title: Prevalence and lifestyle determinants of central obesity in children.
abstract: OBJECTIVE
  Central obesity is a strong risk factor for metabolic disorders and cardiometabolic diseases in children and adolescents. The aim of the present study was to evaluate the prevalence of central obesity and to determine its cross-sectional association with lifestyle habits in a sample of school-aged children in Greece.
  
  
  METHODS
  The study sample consisted of 124,113 children (9.9 ± 1.1 years old, 51 % boys) attending the third and fifth grade of primary school. Anthropometric measurements were performed by trained physical education teachers, and central obesity was defined as waist-to-height ratio ≥0.5. Children's lifestyle habits were assessed through 7-day recall questionnaires.
  
  
  RESULTS
  Of the participating children, 33.4 % were classified as centrally obese. Central obesity was significantly more prevalent in boys than in girls (36.0 vs. 30.7 %, P < 0.001) and was present in 95 % of obese children, as well as in a significant percentage of overweight (69.5 %) and normal-weight ones (12.0 %). Children with central obesity, compared to their non-centrally obese counterparts, reported poorer dietary habits and were less physically active. According to multiple logistic regression analysis, frequent breakfast (OR 0.72, 95 % CI 0.69-0.75) and snack consumption (OR 0.70, 95 % CI 0.67-0.74), as well as frequent participation in sedentary activities (OR 1.10, 95 % CI 1.07-1.14), were the strongest lifestyle determinants of central obesity.
  
  
  CONCLUSIONS
  Strategies for the prevention of central obesity and associated comorbidities are urgently needed, for both obese and non-obese children. Our results suggest the need for a shift towards a healthier environment for our children, with emphasis on specific lifestyle habits, such as regular meal consumption and low sedentariness.
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, 70, El. Venizelou str., Athens, Greece.
authors.forename: Dimitris A
authors.initials: DA
authors.lastname: Grigorakis
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, 70, El. Venizelou str., Athens, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Georgoulis
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, 70, El. Venizelou str., Athens, Greece.
authors.forename: Glykeria
authors.initials: G
authors.lastname: Psarra
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, 70, El. Venizelou str., Athens, Greece.|Department of Physical Education and Sport Science, University of Athens, 41, Ethnikis Antistaseos str., 17237, Daphne, Greece.
authors.forename: Konstantinos D
authors.initials: KD
authors.lastname: Tambalis
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, 70, El. Venizelou str., Athens, Greece.
authors.forename: Demosthenes B
authors.initials: DB
authors.lastname: Panagiotakos
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, 70, El. Venizelou str., Athens, Greece. lasidoss@utmb.edu.|Departments of Internal Medicine, Nutrition and Metabolism and Surgery, Shriners Hospital for Children, University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX, 77555-0177, USA. lasidoss@utmb.edu.
authors.forename: Labros S
authors.initials: LS
authors.lastname: Sidossis
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D011939:Mental Recall; D056128:Obesity, Abdominal / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000453:epidemiology*; D015995:Prevalence; D011795:Surveys and Questionnaires; D049629:Waist-Hip Ratio
keywords: Abdominal adiposity; Childhood central obesity; Dietary habits; Lifestyle; Physical activity; Sedentary activities