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Li Q, Huang G, Pei X, Tang X, Zhang R, Huang Y, Liu Z, Yi R, Xing C, Zhang X, Guo T. The Effect of Catgut Embedding at Acupoints Versus Nonacupoints in Abdominal Obesity: Protocol for a Multicenter, Double-Blind, 16-Week Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e46863. [PMID: 37428535 PMCID: PMC10366970 DOI: 10.2196/46863] [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: 02/28/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Obesity is an increasing problem worldwide. The effective treatments for obesity mainly include diet, physical activity, behavioral intervention, pharmacotherapy, and bariatric surgery, which all have certain limitations. As a specific type of acupuncture therapy, acupoint catgut embedding (ACE) has gained substantial attention in the management of obesity in recent years. Previous studies suggested that ACE may be an effective obesity treatment. However, the evidence for the efficacy of ACE in abdominal obesity (AO) remains inadequate due to the paucity of high-quality studies. OBJECTIVE This study aims to investigate the difference in the effectiveness of catgut embedding at acupoints and catgut embedding at nonacupoints in patients with AO and to further validate the efficacy and safety of ACE for AO. METHODS This is a multicenter, double-blind, 16-week randomized controlled trial. A total of 92 eligible participants with AO will be randomly divided into 2 groups (1:1 allocation ratio). The ACE group will receive catgut embedding at acupoints and the control group will receive catgut embedding at nonacupoints. The intervention will be performed every 2 weeks for a total of 6 sessions. Follow-up will be performed every 2 weeks for a total of 2 visits. The primary outcome is waist circumference. Secondary outcomes include body weight, BMI, hip circumference, and the visual analog scale of appetite. Upon the completion of the trial, we will evaluate the effect of catgut embedding at acupoints or nonacupoints on obesity indicators in patients with AO. For treatment outcomes, an intention-to-treat analysis will be performed. RESULTS The start of recruitment began in August 2019 and is expected to end in September 2023. CONCLUSIONS Although studies have been conducted to demonstrate the effectiveness of ACE in the treatment of obesity, the evidence for the efficacy of ACE in AO remains insufficient due to the quality of the studies. This rigorous normative randomized controlled trial will verify the effect of catgut embedding at acupoints or nonacupoints in patients with AO. The findings will provide credible evidence as to whether ACE is an effective and safe treatment for AO. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1800016947; https://tinyurl.com/2p82257p. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46863.
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Affiliation(s)
- Qifu Li
- School of Second Clinical Medicine, The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, China
| | - Gaoyangzi Huang
- School of Second Clinical Medicine, The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, China
| | - Xianmei Pei
- School of Second Clinical Medicine, The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, China
| | - Xin Tang
- School of Second Clinical Medicine, The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, China
| | - Renrui Zhang
- School of Second Clinical Medicine, The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, China
| | - Ya Huang
- School of Second Clinical Medicine, The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, China
| | - Zili Liu
- School of Second Clinical Medicine, The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, China
| | - Rong Yi
- Department of Acupuncture and Moxibustion, Kunming Hospital of Traditional Chinese Medicine, Kunming, China
| | - Chonghui Xing
- Department of Acupuncture and Moxibustion, The Sports Trauma Specialist Hospital of Yunnan Province, Kunming, China
| | - Xinghe Zhang
- School of Second Clinical Medicine, The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, China
| | - Taipin Guo
- School of Second Clinical Medicine, The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, China
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Kryst Ł, Żegleń M, Badzińska J, Woronkowicz A, Kowal M. Intergenerational Changes in the Waist Circumference and Selected Associated Indicators among Children and Adolescents from Kraków (Poland), between 1983 and 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5344. [PMID: 37047960 PMCID: PMC10094173 DOI: 10.3390/ijerph20075344] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 06/19/2023]
Abstract
The aim of the study was to examine the direction of the secular changes in the waist and hips circumferences, as well as selected associated body proportions, among children and adolescents from Kraków, Poland. The study group included 8-18-year-olds examined in three cross-sectional studies (1983, 2010, and 2020). The analyzed characteristics included body height, circumferences of the waist and hips, which were used to calculate Waist-to-Hip Ratio (WHR), and Waist-to-Height Ratio (WHtR). There was a secular increase regarding the majority of the analyzed features, particularly for the younger children (i.e., prepubertal/early pubertal age). The trends were also especially evident when comparing the results of the 1983 series to the results of their peers examined in 2020. An opposite trend was noted in adolescent girls. The observed changes reflect the secular trend resulting from changes in body composition and fat distribution happening due to alterations in the lifestyle and socio-economic environment of the population over the years. It should also be stressed that the increase in the studied characteristics occurred mainly in younger children. This suggests that the observed changes may have resulted from a shift in the age of maturation and also from the personal and social motivators characteristic for late adolescence.
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Affiliation(s)
- Łukasz Kryst
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, 31-571 Kraków, Poland
| | - Magdalena Żegleń
- Pain Research Group, Institute of Psychology, Faculty of Philosophy, Jagiellonian University, 30-060 Kraków, Poland
| | - Julia Badzińska
- Pain Research Group, Institute of Psychology, Faculty of Philosophy, Jagiellonian University, 30-060 Kraków, Poland
- Doctoral School in the Social Sciences, Jagiellonian University, 30-060 Kraków, Poland
| | - Agnieszka Woronkowicz
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, 31-571 Kraków, Poland
| | - Małgorzata Kowal
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, 31-571 Kraków, Poland
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Kryst Ł, Żegleń M, Kowal M, Woronkowicz A. Secular changes in the waist, hips circumferences and selected associated indicators, among preschool children from Kraków (Poland), between 1983 and 2018. Am J Hum Biol 2022; 34:e23748. [PMID: 35333429 DOI: 10.1002/ajhb.23748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Waist circumference and derived indicators are great for measuring the risk of abdominal obesity. The main aim of the study was to assess the changes in the waist, hips circumferences and selected associated indicators, among preschool children (3-7 years of age) from Kraków, Poland, between 1983, 2008 and 2018. METHODS The research was conducted in randomly selected kindergarten in Krakow (Poland). The 1983 cohort consisted of 1414 children and the 2008 and 2018 series included 1050 preschoolers each. Analyzed characteristics included waist and hip circumferences, body height, waist-to-hips ratio (WHR) and waist-to-height ratio (WHtR). RESULTS There was a negative secular trend regarding circumferences of the hips and waist, as well as WHtR. In girls, WHR was, the greatest in the 2018 cohort, while among boys there was a secular increase in the value of this parameter compared to the 2008 cohort, but not to the 1983 series. CONCLUSIONS The coexistence of currently noted trends with the previously described secular decrease in the prevalence of overweight/obesity and increase in trunk adiposity in the same population, suggests that WHR is preferable to body mass index in assessing the risk associated with excess adiposity in the population examined in the presented study.
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Affiliation(s)
- Łukasz Kryst
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, Kraków, Poland
| | - Magdalena Żegleń
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Małgorzata Kowal
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, Kraków, Poland
| | - Agnieszka Woronkowicz
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, Kraków, Poland
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Kankaria A, Narang R, Saxena A, Ramakrishnan S, Desai A, Thangjam RS, Krishnan A. Determinants of Waist-to-Height Ratio and Its Relation to Hypertension among School Children in India: A Multicenter Study. Indian J Pediatr 2022; 89:546-552. [PMID: 34406592 DOI: 10.1007/s12098-021-03879-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 06/04/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To study the factors associated with waist-to-height ratio (WHtR) among school children aged 5-15 y and its association with hypertension. METHODS In this cross-sectional study, data on background characteristics, socioeconomic status (SES), anthropometric parameters, and blood pressure were obtained from school children from three states of India. WHtR ≥ 0.5 was defined as obesity and hypertensives were defined based on Fourth Report criteria. Descriptive statistics were applied and multiple linear regression was done to identify factors associated with WHtR. A receiver operating characteristics (ROC) analysis was used to evaluate the predictive ability of WHtR to predict hypertension RESULTS: The mean WHtR among the 12,068 students was 0.40 (± 0.05) and it showed a U-shaped distribution with age with trough at 10 y of age for both genders. Mean WHtR was higher among residents of Manipur, among boys and hypertensives. WHtR was positively associated with weight > 30 kg, male gender, schools with high SES, Manipur and Goa region, and negatively associated with age > 10 y. The area under the ROC curve of WHtR for diagnosis of hypertension was low 0.544 (95% CI 0.532, 0.556). CONCLUSION There is a nonlinear relation between age, gender, and WHtR, which varies by geographical region and HT. This would need to be kept in mind while using it to identify obesity in children, though its discriminant value for hypertension is low.
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Affiliation(s)
- Ankita Kankaria
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Rajiv Narang
- Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Anita Saxena
- Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
| | | | - Ankush Desai
- Endocrinology Unit, Department of Medicine, Goa Medical College, Bambolim, Goa, India
| | - Rajendra S Thangjam
- Department of Medicine, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
| | - Anand Krishnan
- Department of Community Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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De Smidt JJA, Odendaal HJ, Nel DG, Nolan H, Du Plessis C, Brink LT, Oelofse A. The effects of in utero exposure to teratogens on organ size: a prospective paediatric study. J Dev Orig Health Dis 2021; 12:748-757. [PMID: 33198841 PMCID: PMC8536468 DOI: 10.1017/s2040174420001002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In low-income countries, prospective data on combined effects of in utero teratogen exposure are lacking and necessitates new research. The aim of the present study was to explore the effect of in utero teratogen exposure on the size of the kidneys and pancreas 5 years after birth in a low-income paediatric population. Data was collected from 500 mother-child pairs from a low-income setting. Anthropometric measurements included body weight, (BW) body height, mid-upper arm and waist circumference (WC). Clinical measurements included blood pressure (BP), mean arterial pressure and heart rate. Ultrasound measurements included pancreas, and kidney measurements at age 5 years. The main outcome of interest was the effect of maternal smoking and alcohol consumption on ultrasound measurements of organ size at age 5 years. Left and right kidney length measurements were significantly lower in smoking exposed children compared to controls (p = 0.04 and p = 0.03). Pancreas body measurements were significantly lower in smoking exposed children (p = 0.04). Multiple regression analyses were used to examine the associations between the independent variables (IDVs), maternal age, body mass index (BMI), mid-upper arm circumference (MUAC) and BW of the child, on the dependent variables (DVs) kidney lengths and kidney volumes. Also, the association between in utero exposure to alcohol and nicotine and pancreas size. WC was strongest (r = 0.28; p < 0.01) associated with pancreas head [F (4, 454) = 13.44; R2 = 0.11; p < 0.01] and tail (r = 0.30; p < 0.01) measurements at age 5 years, with in utero exposure, sex of the child and BMI as covariates. Kidney length and pancreas body measurements are affected by in utero exposure to nicotine at age 5 years and might contribute to cardiometabolic risk in later life. Also, findings from this study report on ultrasound reference values for kidney and pancreas measurements of children at age 5 years from a low-income setting.
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Affiliation(s)
- J. J. A. De Smidt
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - H. J. Odendaal
- Department of Obstetrics and Gynaecology, Stellenbosch University, Stellenbosch, South Africa
| | - D. G. Nel
- Department of Statistics and Actuarial Science, Stellenbosch University, Stellenbosch, South Africa
| | - H. Nolan
- Department of Obstetrics and Gynaecology, Stellenbosch University, Stellenbosch, South Africa
| | - C. Du Plessis
- Department of Obstetrics and Gynaecology, Stellenbosch University, Stellenbosch, South Africa
| | - L. T. Brink
- Department of Obstetrics and Gynaecology, Stellenbosch University, Stellenbosch, South Africa
| | - A. Oelofse
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
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Distribution of waist-to-height ratio and cardiometabolic risk in children and adolescents: a population-based study. Sci Rep 2021; 11:9524. [PMID: 33947900 PMCID: PMC8096959 DOI: 10.1038/s41598-021-88951-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 04/08/2021] [Indexed: 12/12/2022] Open
Abstract
This study was performed to evaluate the waist-to-height ratio (WHtR) distribution and assess its relationship with cardiometabolic risk in children and adolescents. A total of 8091 subjects aged 10–18 years were included from a nationally representative survey. Participants were classified into three groups: (1) < 85th, (2) ≥ 85th and < 95th, and (3) ≥ 95th percentile of WHtR. The WHtR distribution varied with sex and age. Whereas WHtR decreased from age 10–15 years in boys and from age 10–12 years in girls, it slightly increased thereafter. Compared to the < 85th percentile group, the WHtR ≥ 85th and < 95th percentile group had an odds ratio (OR) of 1.2 for elevated blood pressure (BP), 1.89 for elevated triglycerides (TGs), 1.47 for reduced high-density lipoprotein cholesterol (HDL-C) and 4.82 for metabolic syndrome (MetS). The ≥ 95th percentile group had an OR of 1.4 for elevated BP, 2.54 for elevated glucose, 2.22 for elevated TGs, 1.74 for reduced HDL-C, and 9.45 for MetS compared to the < 85th percentile group. Our results suggest that sex- and age-specific WHtR percentiles can be used as a simple clinical measurement to estimate cardiometabolic risk.
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Anthropometric Markers and Iron Status of 6-12-Year-Old Thai Children: Associations and Predictors. J Nutr Metab 2021; 2021:9629718. [PMID: 33953979 PMCID: PMC8057914 DOI: 10.1155/2021/9629718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 02/03/2021] [Accepted: 03/31/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Obesity may be associated with poor iron status. The objective of this study was to investigate the association between different indices of iron status and anthropometric measurements in Thai children. Materials and Methods Anthropometry (weight, height, waist circumference (WC), and body composition assessed by bioelectrical impedance analysis) and iron indices were measured in 336 Thai children aged 6-12 years. Iron deficiency (ID) was defined using two or more of the following: (1) %transferrin saturation (%Tsat) < 16%; (2) serum ferritin (SF) < 15 μg/mL; and (3) soluble transferrin receptor (sTfR) > 5 mg/L. Iron deficiency anaemia (IDA) was defined as haemoglobin < WHO age cutoff combined with ID. Overweight and obesity were defined as body mass index (BMI) standard deviation score (SDS) ≥ +1 SDS or +2 SDS, respectively (WHO growth reference). Results BMI SDS was significantly positively correlated with sTfR and SF (sTfR, r: 0.209, p < 0.001; SF, r: 0.214, p < 0.001) and negatively correlated with %Tsat (r: -0.132, p = 0.013). Correlations between WC SDS and %fat mass and each iron marker were similar. The percentage with low SF was significantly lower than that using other individual markers. ID prevalence was not significantly different between normal-weight and overweight/obesity groups although a significantly higher proportion of overweight/obese children had sTfR >5 mg/L. Puberty and menarche were significant predictors of ID (puberty adjusted OR: 2.20, 95% CI: 0.43, 11.25; menarche adjusted OR: 6.11, 95% CI: 1.21, 30.94). Conclusion Greater adiposity was associated with poorer iron status. However, SF may not be a good indicator of iron status in Thai children, particularly in those who are overweight/obese, whereas sTfR merits further investigation.
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Alshamiri MQ, Mohd A Habbab F, AL-Qahtani SS, Alghalayini KA, Al-Qattan OM, El-shaer F. Waist-to-Height Ratio (WHtR) in Predicting Coronary Artery Disease Compared to Body Mass Index and Waist Circumference in a Single Center from Saudi Arabia. Cardiol Res Pract 2020; 2020:4250793. [PMID: 32257425 PMCID: PMC7102403 DOI: 10.1155/2020/4250793] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/01/2020] [Accepted: 02/21/2020] [Indexed: 11/17/2022] Open
Abstract
This study aims to study the efficiency of the Waist-to-Height Ratio (WHtR) for determining coronary artery disease. It compares the frequency of abnormal WHtR, as a proxy for abdominal obesity, to that of body mass index (BMI) and waist circumference (WC). It also relates the findings to other cardiometabolic risk factors in University Hospital patients. A cross-sectional study design was used, where a sample of 200 patients (142 males and 58 females) who attended the adult cardiac clinic were purposively included. BMI, WC, and WHtR were measured, where frequencies of WHtR were compared to those of BMI and WC. The findings were related to the history of coronary artery disease (CAD) and history of cardiometabolic risk factors, including diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia. Majority of the male patients were older, taller, and had a lower BMI value. It also showed that the prevalence of dyslipidemia and CAD was higher in male patients. No significant difference between both genders was noticed for weight, WC, WHtR, hypertension, or DM. BMI was least associated with high-risk cardiac population in both males and females (39.4% and 60.3%), followed by WC (84.5% and 96.6%, respectively). WHtR showed the highest association with gender (male 98.6% and females 98.3%). These findings were noticed in patients with all risk factors. WHtR is superior to BMI and WC for determining the elevated risk of diabetes, hypertension, dyslipidemia, and CAD in a single university institute. The role of WHtR in both normal and diseased Saudi population should be delineated.
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Affiliation(s)
| | | | | | | | | | - Fayez El-shaer
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Hosseini M, Yousefifard M, Baikpour M, Motlagh ME, Heshmat R, Qorbani M, Ataei N, Yaseri M, Abbasi A, Kelishadi R. Age-Period-Cohort Analysis of Abdominal Obesity in Iranian Children and Adolescents: The CASPIAN Study. Int J Endocrinol Metab 2020; 18:e82866. [PMID: 32308693 PMCID: PMC7138598 DOI: 10.5812/ijem.82866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/26/2019] [Accepted: 12/04/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The assessment of the trend of changes in the prevalence of abdominal obesity can provide useful health information. OBJECTIVES This study aimed to conduct an age-period-cohort (APC) analysis to provide the trend of the prevalence of abdominal obesity in the Iranian pediatric population through the three temporal dimensions of age, period, and cohort. METHODS Data were gathered from a total number of 53,962 Iranian children and adolescents aged 5 to 19 years through four surveys of a national surveillance program (the CASPIAN study) conducted in 2003, 2007, 2011, and 2015. Abdominal obesity was defined as a waist-to-height ratio of ≥ 0.5. The APC analysis was performed using the "apc_ie"command in STATA software. RESULTS A significant correlation existed between age, period, and cohort effects and the prevalence of abdominal obesity in children and adolescents. With increasing age, regardless of considerable fluctuations, the prevalence of abdominal obesity followed an overall increasing trend in both genders. The age effect coefficient increased from -2.1 in the age group of 5 - 9 years to 1.1 in the age group of 10 - 14 years and then decreased to 1.0 in the age group of 15 - 19 years among boys; figures followed an increasing trend in girls from -2.2 to 0.8 and 1.5, respectively. As for the period effect, in both boys and girls, the prevalence of abdominal obesity followed an increasing trend when coming from the earlier periods to the recent ones (from -4.6 to 4.0 in boys and from -4.1 to 2.4 in girls). Likewise, this prevalence increased from earlier birth cohorts to the recent ones in both genders. CONCLUSIONS The prevalence of abdominal obesity is increasing among Iranian children and adolescents and this rising trend is affected by age, period, and birth cohort effects. The findings of this study emphasize the necessity of implementing comprehensive interventions for tackling the epidemic of childhood obesity.
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Affiliation(s)
- Mostafa Hosseini
- Pediatric Chronic Kidney Disease Research Center, The Children’s Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Yousefifard
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Baikpour
- Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Corresponding Author: Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| | - Neamatollah Ataei
- Pediatric Chronic Kidney Disease Research Center, The Children’s Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Pediatric Nephrology, The Children’s Hospital Medical Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Abbasi
- Pediatric Chronic Kidney Disease Research Center, The Children’s Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - 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
- Corresponding Author: Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar-Jarib Ave, Isfahan, Iran.
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Sousa CM, Santana E, Lopes MV, Lima G, Azoubel L, Carneiro É, Barros AK, Pires N. Development of a Computational Model to Predict Excess Body Fat in Adolescents through Low Cost Variables. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2962. [PMID: 31426509 PMCID: PMC6720279 DOI: 10.3390/ijerph16162962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/03/2019] [Accepted: 08/14/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Excess body fat has been growing alarmingly among adolescents, especially in low income and middle income countries where access to health services is scarce. Currently, the main method for assessing overweight in adolescents is the body mass index, but its use is criticized for its low sensitivity and high specificity, which may lead to a late diagnosis of comorbidities associated with excess body fat, such as cardiovascular diseases. Thus, the aim of this study was to develop a computational model using linear regression to predict obesity in adolescents and compare it with commonly used anthropometric methods. To improve the performance of our model, we estimated the percentage of fat and then classified the nutritional status of these adolescents. METHODS The model was developed using easily measurable socio-demographic and clinical variables from a database of 772 adolescents of both genders, aged 10-19 years. The predictive performance was evaluated by the following metrics: accuracy, sensitivity, specificity, and area under ROC curve. The performance of the method was compared to the anthropometric parameters: body mass index and waist-to-height ratio. RESULTS Our model showed a high correlation (R = 0.80) with the body fat percentage value obtained through bioimpedance. In addition, regarding discrimination, our model obtained better results compared to BMI and WHtR: AUROC = 0.80, 0.64, and 0.55, respectively. It also presented a high sensitivity of 92% and low false negative rate (6%), while BMI and WHtR showed low sensitivity (27% and 9.9%) and a high false negative rate (65% and 53%), respectively. CONCLUSIONS The computational model of this study obtained a better performance in the evaluation of excess body fat in adolescents, compared to the usual anthropometric indicators presenting itself as a low cost alternative for screening obesity in adolescents living in Brazilian regions where financial resources are scarce.
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Affiliation(s)
- Carlos Magno Sousa
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Ewaldo Santana
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil.
- Laboratory of Signals Acquisition and Processing, LAPS, State University of Maranhão, Campus Paulo VI, São Luís 65700000, MA, Brazil.
| | - Marcus Vinicius Lopes
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Guilherme Lima
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Luana Azoubel
- Centro de Prevenção de Doenças Renais, University Hospital of Maranhão, São Luís 65080805, MA, Brazil
| | - Érika Carneiro
- Centro de Prevenção de Doenças Renais, University Hospital of Maranhão, São Luís 65080805, MA, Brazil
| | - Allan Kardec Barros
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Nilviane Pires
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
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Kim MS, Kim SY, Kim JH. Secular change in waist circumference and waist-height ratio and optimal cutoff of waist-height ratio for abdominal obesity among Korean children and adolescents over 10 years. KOREAN JOURNAL OF PEDIATRICS 2018; 62:261-268. [PMID: 30514064 PMCID: PMC6642921 DOI: 10.3345/kjp.2018.07038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/03/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE This study aimed to evaluate the time trends of waist circumference (WC) and waist-height ratio (WHR), and to present WC and WHR distributions with optimal WHR cutoff for abdominal obesity in Korean children and adolescents. METHODS We performed a retrospective cross-sectional analysis of data from 13,257 children and adolescents (6,987 boys and 6,270 girls) aged 6-18 years who were included in the third to sixth Korea National Health and Nutrition Examination Survey (KNHANES, 2005-2015). Linear regression analyses were used to identify secular changes in WC and WHR by age, sex, and KNHANES waves. A receiver operating characteristic curve analysis was used to determine the optimal WHR cutoff values for abdominal obesity and cardiometabolic risk factors. RESULTS The mean WC and WHR distributions from 2005 to 2015 showed no significant secular changes between the KNHANES 4 waves (P for trend ≥0.05 in all ages and both sexes). The mean WCs in the present study were lower than those in the 2007 Korean National Growth Charts. The mean WHR at ages <13 years was statistically higher in the boys than in the girls, but did not significantly differ between the sexes among those aged 13 to 18 years. The optimal WHR cutoff for abdominal obesity was 0.48 (area under the curve, 0.985; 95% confidence interval, 0.985-0.985) in the 13- to 18-yearold adolescents. CONCLUSION WC and WHR showed no secular changes over 10 years. The optimal WHR cutoff for abdominal obesity of 0.48 is useful for diagnosing and managing obesity and thus preventing obesityrelated cardiometabolic complications in 13- to 18-year-old Korean adolescents.
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Affiliation(s)
- Min Sub Kim
- 1Department of Pediatrics, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Se Young Kim
- 1Department of Pediatrics, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Jae Hyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
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Hoang NTD, Orellana L, Le TD, Gibson RS, Worsley AF, Sinclair AJ, Szymlek-Gay EA. Anthropometric Status among 6⁻9-Year-Old School Children in Rural Areas in Hai Phong City, Vietnam. Nutrients 2018; 10:nu10101431. [PMID: 30287764 PMCID: PMC6212902 DOI: 10.3390/nu10101431] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 09/19/2018] [Accepted: 09/26/2018] [Indexed: 01/12/2023] Open
Abstract
A double burden of malnutrition in Vietnamese children has emerged as a key challenge: childhood undernutrition remains a public health concern while childhood overweight/obesity has gradually increased. This study aimed to (1) estimate the prevalence of undernutrition and overnutrition among 6–9-year-old primary school children in rural areas of Vietnam, and (2) identify sociodemographic factors associated with undernutrition and overnutrition in this population. A cross-sectional survey was conducted in October 2016 in 2334 children from eight primary schools in rural areas in Hai Phong City, Vietnam. Anthropometric and demographic data were collected. The prevalence of underweight, stunting, wasting, and anthropometric failure was 8.0%, 5.1%, 5.3%, and 11.9%, respectively. Up to 22.1% of children were affected by overweight/obesity, and 31.0% by abdominal overweight/obesity. Low maternal education was associated with higher odds of underweight and anthropometric failure, whereas overweight/obesity or abdominal overweight/obesity were more likely in boys and children of mothers with a high education level. This study provides evidence for a double burden of diseases among primary school children in rural areas in Hai Phong City. Future interventions for the prevention and control of childhood undernutrition and overweight/obesity should take into account child sex and maternal education level.
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Affiliation(s)
- Ngan T D Hoang
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia.
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, VIC 3125, Australia.
| | - Tuyen D Le
- National Institute of Nutrition, Hanoi 10000, Vietnam.
| | - Rosalind S Gibson
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Anthony F Worsley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia.
| | | | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia.
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Suder A, Gomula A, Koziel S. Central overweight and obesity in Polish schoolchildren aged 7-18 years: secular changes of waist circumference between 1966 and 2012. Eur J Pediatr 2017; 176:909-916. [PMID: 28540432 DOI: 10.1007/s00431-017-2938-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 05/13/2017] [Accepted: 05/16/2017] [Indexed: 01/08/2023]
Abstract
UNLABELLED We investigated secular trends of body mass index (BMI) and waist circumference (WC) in Polish schoolchildren examined through a period of almost 50 years. Data on height, weight and WC came from four cross-sectional surveys conducted in Poland between 1966 and 2012, covering 34,005 boys and 34,008 girls. Raw data of BMI and WC were standardized for age classes. Statistical analyses included the Kruskal-Willis test and Pearson Chi-square test. BMI and WC increased during the studied period; however, the growth was higher for WC (increase by 0.56 and 0.44 SD scores for BMI and 1.05 and 0.77 SD scores for WC in boys and girls, respectively). In boys, secular changes in BMI and WC were similar across childhood, early and late adolescence, while in girls they differed, indicating change in the type of adipose tissue distribution to a more central one in late adolescent girls. CONCLUSION During 46 years, there was a tendency to a greater increase of the fraction of individuals with central obesity than the overall one. Since abdominal fat deposit is more connected with higher health risks than subcutaneous fat pattern, probably the number of metabolic complications in Polish children and adolescents will intensify in the future. What is Known: • BMI has significant limitations related to fat distribution, while WC is a measure of central adiposity. • Greater central fat deposition increases the risk of many diseases; therefore, WC may serve as a diagnostic measure for detecting central obesity in children at risk. What is New: • In girls, changes in BMI and WC indicate change in adipose tissue distribution to a more central one in late adolescence girls. • Both general and abdominal obesity in Polish children increased significantly from 1966 to 2012, with the tendency to a greater increase of the fraction of individuals with central obesity than the overall one, implying the number of metabolic complications in Polish children and adolescents may intensify in the future.
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Affiliation(s)
- Agnieszka Suder
- Department of Anatomy, University of Physical Education in Cracow, 31-571, Krakow, Poland
| | - Aleksandra Gomula
- Department of Anthropology, Hirschfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Podwale 75, 50-449, Wroclaw, Poland
| | - Slawomir Koziel
- Department of Anthropology, Hirschfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Podwale 75, 50-449, Wroclaw, Poland.
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