices in the risk of cardiometabolic diseases.
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Affiliation(s)
- Toktam Alirezaei
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Soori
- Safety Promotion and Injury Prevention of Research Center, Cohort Health Employees Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rana Irilouzadian
- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadis Najafimehr
- Safety Promotion and Injury Prevention of Research Center, Cohort Health Employees Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Arefhosseini S, Tutunchi H, Tavakkoli S, Arefhosseini SR, Ebrahimi-Mameghani M. Association of neck circumference-related indices with metabolic, atherogenic and liver function biomarkers in patients with non-alcoholic fatty liver disease: a cross-sectional study. BMJ Open 2023; 13:e073452. [PMID: 37699622 PMCID: PMC10503374 DOI: 10.1136/bmjopen-2023-073452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/20/2023] [Indexed: 09/14/2023] Open
Abstract
OBJECTIVE The present study aimed to establish the association of neck circumference (NC)-related indices with metabolic, atherogenic and liver function biomarkers in patients with non-alcoholic fatty liver disease (NAFLD). DESIGN Cross-sectional study. SETTING Outpatient clinics of Tabriz University of Medical Sciences. PARTICIPANTS A total of 175 adult patients with NAFLD diagnosed by abdominal ultrasonography were included in this study. Sociodemographic characteristics, anthropometric measures and metabolic, atherogenic and liver function biomarkers were assessed. RESULTS Results on 107 women and 68 men with NAFLD showed that 52%, 45.1% and 2.9% of patients had mild, moderate and severe NAFLD, respectively. There were significant differences in most of the anthropometric indices, serum levels of ferritin, creatinine and uric acid as well as liver enzymes, and Aspartate Aminotransferase (AST) to Platelet Ratio Index (APRI) between the genders (p<0.01). However, no significant differences were found in the glycaemic, lipid profile and atherogenic biomarkers. Both NC and neck-to-height ratio (NHtR) were significantly associated with body mass index (BMI) (p=0.018, p<0.001, respectively), waist circumference (WC) (p<0.001, p=0.044, respectively) and waist-to-hip ratio (WHR) (p<0.001, p=0.026, respectively) while results showed only a significant relationship between neck-to-waist ratio (NWR) with BMI (p<0.001) and WC (p<0.001). Among metabolic factors, there were significant and positive correlations between NC and serum haemoglobin A1c (r=0.198, p<0.001), AST (r=0.300, p<0.001), alanine aminotransferase (ALT) (r=0.348, p<0.001), ferritin (r=0.403, p<0.001) and uric acid (r=0.347, p=0.003) while AST/ALT ratio was inversely related to NC (r=-0.226, p=0.003). APRI, Lipid Accumulation Product Index and also Hepatic Steatosis Index were significantly correlated with NC, NHtR and NWR (p<0.01). CONCLUSIONS AND RELEVANCE NC-related indices, particularly NC and NHtR, were correlated with some metabolic and liver function biomarkers (apart from lipid profile and atherogenic factors) in patients with NAFLD.
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Affiliation(s)
- Sara Arefhosseini
- Student Research Committee, Department of Biochemistry and Diet Therapy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Helda Tutunchi
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahrzad Tavakkoli
- Student Research Committee, Department of Biochemistry and Diet Therapy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Rafie Arefhosseini
- Department of Biochemistry and Diet Therapy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrangiz Ebrahimi-Mameghani
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Somdee T, Somdee T, Yangyuen S, Mungvongsa A, Khiewkhern S, Puapittayathorn T, Thitisutthi S, Srikongpan P, Keawmuanga S. Screening tools for metabolic syndrome based on anthropometric cut-off values among Thai working adults: a community-based study. Ann Saudi Med 2023; 43:291-297. [PMID: 37805820 PMCID: PMC10560367 DOI: 10.5144/0256-4947.2023.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/26/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND The metabolic syndrome (MetS) is a universal disease of increasing prevalence, but the prevalence varies depending on ethnicity. There is a crucial need to assess the validity of anthropometric indicators and determine appropriate cut-off values for MetS screening. OBJECTIVE Determine cut-off anthropometric indicators values for screening of MetS. DESIGN Cross-sectional SETTING: Rural and urban areas of provinces with a high prevalence of MetS in the central region of Thailand. SUBJECTS AND METHODS The subjects were recruited based on the International Diabetes Federation definition of MetS, which includes four anthropometric indicators. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity for different cut-off values of all novel indicators. MAIN OUTCOME MEASURES The cut-off values for screening of MetS, which included neck circumference (NC), body roundness index (BRI), conicity index (C-index), and body shape index (BSI). SAMPLE SIZE 2520 participants RESULTS: The BRI and NC were the indices with higher areas under the curve, followed by the C-index and BSI. The optimal cut-off values for BRI and NC were 4.1 and 36.5 cm for males and 4.0 and 34.5 cm for females. CONCLUSIONS This study defined the specific cut-off values for Thai working adults. LIMITATIONS The participants might not be representative of all Thai adults and we may have overestimated MetS for Thai working adults because our research focus was on the highest prevalence of MetS in the central region of Thailand.
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Affiliation(s)
- Thidarat Somdee
- From the Department of Nutrition, Faculty ofPublic Health, Maha Sarakham University, Maha Sarakham, Thailand
| | - Theerasak Somdee
- From the Faculty of Science, Khon Kaen University, Khon Kaen, Thailand
| | - Suneerat Yangyuen
- From the Department of Nutrition, Faculty ofPublic Health, Maha Sarakham University, Maha Sarakham, Thailand
| | - Aravan Mungvongsa
- From the Institute of Public Health, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Santisith Khiewkhern
- From the Department of Nutrition, Faculty ofPublic Health, Maha Sarakham University, Maha Sarakham, Thailand
| | - Thanyathorn Puapittayathorn
- From the Department of Nutrition, Faculty ofPublic Health, Maha Sarakham University, Maha Sarakham, Thailand
| | - Sawan Thitisutthi
- From the Department of Nutrition, Faculty ofPublic Health, Maha Sarakham University, Maha Sarakham, Thailand
| | - Piyaporn Srikongpan
- From the Department of Nutrition, Faculty ofPublic Health, Maha Sarakham University, Maha Sarakham, Thailand
| | - Supattra Keawmuanga
- From the Department of Nutrition, Faculty ofPublic Health, Maha Sarakham University, Maha Sarakham, Thailand
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Carvalho WRC, França AKTDC, dos Santos AM, Padilha LL, Bogea EG. Appropriate neck circumference and waist-to-height ratio cut-off points as predictors of obesity and cardiovascular risk in adolescents. Rev Saude Publica 2023; 57:24. [PMID: 37075407 PMCID: PMC10118407 DOI: 10.11606/s1518-8787.2023057004349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/25/2022] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE To determine neck circumference (NC) and waist-to-height ratio (WHtR) cut-off points as predictors of obesity and cardiovascular risk in adolescents. METHODS Cross-sectional study developed with a subsample of 634 adolescents aged 18 and 19 years belonging to the third phase of the "RPS" cohort (Ribeirão Preto, Pelotas and São Luís) carried out in 2016. The area under the ROC curve (AUC) was identified to assess the predictive capacity of NC and WHtR in relation to the percentage of body fat (%BF), obtained by air displacement plethysmography (ADP), and the cardiovascular risk estimated by the Pathobiological Determinants of Atherosclerosis in Youth (PDAY). RESULTS The prevalence of obesity by %BF was 7.6% in males and 39.4% in females (p-value <0.001), and the high PDAY risk was 13.8% and 10.9%, respectively. For males, NC cut-off point was 44.0 cm and the AUCs were 0.70 (95%CI 0.58-0.83) to predict obesity and 0.71 (95%CI 0.62-0.80) to predict high cardiovascular risk; for females, NC cut-off point was 40 cm and the AUCs were 0.75 (95%CI 0.69-0.80) and 0.63 (95%CI 0.53-0.73), respectively. WHtR cut-off point was 0.50 for both sexes; for males, the AUCs to predict obesity and high risk according to PDAY were 0.90 (95%CI 0.80-0.99) and 0.73 (95%CI 0.63-0.82), respectively; for females, they were 0.87 (95%CI 0.83-0.90) and 0.55 (95%CI 0.45-0.65), respectively. CONCLUSION WHtR and NC are good discriminators to assess obesity and cardiovascular risk in adolescents, especially in males.
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Affiliation(s)
- Wyllyane Rayana Chaves Carvalho
- Universidade Federal do MaranhãoPrograma de Pós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - Ana Karina Teixeira da Cunha França
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Luana Lopes Padilha
- Universidade Federal do MaranhãoPrograma de Pós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - Eduarda Gomes Bogea
- Universidade Federal do MaranhãoPrograma de Pós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós Graduação em Saúde Coletiva. São Luís, MA, Brasil
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Are the different cut-off points for sitting time associated with excess weight in adults? A population based study in Latin America. BMC Public Health 2023; 23:110. [PMID: 36647028 PMCID: PMC9841640 DOI: 10.1186/s12889-023-15029-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Excess weight is increasing worldwide, and in Latin America more than half of the population is excess weight. One of the reasons for this increase has been excessive sitting time. Still, it remains to be seen whether there is an excessive amount of that time in Latin American adults. This study aimed to associate different sitting time cut-off points with the excess weight. METHODS Data from the Latin American Study of Nutrition and Health (ELANS), a cross-sectional population-based survey conducted in eight Latin American countries, were used. The excess weight indicators used were body mass index, and waist and neck circumferences. Sitting time was obtained using questionnaires and categorized at different cut-off points. Differences between sitting time categories (< 4 or ≥ 4; < 6 or ≥ 6; and < 8 or ≥ 8 hours/day) and excess weight were obtained by Student's t test for independent samples and the association between sitting time categories and different indicators of excess weight were obtained by logistic regression. RESULTS The median of the sitting time was 420 min/day (IQR: 240-600). There were no significant differences between body mass index (kg/m2) and waist circumference (cm) with categories of sitting time. The mean values of neck circumference (cm) were significantly higher in ≥4, ≥6 and ≥ 8 hours/day than < 4, < 6, and < 8 hours/day of sitting time in the pooled sample. Some distinct differences by country were observed. There were significant differences among excess weight by body mass index (63.2% versus 60.8) with < 8 vs ≥8 hours/day of sitting time. The proportion of excess weight by neck circumference was higher in participants who reported ≥4, ≥6, and ≥ 8 hours/day compared to < 4, < 6, and < 8 hours/day of sitting time. Considering ≥8 hours/day of sitting time, higher odds of excess weight were found evaluated by body mass index (OR: 1.10; 95% CI: 1.01, 1.20) and neck circumference (OR: 1.13; CI 95%: 1.03, 1.24) overall. CONCLUSIONS Sitting time above 8 hours/day was associated with higher odds of excess weight, even though there were no differences in waist circumference between sitting time categories. TRIAL REGISTRATION Clinical Trials NCT02226627. (27/08/2014).
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Ferrari G, Drenowatz C, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MY, Pareja RG, Herrera-Cuenca M, Del'Arco AP, Peralta M, Marques A, Leme ACB, Sadarangani KP, Guzmán-Habinger J, Chaves JL, Fisberg M. Walking and cycling, as active transportation, and obesity factors in adolescents from eight countries. BMC Pediatr 2022; 22:510. [PMID: 36042429 PMCID: PMC9426250 DOI: 10.1186/s12887-022-03577-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence has shown that active transportation decreases obesity rates, but considering walking or cycling as separate modes could provide additional information on the health benefits in adolescents. This study aimed to examine the associations between walking and cycling as form active transportation and obesity indicators in Latin American adolescents. METHODS Population-based study with 671 adolescents (mean age: 15.9 [standard deviation: 0.8] years) from eight countries participating in the Latin American Study of Nutrition and Health/Estudio Latino Americano Nutrition y Salud (ELANS). Walking and cycling for active transportation were measured using the International Physical Activity Questionnaire long version. Body mass index, waist circumference, neck circumference, and relative fat mass were used as obesity indicators. Associations were estimated using logistic regression models for the pooled data adjusted for country, sex, age, socio-economic levels, race/ethnicity, leisure-time physical activity and energy intake. RESULTS Mean time spent walking and cycling was 22.6 (SD: 33.1) and 5.1 (SD: 24.1) min/day, respectively. The median values were 12.8 (IQR: 4.2; 25.7) and 0 (IQR: 0; 6.2) for walking and cycling. Participants reporting ≥ 10 min/week of walking or cycling for active transportation were 84.2% and 15.5%, respectively. Costa Rica (94.3% and 28.6%) showed the highest prevalence for walking and cycling, respectively, while Venezuela (68.3% and 2.4%) showed the lowest prevalence. There was no significant association between walking for active transportation and any obesity indicator. In the overall sample, cycling for ≥ 10 min/week was significantly associated with a lower likelihood of overweight/obesity based on BMI (OR: 0.86; 95%CI: 0.88; 0.94) and waist circumference (OR: 0.90; 95%CI: 0.83; 0.97) adjusted for country, sex, age, socio-economic level, race/ethnicity, leisure-time physical activity and energy intake compared to cycling for < 10 min/week. There were no significant associations between cycling for active transportation and neck circumference as well as relative fat mass. CONCLUSIONS Cycling for active transportation was negatively associated with obesity indicators, especially body mass index and waist circumference. Programs for promoting cycling for active transportation could be a feasible strategy to tackle the high obesity rates in adolescents in Latin America. TRIAL REGISTRATION ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.
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Affiliation(s)
- Gerson Ferrari
- Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile. .,Faculty of Health Sciences, Universidad Autónoma de Chile, Av. Pedro de Valdivia 425, 7500912, Providencia, Santiago, Chile.
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020, Linz, Austria
| | - Irina Kovalskys
- Nutrition Career, Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, AAZ, C1107, Buenos Aires, Argentina
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, Universidad de Costa Rica, San José, 11501-2060, Costa Rica
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, 8330024, Santiago, Chile
| | - Lilia Yadira Cortés
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, 110231, Bogotá, Colombia
| | - Martha Yépez García
- College of Health Sciences, San Francisco de Quito University, Quito, Ecuador
| | | | - Marianella Herrera-Cuenca
- Center for Development Studies, Central University of Venezuela (CENDES/UCV) Bengoa Foundation, Caracas, Venezuela
| | - Ana Paula Del'Arco
- Pediatric Department, Escola Paulista de Medicina, Federal University of Sao Paulo, Brazil - UNIFESP, São Paulo, Brazil
| | - Miguel Peralta
- CIPER, Faculty of Human Kinetics, University of Lisbon, 1499-002 Cruz Quebrada, Lisbon, Portugal.,ISAMB, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, 1499-002 Cruz Quebrada, Lisbon, Portugal.,ISAMB, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ana Carolina B Leme
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Kabir P Sadarangani
- School of Kinesiology, Faculty of Health and Dentistry, Universidad Diego Portales, 8370057, Santiago, Chile.,School of Kinesiology, Faculty of Dentistry and Rehabilitation Sciences, Universidad San Sebastián, Bío Bío, Chile
| | - Juan Guzmán-Habinger
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago, Chile
| | | | - Mauro Fisberg
- Pediatric Department, Escola Paulista de Medicina, Federal University of Sao Paulo, Brazil - UNIFESP, São Paulo, Brazil.,Pensi Institute, José Luiz Egydio Setúbal Foundation- Sabará Children's Hospital, São Paulo, Brazil
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An investigation of anthropometric measurements of early adolescents and determination of BMI-for-age-based neck circumference and BMI-for-age-based mid-upper-arm circumference cut-off points. Clin Nutr ESPEN 2022; 48:414-420. [DOI: 10.1016/j.clnesp.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 12/25/2021] [Accepted: 01/10/2022] [Indexed: 01/11/2023]
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Liria-Domínguez R, Pérez-Albela M, Vásquez MP, Gómez G, Kovalskys I, Fisberg M, Cortés LY, Yépez García MC, Herrera-Cuenca M, Rigotti A, Ferrari G, Pareja RG. Correlation between Neck Circumference and Other Anthropometric Measurements in Eight Latin American Countries. Results from ELANS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211975. [PMID: 34831736 PMCID: PMC8625507 DOI: 10.3390/ijerph182211975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022]
Abstract
Neck circumference (NC) is being used to identify the risk of chronic diseases. There is a high prevalence of overweight and obesity in Latin America, and neck circumference is a simple and practical measurement to assess this, especially in primary health centers. We analyzed the correlation between the NC anthropometric indicator and other anthropometric measurements such as BMI and waist circumference (WC) in eight Latin American cities. We applied Pearson's correlation to identify the correlate NC with the other anthropometric variables stratified by sex; the sensitivity (Se) and specificity (Sp) by sex were evaluated according to the cut-off established with the Youden Index. The strongest correlations between NC and WC were found when stratified by sex (women: r = 0.71; men: r = 0.69, respectively) followed by the correlation between NC and BMI (r = 0.65, both sex). NC cut-off points of 39.0 cm in men and 32.9 cm in women identified those individuals with an increased WC and 39.8 and 33.7 cm, respectively, for a substantial increase in WC. For BMI ≥ 25.0 kg/m2 for men, the cut-off point was 37.5 cm, and for women, it was 33.1 cm, and for BMI ≥ 30 kg/m2, the cut-off points were 39.2 and 34.2 cm, for men and women, respectively. Conclusion: NC proved to be a useful, practical, and inexpensive tool that can be used to identify, evaluate, and monitor overweight and obese individuals.
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Affiliation(s)
- Reyna Liria-Domínguez
- Instituto de Investigación Nutricional, Lima 15026, Peru;
- Facultad de Ciencias de la Salud, Carrera de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas-UPC, Lima 15067, Peru; (M.P.-A.); (M.-P.V.)
- Correspondence: or
| | - Marcela Pérez-Albela
- Facultad de Ciencias de la Salud, Carrera de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas-UPC, Lima 15067, Peru; (M.P.-A.); (M.-P.V.)
| | - María-Paz Vásquez
- Facultad de Ciencias de la Salud, Carrera de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas-UPC, Lima 15067, Peru; (M.P.-A.); (M.-P.V.)
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José 11501-2060, Costa Rica;
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires C1107 AAZ, Argentina;
| | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil;
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
| | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas 1053, Venezuela;
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8330024, Chile;
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile;
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Herrera-Cuenca M, Kovalskys I, Gerardi A, Hernandez P, Sifontes Y, Gómez G, Yépez García MC, Méndez-Pérez B, Landaeta-Jimenez M, Pareja R, Cortés LY, Rigotti A, Fisberg M, Zimberg IZ. Anthropometric Profile of Latin American Population: Results From the ELANS Study. Front Nutr 2021; 8:740361. [PMID: 34820411 PMCID: PMC8606788 DOI: 10.3389/fnut.2021.740361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/05/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Latin America has experienced changes in lifestyle since 1960. Aim: The aim was to determine the prevalence of obesity and stunting among eight countries of Latin American and to identify the determinant risk factors for obesity. Subjects and Methods: Data were obtained from 9,218 participants of the Latin American Study of Nutrition and Health (ELANS), a multicenter cross-sectional study of the representative samples in eight Latin American countries. All the participants completed a standard protocol to investigate the nutrient intake and anthropometric variables (weight, height, and circumferences) analyzed by country, gender, age, and socioeconomic status. Results: The prevalence of obesity was higher in Costa Rica and Venezuela (29%) and lower in Colombia (16%), stunting was reported higher in Peru (47%) and lower in Argentina (17%), and waist and neck circumferences showed the higher values in Costa Rica (43%) and Chile (52%) and lower values in Colombia (23 and 26%). Conclusion: This study indicates an increasing trend toward overweight and obesity that are associated with lower socioeconomic status, being a woman, and concurs with inadequate intakes of calcium, which may be related to poor quality diet and in the long term could constitute risk factors for the chronic diseases and a health burden to the region.
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Affiliation(s)
- Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV), Caracas, Venezuela
- Fundación Bengoa para la Alimentación y Nutrición, Caracas, Venezuela
| | - Irina Kovalskys
- Facultad de Medicina, Pontificia Universidad Católica de Argentina, Buenos Aires, Argentina
| | - Alejandro Gerardi
- Facultad de Medicina, Pontificia Universidad Católica de Argentina, Buenos Aires, Argentina
| | - Pablo Hernandez
- Escuela de Nutrición y Dietética, Universidad Central de Venezuela, Caracas, Venezuela
| | - Yaritza Sifontes
- Fundación Bengoa para la Alimentación y Nutrición, Caracas, Venezuela
- Escuela de Nutrición y Dietética, Universidad Central de Venezuela, Caracas, Venezuela
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | | | - Betty Méndez-Pérez
- Unidad de Investigación en Bioantropología, Actividad Física y Salud, Instituto de Investigaciones Económicas y Sociales Rodolfo Quintero, Universidad Central de Venezuela, Caracas, Venezuela
| | | | | | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Mauro Fisberg
- Instituto Pensi, Fundação José Egydio Setubal, Sabará Hospital Infantil, São Paulo, Brazil
- Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Iona Zalcman Zimberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Neck circumference measurement as a screening tool for obesity in children – A cross sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.100683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Higher Physical Activity Is Related to Lower Neck Adiposity in Young Men, but to Higher Neck Adiposity in Young Women: An Exploratory Study. Int J Sport Nutr Exerc Metab 2021; 31:250-258. [PMID: 33668020 DOI: 10.1123/ijsnem.2020-0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/09/2020] [Accepted: 12/18/2020] [Indexed: 11/18/2022]
Abstract
The role of lifestyle behaviors on neck adipose tissue (NAT), a fat depot that appears to be involved in the pathogenesis of different cardiometabolic diseases and in inflammatory status, is unknown. In this cross-sectional and exploratory study, the authors examined the relationship between sedentary time and physical activity (PA) with neck adiposity in young adults. A total of 134 subjects (69% women, 23 ± 2 years) were enrolled. The time spent in sedentary behavior and PA of different intensity were objectively measured for 7 consecutive days (24 hr/day), using a wrist (nondominant)-worn accelerometer. The NAT volume was assessed using computed tomography, and the compartmental (subcutaneous, intermuscular, and perivertebral) and total NAT volumes were determined at the level of vertebra C5. Anthropometric indicators and body composition (by dual-energy X-ray absorptiometry) were determined. The time spent in light physical activity and moderate physical activity (MPA) and the overall PA were inversely associated with the intermuscular NAT volume in men, as were the MPA and overall PA with total NAT volume (all ps ≤ .04). Sedentary time was directly related to the total NAT volume (p = .04). An opposite trend was observed in women, finding a direct relationship of MPA with the subcutaneous NAT; of light physical activity, MPA, and overall PA with the perivertebral NAT; and of light physical activity with total NAT volumes (all ps ≤ .05). The observed associations were weak, and after adjusting for multiplicity, the results became nonsignificant (p > .05). These findings suggest that the specific characteristics of PA (time and intensity) might have sex-dependent implications in the accumulation of NAT.
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Neck circumference cut-offs for overweight and obesity in a group of Mexican adolescents. Eur J Clin Nutr 2021; 75:1654-1660. [PMID: 33649525 DOI: 10.1038/s41430-021-00879-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 02/03/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Neck circumference (NC) has been used for screening overweight/obesity for its high correlation with age, weight, body mass index (BMI), and waist circumference (WC). Cut-offs should be population specific. The aim of the study was to obtain cut-offs of NC for overweight/obesity in Mexican adolescents and to correlate them with anthropometric indicators. SUBJECTS/METHODS Weight, height, BMI, NC, WC, and mid-upper arm circumference (MUAC) of 465 12-14-year-old Mexican-mestizo students attending a public school in Mexico City were assessed. Using receiver operating characteristics analyses, neck cut-offs were obtained according to the WHO age and sex criteria for overweight/obesity. RESULTS NC cut-offs with the highest sensitivity and specificity for males and females, respectively, were as follows: 30.0 and 29.3 cm for 12-year-olds; 31.9 and 30.4 cm for 13-year-olds; and, 33.5 and 30.7 cm for 14-year-old adolescents. Overweight/obesity was identified with NC cut-offs in 80% of males and 86% of females, and showed significant correlations (p < 0.01) in males and females with weight (r = 0.821 and r = 0.840, respectively), BMI (r = 0.649 and r = 0.819, respectively), WC (r = 0.710 and r = 0.813, respectively) and MUAC (r = 0.736 and r = 0.815, respectively). CONCLUSIONS Neck circumference may be used as a first-stage screening tool or jointly with BMI to identify overweight/obesity in 12-14-year-old Mexican adolescents.
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Neck circumference and excess weight: proposal of cutoff points for Brazilian adolescents. J Pediatr (Rio J) 2021; 97:191-196. [PMID: 32320681 PMCID: PMC9432223 DOI: 10.1016/j.jped.2020.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/30/2020] [Accepted: 02/02/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To indicate neck circumference (NC) cutoff points to identify excess weight at different stages of somatic maturation and evaluate the association between NC and body mass index (BMI). METHODS Cross-sectional study with 1715 adolescents. BMI was classified according to the World Health Organization (WHO) criteria. Somatic maturation was obtained through the peak growth velocity (PGV). To define the cutoff points, curves of the receiver operating characteristic (ROC) model were constructed. The agreement between the anthropometric evaluation instruments was analyzed. The association between the variables was verified. RESULTS Of the girls, 93 were in the pre-PGV stage, 266 in the PGV stage, and 481 in the post-PGV stage. Of the boys, 264 were in the pre-PGV stage, 334 in the PGV stage, and 277 in the post-PGV stage. For the pre-PGV group, the cutoff point was 28cm for females and 29cm for males; for the group during PGV, the cutoff points were 30cm for females and 33cm for males; in the post-PGV group the cutoff values were 32cm in females and 35cm in males. The prevalence of excess weight was higher in the pre-PGV stage in males and in the PGV stage in females. The correlation coefficients were higher in the pre-PGV and PGV stages. CONCLUSION The cutoff points for NC found in this study showed good sensitivity and specificity to identify excess weight in Brazilian adolescents and can be used as a reference in epidemiological studies.
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Ranasinghe P, Jayawardena R, Gamage N, Pujitha Wickramasinghe V, Hills AP. The range of non-traditional anthropometric parameters to define obesity and obesity-related disease in children: a systematic review. Eur J Clin Nutr 2020; 75:373-384. [PMID: 32801306 DOI: 10.1038/s41430-020-00715-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/08/2020] [Accepted: 08/04/2020] [Indexed: 01/05/2023]
Abstract
Obesity is defined as an abnormal/excessive accumulation of body fat, associated with health consequences. Although overall obesity does confer a significant threat to the health of individuals, the distribution of body fat, especially abdominal/central obesity is of greater importance. For practical reasons, proxy anthropometric measurements have been developed to identify central obesity, however, major limitations are noted in these traditional measurements. The present study aims to evaluate the literature, to identify and describe non-traditional anthropometric measurements of overweight and obesity in children. The current systematic review was conducted in accordance with the PRISMA guidelines, and the search was undertaken in the PubMed® database, using MeSH (Medical Subject Headings) terms. Data extracted from each study were: (a) details of the study, (b) anthropometric parameter(s) evaluated in the study and its details, (c) study methods, (d) objectives of the study and/or comparisons, and (e) main findings/conclusions of the study. The search yielded a total of 3697 articles, of which 31 studies were deemed eligible to be included. The literature search identified 13 non-traditional anthropometric parameters. Data on non-traditional anthropometric parameters were derived from 24 countries. Majority were descriptive cross-sectional studies (n = 29), while sample size varied from 65 to 23,043. Non-traditional anthropometric parameters showed variable correlation with obesity and/or related metabolic risk factors. Some parameters involved complex calculations, while others were based on a single anthropometric measurement or derived from traditional measures. Most studies lacked comparison with a 'gold standard' assessment of body fat, hence further research is required to determine their accuracy and precision.
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Affiliation(s)
- Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Nishadi Gamage
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham Drive, Launceston, TAS, Australia
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Filgueiras MDS, Albuquerque FMD, Castro APP, Rocha NP, Milagres LC, Novaes JFD. Neck circumference cutoff points to identify excess android fat. J Pediatr (Rio J) 2020; 96:356-363. [PMID: 30731052 PMCID: PMC9432153 DOI: 10.1016/j.jped.2018.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 11/14/2018] [Accepted: 11/19/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To evaluate the ability of neck circumference to identify excess android fat and to propose cutoff points for Brazilian children. METHOD This was a cross-sectional study with 376 children aged 8 and 9 years enrolled in public and private schools in the urban area of the municipality of Viçosa, Minas Gerais. A semi-structured questionnaire containing sociodemographic and lifestyle information was applied. The following were collected: neck circumference, weight, and height for the calculation of body mass index. The percentage of fat in the android region was determined by dual energy X-ray absorptiometry. Linear regression analysis was used to evaluate the association between neck circumference and android fat, adopting a significance level of 5%. Receiver operating characteristic curves were used to evaluate the capacity of neck circumference to determine the excess android fat, as well as to estimate the cutoff points of neck circumference according to gender. RESULTS Multiple linear regression showed an association between neck circumference and android fat (β: 2.94, 95% CI: 2.41, 3.47). Neck circumference was able to identify excess android fat in girls (AUC: 0.909, 95% CI: 0.999, 0.945) and boys (AUC: 0.938, 95% CI: 0.892, 0.968). The proposed cutoff points showed satisfactory sensitivity, specificity, and predictive values. CONCLUSIONS Neck circumference is capable of identifying excess android fat in children and can be used in clinical practice and in population studies to determine central adiposity. The proposed cutoff points were satisfactory, but should be validated for other populations.
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Affiliation(s)
| | | | | | - Naruna Pereira Rocha
- Universidade Federal de Viçosa (UFV), Departamento de Nutrição e Saúde, Viçosa, MG, Brazil
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Filgueiras MDS, Albuquerque FMD, Castro APP, Rocha NP, Milagres LC, Novaes JFD. Neck circumference cutoff points to identify excess android fat. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2019.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Zaciragic A, Elezovic M, Avdagic N, Babic N, Dervisevic A, Lepara O, Huskic J. Relationship between the Neck Circumference, Standard Anthropometric Measures, and Blood Pressure in Bosnian Young Adults. Eurasian J Med 2019; 51:150-153. [PMID: 31258355 DOI: 10.5152/eurasianjmed.2018.18197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 09/15/2018] [Indexed: 11/22/2022] Open
Abstract
Objective The association between the neck circumference (NC) and components of metabolic syndrome in different countries and ethnic groups has been insufficiently investigated. The aim of the present study was to assess the impact of gender on NC values and to determine whether NC correlates with standard anthropometric measures and blood pressure values in Bosnian young adults. Materials and Methods Study participants were recruited by the snowball method. The NC, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured by trained personnel. Differences between the means were assessed by a Student's t-test. Coefficients of correlation were determined by Pearson's test. Results In young men (n=49), the value of NC was 37.71±1.79 cm, while in young women, (n=62) the value of NC was 32.23±1.83 cm (p<0.001). A significant positive correlation in both genders between the NC and BMI (r=0.70, p<0.001 in men; r=0.53,p<0.001 in women), and between the NC and WC (r=0.48, p<0.001 in men; r=0.38, p=0.01 in women), was found. A significant correlation between the NC and SBP (r=0.08, p=0.57), and DBP (r=0.20, p=0.17), in young men was not determined. Likewise, in young women, a significant correlation between the NC and SBP (r=0.08, p=0.54), and DBP (r=0.09, p=0.49), was not observed. Conclusion Our results suggest that the NC measurement can be used as a valid method in obesity assessment in young adults. A lack of association between the NC and blood pressure requires additional investigation.
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Affiliation(s)
- Asija Zaciragic
- Department of Human Physiology, University of Sarajevo School of Medicine, Sarajevo, Bosnia and Herzegovina
| | - Mehmed Elezovic
- Clinic of Family Medicine, Bosanska Krupa Health Centre, Bosanska Krupa, Bosnia and Herzegovina
| | - Nesina Avdagic
- Department of Human Physiology, University of Sarajevo School of Medicine, Sarajevo, Bosnia and Herzegovina
| | - Nermina Babic
- Department of Human Physiology, University of Sarajevo School of Medicine, Sarajevo, Bosnia and Herzegovina
| | - Amela Dervisevic
- Department of Human Physiology, University of Sarajevo School of Medicine, Sarajevo, Bosnia and Herzegovina
| | - Orhan Lepara
- Department of Human Physiology, University of Sarajevo School of Medicine, Sarajevo, Bosnia and Herzegovina
| | - Jasminko Huskic
- Department of Human Physiology, University of Sarajevo School of Medicine, Sarajevo, Bosnia and Herzegovina
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Luis de Moraes Ferrari G, Kovalskys I, Fisberg M, Gomez G, Rigotti A, Sanabria LYC, García MCY, Torres RGP, Herrera-Cuenca M, Zimberg IZ, Guajardo V, Pratt M, Pires C, Solé D. Association of moderate-to-vigorous physical activity with neck circumference in eight Latin American countries. BMC Public Health 2019; 19:809. [PMID: 31234866 PMCID: PMC6591862 DOI: 10.1186/s12889-019-7153-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 06/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity is a cornerstone in the prevention and treatment of obesity. There are relatively few studies that explore the effect of accelerometer-determined moderate-to-vigorous physical activity (MVPA) on neck circumference (NC), most of them confined to single high-income countries. The present study investigated the association of accelerometer-determined MVPA with NC in adolescents and adults from eight Latin American countries, which are mostly upper-middle income countries. METHODS The sample consisted of 2370 participants (47.8% male) from the Latin American Study of Nutrition and Health, a multicenter cross-sectional nutrition and health surveillance study of a nationally representative sample from eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela). Times (min/day) in MVPA (defined as time accumulated at ≥1952 activity counts/min) was assessed by ActiGraph GT3X+ accelerometer over 7 days. NC for adolescent was categorized as abnormal if circumference was > 34.5 cm for boys and > 31.25 for girls, whereas for adults the cut-off points for abnormal were > 39 cm for men and > 35 cm women. Multilevel logistic models, including country and region as random effects and adjusted for sex, age, socioeconomic level, and educational level, were used to study the association between MVPA and NC. RESULTS The average time of MVPA was 34.88 min/day, ranging from 31.16 in Venezuela to 40.27 in Chile. Concerning NC, 37.0% of the sample was classified as having elevated NC. Chile was the country with the highest percentage of people with elevated NC (56.9%), and Colombia had the lowest percentage (24.8%). Overall, the MVPA (min/day) was associated with elevated NC (OR = 0.994, CI95% = 0.990-0.998). In Costa Rica and Peru, there were significant associations between MVPA and NC when analyzed by country. CONCLUSIONS The present study provided evidence of significant associations between MVPA and NC in adolescents and adults from Latin America, independent of sex, age, socioeconomic level, and educational level. This analysis of accelerometry data and NC represents the first examination of these associations in eight Latin America countries. Further research is required to understand the differences between countries in the observed associations. TRIAL REGISTRATION ClinicalTrials.Gov NCT02226627 . Retrospectively registered on August 27, 2014.
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Affiliation(s)
- Gerson Luis de Moraes Ferrari
- Centro de Investigación en Fisiologia del Ejercicio-CIFE, Universidad Mayor, José Toribio Medina, 29. Estacion Central, Santiago, Chile
- Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria, da Universidade Federal de São Paulo, São Paulo, Brazil
| | - Irina Kovalskys
- Commitee of Nutrition and WellbeingInternational Life Science Institute, Buenos Aires, Argentina
| | - Mauro Fisberg
- Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil
- Departamento de Pediatria, da Universidade Federal de São Paulo, São Paulo, Brazil
| | - Georgina Gomez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | | | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela/Fundación Bengoa, Caracas, Venezuela
| | - Ioná Zalcman Zimberg
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Viviana Guajardo
- Commitee of Nutrition and WellbeingInternational Life Science Institute, Buenos Aires, Argentina
| | - Michael Pratt
- Institute for Public Health, University of California San Diego, La Jolla, CA USA
| | - Carlos Pires
- Centre for Mathematics of the University of Trás-os-Montes e Alto Douro (CM-UTAD), Vila Real, Portugal
| | - Dirceu Solé
- Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria, da Universidade Federal de São Paulo, São Paulo, Brazil
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Mastroeni SSDBS, Mastroeni MF, Ekwaru JP, Setayeshgar S, Veugelers PJ, Gonçalves MDC, Rondó PHDC. Anthropometric measurements as a potential non-invasive alternative for the diagnosis of metabolic syndrome in adolescents. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:30-39. [PMID: 30864629 PMCID: PMC10118845 DOI: 10.20945/2359-3997000000100] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 11/14/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify which anthropometric measurement would be the best predictor of metabolic syndrome (MetS) in Brazilian adolescents. SUBJECTS AND METHODS Cross-sectional study conducted on 222 adolescents (15-17 years) from a city in southern Brazil. Anthropometric, physical activity, blood pressure and biochemical parameters were investigated. MetS criteria were transformed into a continuous variable (MetS score). Linear regression analyses were performed to assess the associations of BMI, hip circumference, neck circumference (NC), triceps skinfold, subscapular skinfold and body fat percentage with MetS score. ROC curves were constructed to determine the cutoff for each anthropometric measurement. RESULTS The prevalence of MetS was 7.2%. Each anthropometric measurement was significantly (p < 0.001) associated with MetS score. After adjusting for potential confounding variables (age, sex, physical activity, and maternal education), the standardized coefficients of NC and body fat percentage appeared to have the strongest association (beta = 0.69 standard deviation) with MetS score. The regression of BMI provided the best model fit (adjusted R2 = 0.31). BMI predicted MetS with high sensitivity (100.0%) and specificity (86.4%). CONCLUSIONS Our results suggest that BMI and NC are effective screening tools for MetS in adolescents. The early diagnosis of MetS combined with targeted lifestyle interventions in adolescence may help reduce the burden of cardiovascular diseases and diabetes in adulthood.
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Affiliation(s)
- Silmara Salete de Barros Silva Mastroeni
- Departamento de Educação Física, Universidade da Região de Joinville (Univille), Joinville, SC, Brasil.,Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Marco Fabio Mastroeni
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.,Programa de Pós-Graduação em Saúde e Meio Ambiente, Universidade da Região de Joinville (Univille), Joinville, SC, Brasil
| | - John Paul Ekwaru
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Solmaz Setayeshgar
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paul J Veugelers
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Neck Circumference and Its Association with Cardiometabolic Risk Factors in Pediatric Population. ACTA ACUST UNITED AC 2019; 55:medicina55050183. [PMID: 31117308 PMCID: PMC6572278 DOI: 10.3390/medicina55050183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 02/05/2023]
Abstract
Background and objectives: To identify the relationship between neck circumference (NC) and cardiometabolic risk factors in children. Materials and Methods: Children and adolescents 6–18 years old (n = 548) from five counties of San Luis Potosí, México were included. Data was collected for biological markers (glucose and lipid profile) and anthropometric and clinical measurements—weight, height, NC, waist circumference (WC), and blood pressure (BP). Body mass index (BMI) was calculated using Quetelet formula (kg/m2). Descriptive analysis, correlation tests, and receiver operating characteristic (ROC) analysis were performed. Results: NC was highly correlated with BMI and WC in both genders (p <0.0001). The most frequent risk factor was high BMI (38.7%). Sensitivity and specificity analysis of NC and high BMI showed an area under the ROC curve of 0.887. Conclusions: According to our findings, NC is a simple, low-cost, and non-invasive measurement, which has a high association with high BMI and increased WC.
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Alzeidan R, Fayed A, Hersi AS, Elmorshedy H. Performance of neck circumference to predict obesity and metabolic syndrome among adult Saudis: a cross-sectional study. BMC OBESITY 2019; 6:13. [PMID: 30984406 PMCID: PMC6442431 DOI: 10.1186/s40608-019-0235-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 02/21/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Neck circumference (NC) is a novel simple and stable body measurement, a growing body of evidence indicates its validity to diagnose obesity and metabolic syndrome (MetS). Because the cutoff value of NC is gender and ethnic-specific; we conducted the current study to explore the performance of NC to predict general obesity, central obesity, and MetS among adult Saudis of both genders. METHODS This is a cross-sectional study which included 3063 adult Saudis (1156 males and 1907 females) with a mean age of 38.6 ± 14.1 years. Anthropometric measurements and blood pressure were assessed by a standardized methodology. Blood tests including fasting lipid panel, blood glucose, fasting blood glucose and hemoglobin A1c (HBA1c) were measured for all participants. We identified the MetS based on Adult Treatment Panel III (ATPIII definition). Data were analyzed using SPSS®19 (PASW statistics data document 19); NC was compared to relevant anthropometric measures to predict obesity and MetS using Receiver Operator Characteristic (ROC) analyses. The cutoff value of NC which possessed good discriminating power between obese and non-obese patients was estimated by Youden index, and we estimated the adjusted Odds Ratio (OR) to delineate the association between NC and the outcome variables by multiple logistic regression analysis. RESULTS ROC analyses demonstrated good performance of NC for general obesity, central obesity and MetS; as a predictor of obesity in non-diabetics, Area Under the Curve (AUC) ranged from 0.77-0.86. In MetS, AUC was 0.77 and 0.82 for males and females respectively. The best cutoff values of the NC to predict obesity were ≥ 37.5 cm for males versus ≥32.5 cm for females. The results of adjusted logistic regression analysis adjusted for age and waist height ratio, revealed a consistent positive association between NC, general obesity, MetS, and central obesity: ORs were 4.26, 3.03, 1.45 for males versus 4.65, 3.66, and1.47 for females respectively. CONCLUSION NC stands out as an independent predictor of obesity and the MetS. Its stability, easiness of application, low cost and the cultural acceptance, justify its use as a screening tool for general and central obesity as well as MetS among Saudis under community settings, and as an additional routine measurement for health professionals.
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Affiliation(s)
- Rasmieh Alzeidan
- Cardiac Sciences Department Riyadh, King Saud University, College of Medicine, Riyadh, Saudi Arabia
| | - Amel Fayed
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Ahmed S. Hersi
- Cardiac Sciences Department Riyadh, King Saud University, College of Medicine, Riyadh, Saudi Arabia
| | - Hala Elmorshedy
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Bordon S, Srebernich SM, Bernardi JLD, Merhi VAL. Screen time, body mass index and neck circumference: is there an association with social class in children? REVISTA BRASILEIRA DE CINEANTROPOMETRIA E DESEMPENHO HUMANO 2019. [DOI: 10.1590/1980-0037.2019v21e58235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Life habits during childhood are decisive for future health conditions. The aim of this study was to evaluate screen time and anthropometry of children enrolled in municipal schools in the interior of the State of São Paulo. A cross-sectional study was carried out with students from 9 to 10 years of age from a city in the State of São Paulo, Brazil. A socioeconomic questionnaire validated by the Brazilian Association of Research Companies was used, containing also the determination of screen time (TV, video game, computer and cell phone), recommended by the Pediatrics Society. Anthropometry data was collected according to the Lohmam Anthropometric Standardization Reference Manual and compared to the z-score level with the WHO 2007. For the statistical analysis, Kruskal-Wallis, Chi-square or Fisher’s Exact tests were used.The confidence level was at 95%. Out of the 703 schoolchildren assessed, 97.44% had adequate height, 59.17% eutrophy BMI and 30.44% overweight. There was a correlation between BMI and non-stratified social class (p=0.038) and BMI and neck circumference (NC) (p<0.001).The z-score of the BMI showed that children with weight loss stayed longer watching TV (p=0.0486). The gender comparison showed that girls of higher social class stayed longer at the computer (p=0.0351) and using the cell phone (p<0.0001),and boys playing videogame (p=0.0005). Overweight and weight loss shown in the positive correlation between BMI and NC, although on opposite sides, were associated with screen time and especially with TV in children of higher social class.
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Moradi S, Mohammadi H, Ghavami A, Rouhani MH. Neck circumference and blood pressure among children: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2018; 12:822-832. [DOI: 10.1016/j.jash.2018.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/21/2018] [Accepted: 10/27/2018] [Indexed: 02/07/2023]
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Zaciragic A, Elezovic M, Babic N, Avdagic N, Dervisevic A, Huskic J. Neck Circumference as an Indicator of Central Obesity in Healthy Young Bosnian Adults: Cross-sectional Study. Int J Prev Med 2018; 9:42. [PMID: 29899880 PMCID: PMC5981223 DOI: 10.4103/ijpvm.ijpvm_484_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/16/2018] [Indexed: 11/23/2022] Open
Abstract
Background: Neck circumference (NC) is an index of subcutaneous adipose tissue distribution in an area of the upper part of the body. The aim of this study was to assess whether NC can be used as an indicator of central obesity and to determine the prevalence of central obesity in apparently healthy Bosnian young adults. Methods: Participants for this cross-sectional study were recruited using the snowball method. NC was measured in horizontal straight position by placing the top edge of a plastic tape only below the laryngeal prominence and perpendicular to the longitudinal axis of the neck, with the head positioned in the Frankfort horizontal plane. Body mass index, waist circumference (WC), and waist-to-hip ratio were taken following the WHO guidelines. Results: The study included 111 second year University of Sarajevo Dentistry students (49 students of male gender and 62 students of the female gender). Determined the optimal cutoff value of NC in the detection of central obesity based on WC values in healthy young participants of male gender was ≥37.45 cm (P < 0.001), while in healthy young participants of the female gender, it was ≥32.75 cm (P < 0.001). Based on the WHO guidelines for WC, central obesity was determined in 24.49% (n = 12) of male patients, and in 29.03% (n = 18) of female participants included in our investigation (P < 0.05). Conclusions: The results of the present study indicate that NC may be used as a screening tool for central obesity in healthy young adults. Prevalence of central obesity observed among student population suggests that there is a justified need for an implementation of healthy lifestyle programs in this population that would have preventive purposes.
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Affiliation(s)
- Asija Zaciragic
- Department of Human Physiology, Faculty of Medicine, University of Sarajevo; Cekalusa, Sarajevo, Bosnia and Herzegovina
| | - Mehmed Elezovic
- Department of Family Medicine, Health Centre Bosanska Krupa, Bosanska Krupa, Bosnia and Herzegovina
| | - Nermina Babic
- Department of Human Physiology, Faculty of Medicine, University of Sarajevo; Cekalusa, Sarajevo, Bosnia and Herzegovina
| | - Nesina Avdagic
- Department of Human Physiology, Faculty of Medicine, University of Sarajevo; Cekalusa, Sarajevo, Bosnia and Herzegovina
| | - Amela Dervisevic
- Department of Human Physiology, Faculty of Medicine, University of Sarajevo; Cekalusa, Sarajevo, Bosnia and Herzegovina
| | - Jasminko Huskic
- Department of Human Physiology, Faculty of Medicine, University of Sarajevo; Cekalusa, Sarajevo, Bosnia and Herzegovina
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Morais AA, Morais UAB, Soares MMS, Romano MCC, Lamounier JA. Neck circumference in adolescents and cardiometabolic risk: A sistematic review. ACTA ACUST UNITED AC 2018; 64:54-62. [PMID: 29561943 DOI: 10.1590/1806-9282.64.01.54] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/15/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To critically analyze articles on the relation between neck circumference (NC) in adolescents and: body mass index, fat distribution, metabolic syndrome and its individual components, and cardiovascular risk. METHOD Systematic review undertaken by two independent researchers using the Pubmed/Medline, Lilacs/Medline, Scielo and Cochrane databases in English, Spanish and Portuguese in the period comprising the past 5 years. RESULTS Eighteen (18) articles were selected. The articles show an association between NC in adolescents and body fat (BMI), central fat distribution (WC), metabolic syndrome and several of its individual components, and cardiovascular risk. Some values are proposed for NC cutoff points as a diagnostic tool for nutritional status, high blood pressure and pre-hypertension, cardiovascular risk, insulin resistance and metabolic syndrome. We identified a percentile curve constructed for Brazilian adolescents. CONCLUSION There is a shortage of studies with representative samples, variety at the NC measurement sites, and the age of the participants, which makes it difficult to establish definitive landmarks.
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Affiliation(s)
- Aisha Aguiar Morais
- MD, Endocrinologist, MSc and Professor, Faculdade de Medicina, Universidade de São João del-Rei (UFSJ), Campus Centro-Oeste (CCO), Divinópolis, MG, Brazil
| | | | - Maria Marta Sarquis Soares
- MD, Endocrinologist, Post-doctoral degree, Professor at Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Joel Alves Lamounier
- MD, Pediatrician, PhD and Professor, UFMG; Professor and Head of the Medicine Department, UFSJ, São João del-Rei, MG, Brazil
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Ataie-Jafari A, Namazi N, Djalalinia S, Chaghamirzayi P, Abdar ME, Zadehe SS, Asayesh H, Zarei M, Gorabi AM, Mansourian M, Qorbani M. Neck circumference and its association with cardiometabolic risk factors: a systematic review and meta-analysis. Diabetol Metab Syndr 2018; 10:72. [PMID: 30288175 PMCID: PMC6162928 DOI: 10.1186/s13098-018-0373-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 09/14/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Recently, neck circumference (NC) has been used to predict the risk of cardiometabolic factors. This study aimed to perform a systematic review and meta-analysis to examine: (i) the sensitivity (SE) and specificity (SP) of NC to predict cardiometabolic risk factors and (ii) the association between NC and the risk of cardiometabolic parameters. METHODS A systematic search was conducted through PubMed/Medline, Institute of Scientific Information, and Scopus, until 2017 based on the search terms of metabolic syndrome (MetS) and cardio metabolic risk factors. Random-effect model was used to perform a meta-analysis and estimate the pooled SE, SP and correlation coefficient (CC). RESULTS A total of 41 full texts were selected for systematic review. The pooled SE of greater NC to predict MetS was 65% (95% CI 58, 72) and 77% (95% CI 55, 99) in adult and children, respectively. Additionally, the pooled SP was 66% (95% CI 60, 72) and 66% (95% CI 48, 84) in adult and children, respectively. According to the results of meta-analysis in adults, NC had a positive and significant correlation with fasting blood sugar (FBS) (CC: 0.16, 95% CI 0.13, 0.20), HOMA-IR (0.38, 95% CI 0.25, 0.50), total cholesterol (TC) (0.07 95% CI 0.02, 0.12), triglyceride (TG) concentrations (0.23, 95% CI 0.19, 0.28) and low density lipoprotein cholesterol (LDL-C) (0.14, 95% CI 0.07, 0.22). Among children, NC was positively associated with FBS (CC: 0.12, 95% CI 0.07, 0.16), TG (CC: 0.21, 95% CI 0.17, 0.25), and TC concentrations (CC: 0.07, 95% CI 0.02, 0.12). However, it was not significant for LDL-C. CONCLUSION NC has a good predictive value to identify some cardiometabolic risk factors. There was a positive association between high NC and most cardiometabolic risk factors. However due to high heterogeneity, findings should be declared with caution.
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Affiliation(s)
- Asal Ataie-Jafari
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Nazli Namazi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Esmaeili Abdar
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Sara Sarrafi Zadehe
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Maryam Zarei
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor Malaysia
| | - Armita Mahdavi Gorabi
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Mansourian
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Lisboa KWDSC, Lira Neto JCG, Araújo MFMD, Freitas RWJFD, Gomes EB, Bispo GMB, Rodrigues EMD, Damasceno MMC. A relação pescoço-coxa (RPCx) pode servir como índice antropométrico para diagnosticar a síndrome metabólica? ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo: Investigar a Relação Pescoço-Coxa (RPCx) como índice antropométrico para diagnosticar a Síndrome Metabólica em estudantes universitários brasileiros. Métodos: Estudo transversal com 691 adultos (> 18 anos) de ambos os sexos. Foram investigados os seguintes parâmetros antropométricos: circumferência abdominal, circumferência de pescoço, circumferência de coxa, índice de massa corporal e RPCx. Além disso, foram coletados dados laboratoriais, tais como: triglicérides, glicemia e colesterol HDL. Resultados: Foram encontrados valores de circumferência abdominal (83,59 ± 10,68 cm), de pescoço (37,29 ± 2,36 cm), coxa (52,37 ± 5,71 cm) e relação de pescoço-coxa (0,72 ± 0,07 cm) superiores entre os homens (p <0,001). Ao analisar os componentes da síndrome, a RPCx mostrou uma correlação linear positiva estatisticamente significante com todos. Conclusão: Nesta pesquisa foi demonstrado que a RPCx não serve como critério diagnóstico da SM, mas indica alterações nos componentes constituintes da síndrome.
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Kroll C, Mastroeni SSBS, Czarnobay SA, Ekwaru JP, Veugelers PJ, Mastroeni MF. The accuracy of neck circumference for assessing overweight and obesity: a systematic review and meta-analysis. Ann Hum Biol 2017; 44:667-677. [PMID: 29037078 DOI: 10.1080/03014460.2017.1390153] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
CONTEXT Neck circumference (NC) has been suggested as an alternative measure to screen for excess body weight. OBJECTIVE The aim of this study was to demonstrate the accuracy of neck circumference (NC) as a measure for assessing overweight and obesity in both sexes in different age groups. METHODS Detailed individual search strategies were developed for each of the following bibliographic databases: Cochrane, LILACS, PubMed/MEDLINE, Science Direct, Scopus and Web of Science. The QUADAS-2 checklist was used to assess the methodology of the studies included. RESULTS Thirty-eight assessments were performed in 11 articles according to age, sex and weight status. Using sensitivity and specificity, 27 assessments (71.0%) considered NC an accurate measure to diagnose overweight and obesity. The best sensitivity and specificity were found for the age >19 years (82.0%, 82.0%), female (80.0%, 73.0%), and obese (80.0%, 85.0%) categories. CONCLUSION NC is an accurate tool for assessing overweight and obesity in males and females of different age groups and could be used to screen for excess body weight in routine medical practice or epidemiological studies. It is also believed that more studies will permit the creation of a reference dataset of NC cut-off values for world populations.
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Affiliation(s)
- Caroline Kroll
- a Post-Graduation Program in Health and Environment , University of Joinville Region - UNIVILLE , Joinville , SC , Brazil
| | - Silmara S B S Mastroeni
- b Department of Physical Education , University of Joinville Region - UNIVILLE , Joinville , SC , Brazil
| | - Sandra A Czarnobay
- a Post-Graduation Program in Health and Environment , University of Joinville Region - UNIVILLE , Joinville , SC , Brazil
| | - John Paul Ekwaru
- c Population Health Intervention Research Unit, School of Public Health , University of Alberta , Edmonton , Alberta , Canada
| | - Paul J Veugelers
- c Population Health Intervention Research Unit, School of Public Health , University of Alberta , Edmonton , Alberta , Canada
| | - Marco F Mastroeni
- a Post-Graduation Program in Health and Environment , University of Joinville Region - UNIVILLE , Joinville , SC , Brazil
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Patnaik L, Pattnaik S, Rao EV, Sahu T. Validating neck circumference and waist circumference as anthropometric measures of overweight/obesity in adolescents. Indian Pediatr 2017; 54:377-380. [DOI: 10.1007/s13312-017-1110-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rajagopalan A, Balaji N. Association of Neck Circumference and Obesity with Blood Pressure among Adolescents in Urban and Rural Population in North Tamil Nadu. J Nat Sci Biol Med 2017; 8:144-149. [PMID: 28781477 PMCID: PMC5523518 DOI: 10.4103/jnsbm.jnsbm_29_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim: Since a few studies exist on the association of neck circumference (NC) and obesity with blood pressure (BP) among adolescents in India, we found it highly relevant to measure the NC and body mass index (BMI) using them as indicators of upper body subcutaneous fat and obesity and relate them to BP in a rural and urban adolescent population in North Tamil Nadu. Materials and Methods: This is a community-based cross-sectional study of descriptive design where 500 students from urban and rural areas were selected, and their BMI, NC, and BP were measured using standardized instruments. Results: Among urban and rural population high and normal NC positively correlated with BMI, systolic BP (SBP) and diastolic BP (DBP), indicating that the data clearly reflects increase in BMI, SBP, and DBP values with increase in NC or vice versa. The correlation was statistically significant (P < 0.001) significantly higher BMI (P < 0.01), SBP (P < 0.05), and NC (P < 0.001) was observed in urban population than rural. DBP was not significantly different in rural and urban population. 95th percentile values are significantly higher than rest in both urban and rural population. Only the 95th percentile values correlate and reflect similar changes in BMI, SBP, and DBP. Conclusion: Our studies indicate a strong association of elevation in BP with high NC and increase in BMI. Overweight and obesity were positively correlated with increase in SBP and DBP.
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Affiliation(s)
- Archana Rajagopalan
- Department of Physiology, Saveetha Medical College, Saveetha University, Chennai, Tamil Nadu, India
| | - Nisha Balaji
- Department of Physiology, Saveetha Medical College, Saveetha University, Chennai, Tamil Nadu, India
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Kelishadi R, Djalalinia S, Motlagh ME, Rahimi A, Bahreynian M, Arefirad T, Ardalan G, Safiri S, Hasani M, Asayesh H, Mansourian M, Qorbani M. Association of neck circumference with general and abdominal obesity in children and adolescents: the weight disorders survey of the CASPIAN-IV study. BMJ Open 2016; 6:e011794. [PMID: 27694487 PMCID: PMC5051415 DOI: 10.1136/bmjopen-2016-011794] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the association of neck circumference (NC) with obesity to determine the sex-specific and age-specific optimal cut-off points of this measure in association with obesity in a national sample of the Iranian paediatric population. METHODS This survey on weight disorders was conducted among a national sample of Iranian children and adolescents, aged 6-18 years. Using the area under the curve (AUC) of the receiver operator characteristic curves, we evaluated the association of NC with general and abdominal obesity. RESULTS This national survey was conducted among 23 043 school students (50.8% boys) with a mean age (SD) of 12.55 (3.31) years. A significant association was documented between NC and other anthropometric measures in both sexes and in the whole population. In all age groups and genders, NC performed relatively well in classifying participants to overweight (AUC: 0.67 to 0.75, p<0.001), general obesity (AUC: 0.81 to 0.85, p<0.001) and abdominal obesity (AUC: 0.73 to 0.78, p<0.001). CONCLUSIONS NC can be considered as a simple time-saving clinical tool for obesity detection in large population-based studies in children and adolescents. It is significantly correlated with indices of adiposity and can reliably identify children with general and abdominal obesity in the Iranian paediatric population.
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Affiliation(s)
- Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin Djalalinia
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Ali Rahimi
- School of Humanities and Tourism Management, Bangkok University, Bangkok, Thailand
| | - Maryam Bahreynian
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahereh Arefirad
- Department of Exercise Physiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Gelayol Ardalan
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Motahare Hasani
- Department of Nutrition, School of School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Morteza Mansourian
- Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ma C, Wang R, Liu Y, Lu Q, Liu X, Yin F. Diagnostic performance of neck circumference to identify overweight and obesity as defined by body mass index in children and adolescents: systematic review and meta-analysis. Ann Hum Biol 2016; 44:223-229. [PMID: 27588606 DOI: 10.1080/03014460.2016.1224387] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Chunming Ma
- Department of Endocrinology, the First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, PR China
| | - Rui Wang
- Department of Endocrinology, the First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, PR China
| | - Yue Liu
- Department of Endocrinology, the First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, PR China
| | - Qiang Lu
- Department of Endocrinology, the First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, PR China
| | - Xiaoli Liu
- Department of Endocrinology, the First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, PR China
| | - Fuzai Yin
- Department of Endocrinology, the First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, PR China
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Hatipoğlu N, Doğan S, Mazıcıoğlu MM, Kurtoğlu S. Relationship between Neck Circumference and Non-Alcoholic Fatty Liver Disease in Childhood Obesity. J Clin Res Pediatr Endocrinol 2016; 8:32-9. [PMID: 26758497 PMCID: PMC4805046 DOI: 10.4274/jcrpe.2313] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The aim of this study was to establish the association between anthropometric parameters and non-alcoholic fatty liver disease (NAFLD) and to determine the most reliable measurement as a parameter in predicting NAFLD. METHODS Two-hundred fifty-three obese children of ages 10 to 18 years were enrolled in this study. Anthropometric data and metabolic parameters such as fasting blood glucose, insulin and lipid levels, were measured. Liver function tests were assessed. NAFLD was determined by ultrasound. RESULTS Most metabolic parameters and anthropometric indices were significantly higher in children with NAFLD. A univariate logistic regression analysis was performed, taking NAFLD status as the dependent variable and anthropometric parameters as the independent variables. NAFLD was affected significantly by the anthropometric values. The multiple logistic regression analysis showed that neck circumference (NC) was the only parameter which determined the risk in both genders. Each 1 cm increase in the NC increased the risk of NAFLD 1.544-fold (p<0.001, 95% confidence interval (CI): 1.357-2.214) in the boys and 1.733-fold (p=0.001, 95% CI: 1.185-2.012) in the girls. Receiver operating characteristic analysis was performed to compare the reliability of anthropometric measurements. NC was observed to be a better indicator. CONCLUSION Measurement of the NC was shown to be associated with NAFLD in children. We suggest the use of NC as a novel, simple, practical, and reliable anthropometric index in predicting children at risk for NAFLD.
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Affiliation(s)
- Nihal Hatipoğlu
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey, Phone: +90 352 438 00 76 E-mail:
| | - Serap Doğan
- Erciyes University Faculty of Medicine, Department of Radiology, Kayseri, Turkey
| | - M. Mümtaz Mazıcıoğlu
- Erciyes University Faculty of Medicine, Department of Family Medicine, Kayseri, Turkey
| | - Selim Kurtoğlu
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
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Hassan NE, Atef A, El-Masry SA, Ibrahim A, Shady MMA, Al-Tohamy M, Kamel IH, Elashry GIA. Neck Circumference as a Predictor of Adiposity among Healthy and Obese Children. Open Access Maced J Med Sci 2015; 3:558-62. [PMID: 27275287 PMCID: PMC4877887 DOI: 10.3889/oamjms.2015.122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 11/05/2015] [Accepted: 11/16/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND: Obesity, particularly in the upper part of body, is a major health problem. Because body mass index (BMI) does not adequately describe regional adiposity, other indices of body fatness are being explored. OBJECTIVES: To determine if neck circumference is a valid measure of adiposity (fat distribution) among group of Egyptian children. SUBJECTS AND METHODS: This is a cross sectional study, included 50 obese subjects, aged 7 - 12 years recruited from Endocrine, obesity and Metabolism Pediatric Unit at Children Hospital, Cairo University and 50 healthy children, age and sex matched. All children were subjected to blood pressure assessment (systolic SBP and diastolic DBP), and anthropometric assessment (body weight, height, neck circumference (NC), waist (WC) and hip (HC) circumferences, and skin fold thicknesses at three sites: biceps, triceps and sub scapular. BMI [weight (kg)/height (m2)] was calculated. RESULTS: In healthy females, significant associations were detected between NC and SBP, DBP and all anthropometric measurements. However, in healthy males NC was not significantly associated with BMI, SBP and DBP. In the obese group; both sexes; insignificant association was found between NC and SBP, DBP, BMI and skinfold thickness. CONCLUSION: NC is related to fat distribution among normal healthy female children. However, this relation disappears with increasing adiposity. The results do not support the use of NC as a useful screening tool for childhood obesity.
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Affiliation(s)
- Nayera E Hassan
- Biological Anthropology Department, National Research Centre, Dokki, Cairo, Egypt (Affiliation ID 60014618)
| | - Abeer Atef
- Department of Pediatrics, Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), New Children's Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sahar A El-Masry
- Biological Anthropology Department, National Research Centre, Dokki, Cairo, Egypt (Affiliation ID 60014618)
| | - Amany Ibrahim
- Department of Pediatrics, Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), New Children's Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mones M Abu Shady
- Child Health Department, National Research Centre, Dokki, Cairo, Egypt (Affiliation ID: 60014618)
| | - Muhammad Al-Tohamy
- Biological Anthropology Department, National Research Centre, Dokki, Cairo, Egypt (Affiliation ID 60014618)
| | - Iman H Kamel
- Child Health Department, National Research Centre, Dokki, Cairo, Egypt (Affiliation ID: 60014618)
| | - Galal Ismail Ahmed Elashry
- Biological Anthropology Department, National Research Centre, Dokki, Cairo, Egypt (Affiliation ID 60014618)
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Santos DD, Contarato AAPF, Kroll C, Bertoli M, Czarnobay SA, Figueirêdo KBW, Mastroeni SSDBS, Mastroeni MF. Neck circumference as a complementary measure to identify excess body weight in children aged 13-24 months. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2015. [DOI: 10.1590/s1519-38292015000300005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objectives:to analyze the accuracy of neck circumference (NC) as a measure for assessing excess body weight in children aged 13-24 months of life, according to gender.Methods:this is a cross-sectional study comparing the neck circumferences in relation to body mass index (BMI) and other anthropometric measures. The best cut-off point for identifying excess body weight was determined using the Receiver Operating Characteristics curve (ROC curve), according to gender and age groups 13-15 months, 16-19 months and 20-24 months.Results:NC waspositively correlated (p<0.001) with body weight and BMI in both genders, and length in girls (p<0.001). Positive correlations were found between NC and BMI in the three age groups (13-15, 16-19 and 20-24 months) in both boys and girls. The NC cut-off points for boys were 23.6, 23.9 and 24.0 cm, and 23.4, 23.5 and 23.6 cm for girls, for the 1315, 16-19 and 20-24 age groups respectively.Conclusions:NC can be used to screen for excess body weight in children aged 13-24 months. However, further studies with a larger sample will be required in order to complement these results.
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