Agreement Analysis among Measures of Thinness and Obesity Assessment in Iranian School Children and Adolescents

A multivariate multilevel analysis of the risk factors associated with anthropometric indices in Iranian mid-adolescents

BACKGROUND

The present study was conducted to jointly assess some specific factors related to body fat measures using a multivariate multilevel analysis in a representative sample of Iranian mid-adolescents.

METHODS

This study was conducted among 2538 students (1286 boys) aged 14-20 years old, who were randomly selected among 16 public high schools by multi-stage random sampling procedure from all education districts of Shiraz, Iran. Data on demographic characteristics, family history of obesity, physical activity, socio-economic (SES) variables and screen time were collected. Height, weight, triceps (TST), abdominal (AST), and subscapular (SST) skinfold thickness were measured and their body mass index (BMI) was calculated. A multivariate multilevel approach was used to analyze the factors associated with obesity measures of the TST, AST, SST at the child and district levels.

RESULTS

In this study, the prevalence of overweight and obesity was estimated to be 10.2 and 5.1%, respectively. Overall, the major portion of the total variance in TST (97.1%), AST (97.7%), and SST (97.5%) was found at the child level. The results of multivariate multilevel method revealed that being girls, having a family history of obesity, and SES were significantly associated with increasing of three body fat measures (all the p-values were less than 0.05). There were significant positive associations between moderate to vigorous physical activities with AST and SST (for AST: β =2.54, SE = 1.40, p = 0.05; for SST: β =2.24, SE = 1.20, p = 0.05). Compared to children in 14-16 age group, children in age group 16-18 years had less TST (β = - 0.67, SE = 0.34, p = 0.04). Furthermore, other age groups and screen time did not play an important role in three outcome variables.

CONCLUSIONS

The results showed some factors that contribute to three body fat measures. Therefore, it is necessary to develop effective interventions to prevent the effects of individual and environmental undesirable factors on childhood obesity in both family and community levels.

Nutritional status among young adolescents attending primary school in Tanzania: contributions of mid-upper arm circumference (MUAC) for adolescent assessment

Background

Adolescence is a critical time of development and nutritional status in adolescence influences both current and future adult health outcomes. However, data on adolescent nutritional status is limited in low-resource settings. Mid-upper arm circumference (MUAC) has the potential to offer a simple, low-resource alternative or supplement to body mass index (BMI) in assessing nutrition in adolescent populations.

Methods

This is secondary data analysis, from a cross-sectional pilot study, which analyses anthropometric data from a sample of young adolescents attending their last year of primary school in Pwani Region and Dar es Salaam Region, Tanzania (n = 154; 92 girls & 62 boys; mean age 13.2 years).

Results

The majority of adolescents (75%) were of normal nutritional status defined by BMI. Significantly more males were stunted than females, while significantly more females were overweight than males. Among those identified as outside the normal nutrition ranges, there was inconsistency between MUAC and BMI cut-offs. Bivariate analyses indicate that BMI and MUAC show a positive correlation for both female and male participants, and the relationship between BMI and MUAC was more strongly correlated among adolescent females.

Conclusions

Further studies are needed with more nutritionally and demographically diverse populations to better understand the nutritional status of adolescents and the practical contribution of MUAC cut-offs to measure adolescent nutrition.

Growth curves and their associated weight and height factors in children from birth to 4 years old in West Azerbaijan Province, northwest Iran

BACKGROUND

Growth trajectory standards are important components that need to be monitored for suitable child growth. This study examined longitudinal data to identify the factors affecting growth trajectory standards of height and weight for infants.

METHODS

This study included 566 neonates (286 boys and 280 girls) born in West Azerbaijan Province, northwest Iran, who were followed from birth to 4 years of age. The subjects' weight and height were recorded at birth, 1, 2, 4, 6, 9 months and 1, 1.5, 2, 3, and 4 years of age. In this study, the Lambda-Mu-Sigma (LMS) method was used to construct the growth curves for each measure. The linear mixed model was employed to determine the factors affecting the growth trajectory.

RESULTS

The study demonstrates that the place of birth, duration of breastfeeding, and infants' gender had a significant effect on the growth trajectory. Nonetheless, other variables did not have any significant effect on growth. Growth curves for significant factors of weight and height (5th, 50th, 95th percentiles) were obtained. There was a rapid increase in the growth curve from birth to 2 years of age, which then remained relatively constant up to 4 years of age.

DISCUSSION

This paper provides the first local growth trajectory standards of height and weight for infants by analyzing longitudinal measurements in West Azerbaijan province. This study determined the factors affecting the growth trend in both indices. It seems that there was a significant difference in the growth trajectories of infants in subgroups of the effective factor.

Changes of Overweight and Obesity Prevalence Among School Children in North West of Iran After 3 Years Follow-up (2009-2011): A Longitudinal Study

Background:

Obesity and overweight among children is a major public health problem in developed and developing countries and has important health and economic implications. This longitudinal study aimed to assessing the prevalence trend of overweight and obesity in West Azerbaijan in North West of Iran.

Methods:

This study was a longitudinal follow-up study and was conducted in school children at 2009–2011 year. The subjects were all school children (12 years of age) that were recruited from rural and urban schools in West Azerbaijan. Overall, 22,820 girls and 28,763 boys were enrolled in 2009 and were followed for 3 years. A body mass index (BMI) 85^th–95^th percentile was classified as overweight and a BMI >95^th percentile was classified as obese. All statistical analyses were performed using the Excel Software. Descriptive statistics were used to characterize the sample in different time periods. The prevalence was calculated as the ratio of number of present cases to a given population number in a given subgroup at a given time.

Results:

In urban schools, the prevalence of overweight among girls and boys was 118.26 and 103.9 per 1000 persons in 2009 year, respectively, and this trend was increased in both girls (152.90 per 1000 persons) and boys (125.72 per 1000 persons) in 2011. The obesity trend was increased among both girls and boys (22.26 and 26.52 among girls and boys in 2009 to 24.66 and 28.65 per 1000 persons in 2011), respectively. In rural schools, the prevalence of overweight among girls was increased from 84.5 in 2009 to 108.89 per 1000 persons in 2011, but this trend was decreased among boys (from 95.49 in 2009 to 43.9 per 1000 persons in 2011), and the prevalence of obesity among boys was increased at the end of follow-up, but this trend was decreased among girls.

Conclusions:

Overweight and obesity in children has increased. Further studies are necessary to evaluate the relationship between obesity and overweight and risk factors such as dietary pattern and physical inactivity.

Gender and urban-rural difference in anthropometric indices predicting dyslipidemia in Chinese primary school children: a cross-sectional study

BACKGROUND

Childhood dyslipidemia is a critical factor of lifelong health. Therefore, screening and controlling dyslipidemia from childhood is a practical healthy strategy. However, few studies have examined the performance of anthropometric predictors of dyslipidemia in Chinese children, let alone the potential gender and urban-rural disparity. Thus, we evaluated anthropometric indices predicting dyslipidemia by genders and living areas in Chinese children.

METHODS

Data were from a health and nutrition survey conducted in seven urban areas and two rural areas in China between 2011 and 2012. The serum lipid levels of the participants were compared between genders and living areas. The body mass index z-score (BMI z-score), waist-hip ratio (WHR), waist-height ratio (WHtR), and mid-upper arm height ratio (MaHtR) were used as predictors. The receiver operating characteristic (ROC) analysis was performed to investigate the ability of anthropometric indices predicting dyslipidemia.

RESULTS

A total of 773 participants (average age = 9.3 ± 1.7 y) were included. The prevalence of dyslipidemia was 10.9%. Anthropometric indices were all significantly related to blood lipid profiles in boys after adjustment for age. The areas under the ROC curves (ACUs) were significantly larger than 0.5 in boys (ranged between 0.66-0.73), and were larger in rural boys (ranged between 0.68 and 0.94). MaHtR and WHR were associated with the highest specificity (93.8%) and highest sensitivity (100%), respectively.

CONCLUSION

Using anthropometric indices, screening for dyslipidemia may be more appropriate in boys than in girls in China, especially in rural boys. The BMI z-score, WHR, WHtR, and MaHtR were all significantly associated with dyslipidemia in boys; using WHR and MaHtR as indicators achieved the highest sensitivity and specificity, respectively.

Trend of Overweight and Obesity, Based on Population Study among School Children in North West of Iran: Implications for When to Intervene

INTRODUCTION

Childhood overweight and obesity is a major public health problem in both developed and developing countries. Overweight and obesity in children may have severe consequences later in a dolescence and adulthood. The aim of current study was to determine the prevalence trend of overweight and obesity in school-aged children from 2009 to 2011.

METHODS

The present study was a population-based study and conducted in three consecutive years, from 2009 to 2011. The study population included all of primary, secondary and high school children in rural and urban regions of West Azerbaijan province in West-North of Iran. Body mass index (BMI), the ratio of weight to height squared [weight (kg)]/ [height (m)]2, was calculated to the nearest decimal place. Overweight and obesity were classified using CDC recommendations for age and sex: a BMI 85th- 95th percentile was classified as overweight and a BMI >95th percentile was classified as obese. All statistical analyses were performed using the Excel Software. Descriptive statistics were used to characterize the sample in different time periods. The prevalence was calculated as the ratio of number present cases to a given population number in a given subgroup at a given time.

RESULTS

Overall, 165740, 145146 and 146203 school children were assessed at 2009, 2010 and 2011, respectively. Prevalence of overweight in primary school children among girls were 52.83, 86.93 and 116.36 and for boys were 57.07, 53.4 and 93.55 per 1000 person in 2009, 2010 and 2011 years, respectively. The prevalence of obesity in secondary school children for girls were 22.26, 27.75 and 28.43 and 26.52, 25.72 and 35.85 for boys per 1000 person in 2009, 2010 and 2011, respectively, The highest prevalence of overweight was 77.58, 142.4 and 126.46 per 1000 person among primary, secondary and high school children, respectively, in 2011. The lowest prevalence of obesity was 12.52, 24.1 and 21.61 per 1000 person among primary, secondary and high school children, respectively, in 2009.

CONCLUSIONS

However, the rapid increase in both obesity and overweight should have a special attention. Research on prevalence trend of overweight and obesity in children is poorly reported in Iran. So that, future studies need to follow-up on the associations between overweight and obesity with health outcomes when children develop and reach adolescence and adulthood.

Longitudinal standards for growth velocity of infants from birth to 4 years born in West Azerbaijan Province of northwest Iran

OBJECTIVES:

Growth velocity is an important factor to monitor for appropriate child growth. This study presents the growth velocity of infants based on length, weight, and head circumference.

METHODS:

The subjects of this study were 308 neonates (160 boys and 148 girls) born in West Azerbaijan Province of northwestern Iran who were followed from birth for 4 years. The weights and lengths of the subjects were recorded at birth, 1, 2, 4, 6, and 9 months, and 1, 1.5, 2, 3, and 4 years of age, while the head circumferences were measured just up to 1.5 years of age. In this study, the Lambda-Mu-Sigma (LMS) method using LMS Chartmaker Pro (Institute of Child Health, London, UK) was utilized to obtain growth velocity percentiles.

RESULTS:

After obtaining growth velocity charts for weight, length, and head circumference (5th, 50th, and 95th percentiles), the researchers could deduce that there was a sharp decrease in the velocity growth charts from birth to 2 years of age but these charts remained relatively stable up to 4 years for both sexes. Growth velocities for the length and weight of boys in the present sample are slightly but not significantly greater than those in girls through the first months of infancy and there was no significant difference between girls and boys up to 4 years.

CONCLUSIONS:

This paper provided the first local growth velocity standards of length, weight, and head circumference for infants by analyzing longitudinal measurements produced for West Azerbaijan Province, which should be updated periodically. It seems that there has been a significant difference between the growth velocity of infants in northwestern Iran and southern Iran within the past few years.

Child Weight Growth Chart and Its Associated Factors in Birth Cohort of Maku Using a Growth Curve Model and LMS Method

Background:

Infant growth is defined as a positive change in body size over a period of time, and is a sensitive predictor of social health. The most effective way to determine child growth is by measuring birth weight and constructing a weight growth trajectory. Many studies were conducted on the effects of different factors on birth weight, but investigations of these effects on growth trajectory are really sparse. This study analyzes longitudinal data to determine factors affecting growth trajectory and used LMS chart for comparing children.

Materials and Methods:

In a cohort study, 256 neonates born in 2004 in Maku, Iran, were recruited and were followed until 2009.The weight of the neonates were measured at 12 occasions from birth, until the age of 5 years. A growth curve model was used to determine the affecting factors. The parametric LMS method was used to construct the reference centiles curve of the weight (5th, 50th, 95th percentiles).

Findings:

The findings show that while controlling the other factors, birth region, breast feeding duration, mother’s education and infants’ gender significantly influenced the longitudinal weight rate. However, other variables did not reveal any significant association with growth. The growth charts increased rapidly from birth to 5 years of age for both sexes. It was observed that male children grew faster than females, through the first year of age up to 5 years.

Conclusion:

Although every child has a growth potential, this capacity could be influenced by various factors and can be compared with other infants through a growth chart. We used longitudinal data to obtain the risk factor of growth trajectory. LMS method was also used for description of growth. Thereafter, the weight chart of Shiraz, southern Iran’s corresponding infants, was compared.

Obese and overweight children and adolescents: an algorithmic clinical approach

Obesity in children and adolescents is a hot issue throughout the world. Numerous complications are related to childhood obesity, such as cardiovascular disease, diabetes, insulin resistance and psychological problems. Therefore, identification and treatment of this problem have an important role in the health system. In this clinical approach, we have provided a general overview of the assessment and management of obesity in children and adolescents, including definitions, history-taking, physical examinations, and laboratory testing for general practitioners and pediatricians. Furthermore, conventional therapies (physical activity, eating habits and behavioral modification) and non-conventional treatments (drugs and surgery options) have been discussed.