Correlação entre índice de massa corporal e circunferência da cintura em crianças

Excesso de peso e variáveis associadas em escolares de Itajaí, Santa Catarina, Brasil

ResumoObjetivou-se avaliar a associação das variáveis socioeconômicas, demográficas, dos comportamentos relacionados à saúde e características do ambiente familiar com a prevalência de excesso de peso em alunos do 1º ao 5º ano de escolas do município de Itajaí, Santa Catarina. As variáveis socioeconômicas, demográficas e referentes aos comportamentos e características do ambiente familiar foram identificadas por meio de questionário aplicado aos pais/responsáveis. Foi aferido e determinado o estado nutricional pelo Índice de Massa Corporal e circunferência da cintura. A associação entre o excesso de peso e as demais variáveis foi investigada por meio do teste do Qui-Quadrado de Pearson e de Tendência Linear. A população constituía-se de 417 escolares, 95,2% da amostra. Os dados indicaram que 44,0% apresentaram excesso de peso, que esteve associado à melhor qualidade da dieta (49,4%, p = 0,051), menor frequência de consumo de biscoitos e salgadinhos, hábito de realizar refeições em frente à televisão, ao excesso de peso dos pais (51%, p = 0,002), ao escore da atuação da família na alimentação (51,9%, p = 0,029) e atividade física das crianças. Sugere-se que as ações em saúde devem considerar o entorno familiar e o contexto social das crianças para fomentar estilos de vida mais saudáveis.

Prevalence and factors associated with central obesity in schoolchildren in Santa Catarina, Brazil

Objective: The aims of this article are to estimate the prevalence and to identify the sociodemographic factors and food consumption associated with central obesity in schoolchildren 6-10 years old of the State of Santa Catarina, Brazil. Methods: It consists in a cross-sectional population-based study involving 4,963 schoolchildren enrolled in the public and private sectors. The dependent variable is central obesity investigated by measuring waist circumference and classified according to percentiles/gender/age. Bivariate and multivariate analyzes were also performed. Results: The prevalence of central obesity was 4,9% (CI95%=4,3;5,5), being more prevalent in boys with statistical significance (p=0,003). The other variables investigated (age the schoolchildren, type of school, maternal education, protective and risk food consumption, number of daily meals) were not associated with outcome. Among the schoolchildren who had central obesity (n=243), 99.3% of the boys and 99.0% of the girls also showed overweight/obesity. Conclusion: The prevalence of central obesity was lower than that reported in national and international studies. In this scenario, the gender (male) variable was strongly associated with the outcome. The identified prevalence is a major concern in nutrition and medical science as the central obesity may remain in adulthood and show strong association with cardiovascular risk. It is noteworthy that there is a need for obesity prevention campaigns that encourage children and their parents to adopt a healthier life style. Finally, other studies should be conducted in order to examine potential factors linked to central obesity.

[Waist circumference, waist/height ratio, and neck circumference as parameters of central obesity assessment in children]

Objective:

To analyze studies that assessed the anthropometric parameters waist circumference (WC), waist-to-height ratio (WHR) and neck circumference (NC) as indicators of central obesity in children.

Data sources:

We searched PubMed and SciELO databases using the combined descriptors: "Waist circumference", "Waist-to-height ratio", "Neck circumference", "Children" and "Abdominal fat" in Portuguese, English and Spanish. Inclusion criteria were original articles with information about the WC, WHR and NC in the assessment of central obesity in children. We excluded review articles, short communications, letters and editorials.

Data synthesis:

1,525 abstracts were obtained in the search, and 68 articles were selected for analysis. Of these, 49 articles were included in the review. The WC was the parameter more used in studies, followed by the WHR. Regarding NC, there are few studies in children. The predictive ability of WC and WHR to indicate central adiposity in children was controversial. The cutoff points suggested for the parameters varied among studies, and some differences may be related to ethnicity and lack of standardization of anatomical site used for measurement.

Conclusions:

More studies are needed to evaluate these parameters for determination of central obesity children. Scientific literature about NC is especially scarce, mainly in the pediatric population. There is a need to standardize site measures and establish comparable cutoff points between different populations.