Prevalence of abdominal obesity in Spanish children and adolescents. Do we need waist circumference measurements in pediatric practice?
BACKGROUND
Evidence indicates that central adiposity has increased to a higher degree than general adiposity in children and adolescents in recent decades. However, waist circumference is not a routine measurement in clinical practice.


OBJECTIVE
This study aimed to determine the prevalence of abdominal obesity based on waist circumferences (WC) and waist to height ratio (WHtR) in Spanish children and adolescents aged 6 to 17 years. Further, the prevalence of abdominal obesity (AO) among normal and overweight individuals was analyzed.


METHODS
Data were obtained from a study conducted from 1998 to 2000 in a representative national sample of 1521 children and adolescents aged 6 to 17 years (50.0% female) in Spain. WC and WHtR measurements were obtained in addition to BMI. AO was defined as WHtR ≥0.50 (WHtR-AO), sex and age specific WC≥90(th) percentile (WC-AO1), and sex and age specific WC cut-off values associated with high trunk fat measured by by dual-energy X-ray absorptiometry (WC-AO2).


RESULTS
IOTF- based overweight and obsity prevalence was 21.5% and 6.6% in children and 17.4% and 5.2% in adolescents, respectively. Abdominal obesity (AO) was defined as WHtR≥0.50 (WHtR-AO), sex- and age-specific WC≥90th percentile (WC-AO1), and sex- and age-specific WC cut-off values associated with high trunk fat measured by dual-energy X-ray absorptiometry (WC-AO2). The respective prevalence of WHtR-AO, WC-AO1, and WC-AO2 was 21.3% (24.6% boys; 17.9% girls), 9.4% (9.1% boys; 9.7% girls), and 26.8% (30.6% boys;22.9% girls) in children and 14.3% (20.0% boys; 8.7% girls), 9.6% (9.8% boys; 9.5% girls), and 21.1% (28.8% boys; 13.7% girls) in adolescents.


CONCLUSIONS
The prevalence of AO in Spanish children and adolescents is of concern. The high proportion of AO observed in young patients who are normal weight or overweight indicates a need to include waist circumference measurements in routine clinical practice.
Cardiovascular Risk and Nutrition Research Group (CARIN), REGICOR Study Group, Research Programme in Inflammatory and Cardiovascular Disorders (RICAD), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ; CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
Helmut
H
Schröder
Fundación para la Investigación Nutricional (Nutrition Research Foundation), Barcelona, Spain ; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
Lourdes
L
Ribas
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, United States of America.
Corinna
C
Koebnick
Cardiovascular Risk and Nutrition Research Group (CARIN), REGICOR Study Group, Research Programme in Inflammatory and Cardiovascular Disorders (RICAD), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ; CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
Anna
A
Funtikova
Cardiovascular Risk and Nutrition Research Group (CARIN), REGICOR Study Group, Research Programme in Inflammatory and Cardiovascular Disorders (RICAD), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ; Fundación THAO, Barcelona, Spain.
Santiago F
SF
Gomez
Cardiovascular Risk and Nutrition Research Group (CARIN), REGICOR Study Group, Research Programme in Inflammatory and Cardiovascular Disorders (RICAD), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
Montserat
M
Fíto
Community Nutrition Unit, Bilbao Department of Public Health, Bilbao, Spain.
Carmen
C
Perez-Rodrigo
Fundación para la Investigación Nutricional (Nutrition Research Foundation), Barcelona, Spain ; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain ; Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canarias, Spain.
Lluis
L
Serra-Majem
D015502:Absorptiometry, Photon; D000293:Adolescent; D000886:Anthropometry; D002648:Child; D005260:Female; D057238:Growth Charts; D006801:Humans; D008297:Male; D056128:Obesity, Abdominal / Q000453:epidemiology*; D010372:Pediatrics / Q000379:methods*; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D055105:Waist Circumference / Q000502:physiology*