WAIST/HEIGHT RATIO: A MARKER OF NUTRITIONAL ALTERATION IN PRESCHOOL CHILDREN

Autores

  • Claudio Leone Professor Titular do Departamento de Saúde Materno-Infantil da Faculdade de Saúde Pública da Universidade de São Paulo.
  • Viviane Gabriela Nascimento Professor Titular do Departamento de Saúde Materno-Infantil da Faculdade de Saúde Pública da Universidade de São Paulo./Nutricionista, Pós-doutora pelo Departamento de Saúde Materno-Infantil da Faculdade de Saúde Pública da Universidade de São Paulo. Docente da Universidade Paulista.
  • Janaína Paula Costa da Silva Professor Titular do Departamento de Saúde Materno-Infantil da Faculdade de Saúde Pública da Universidade de São Paulo./Nutricionista, Doutora do Departamento de Saúde Materno-Infantil da Faculdade de Saúde Pública da Universidade de São Paulo.
  • Ciro João Bertoli Professor Titular do Departamento de Saúde Materno-Infantil da Faculdade de Saúde Pública da Universidade de São Paulo./Professor Doutor do Departamento de Medicina da Universidade de Taubaté.

DOI:

https://doi.org/10.7322/jhgd.88962

Palavras-chave:

waist circumference, obesity, overweight, adiposity, preschool.

Resumo

Introduction: The prevalence of obesity in Brazil is progressively increasing among children. In obese individuals, the concentration of fat in the abdominal region is a predictive marker for future health problems. Among the indicators of central adiposity, the waist-to-height ratio (WHR) has been shown to be more sensitive for predicting future health hazards than waist circumference alone. Objective: To analyze the relationship between the WHR and the classification of nutritional status of preschool children. Methods: A cross-sectional study with 711 preschool children in daycare in Taubate, SP. The sampling was probabilistic, having the nursery as the sampling unit. The weight, height and waist circumference of each child were measured. For classifying children with excess weight (risk of overweight, overweight or obesity), or with overweight or obesity the cut-off points of the Z-scores of Body Mass Index (zBMI), proposed by the Ministry of Health (2009), were used, from the point of view of the World Health Organization. The data were analyzed using the ROC (Receiver Operator Curve). Results: The area under the curve (AUC) of WHR for excess weight was 0.851 (p< 0.0001), and for overweight or obesity together was 0.886 (p< 0.0001). Values of 0.52 and 0.54 of the WHR were the cut-off points for optimization of Sensitivity/Specificity respectively for excess weight or overweight or obesity. Conclusion: The WHR is a useful tool in basic health care for children at the beginning of preschool age, for the assessment of nutritional status and central adiposity.

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Referências

Nascimento, VG et al. Prevalência de sobrepeso em crianças pré-escolares em creches públicas: um estudo transversal. Sao Paulo Med J 2012,130(4): 225-229.

Heseker H, Schmid A. Epidemiology of obesity. Ther Umsch 2000, 57(8):478-81.

Wyatt HR. The prevalence of obesity. Prim Care 2003, 30(2):267-79.

Stolk RP, Wink O, Zelissen PM, Meijer R, van Gils AP, Grobbee DE. Validity and reproducibility of ultrasonography for the measurement of intra-abdominal adipose tissue. Int J Obes Relat Metab Disord 2001, 25:1346-51.

Erselcan T, Candan F, Saruhan S, Ayca T. Comparison of body composition analysis methods in clinical routine. Ann Nutr Metab 2000, 44:243-8.

Sousa TF et al. Fatores associados à obesidade central em adultos de Florianópolis, Santa Catarina. Rev Bras Epidemiol 2011, 14(2): 296-309.

Giugliano R, Melo ALP. Diagnóstico de sobrepeso e obesidade em escolares: utilização do índice de massa corporal segundo padrão internacional. J Pediatr 2004; 80:129:34.

Ashwell M. Obesity risk: importance of the waist-to-height ratio. Nursing Standard 2009; 23(41): 49-54.

Ashwell M, Hsieh SD. Six reasons why the waistto-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr 2005;

(5): 303-7.

Pitanga FJG, Lessa I. Razão cintura-estatura como discriminador do risco coronariano de adultos. Rev Assoc Med Bras 2006; 52(3):157-61.

Haun DR, Pitanga FJG, Lessa I. Razão cintura/estatura comparado a outros indicadores antropométricos de obesidade como preditor de risco coronariano elevado. Rev Assoc Med Bras 2009; 55(6): 705-11.

OMS. Obesidade: prevenindo e controlando a epidemia global. Relatório da consultoria da OMS. Tradução: Andréa Favano; revisão científica: Sérgio Setsuo Maeda. São Paulo: Roca; 2004.

Must A, Hollander SA, Economos CD. Childhood obesity: a growing public health concern. Expert Rev Endocrinol Metab 2006; 1: 233-54.

Savva SC, Tornaristis M, Savva ME, Kourides Y, Panagi A, Silikiotou N, et al. Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. Int J Obes Relat Metab Disord 2000; 24:1453-8.

Kahn HS, Imperatore G, Cheng YJ. A population based comparison of BMI percentiles and waistto-height ratio for identifying cardiovascular risk in youth. J Pediatr 2005; 146:482-8.

McCarthy HD, Ashwell M. A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message – ‘keep your waist circumference to less than half your height’.

Int J Obes Relat Metab Disord 2006; 30: 988-92.

Lohman TG, Roche AF, Matorell R. Anthropometric standardization reference manual. 1988. Ilinois: Human Kinetics Publishers.

World Health Organization. Measuring change in nutritional status. Geneva; WHO; 1993. 101 p.

Ministry of Health (Ministério da Saúde). Department of Basic Care, http://nutricao.saude.gov.br/sisvan.php?conteudo=curvas_cresc_oms Accessed on 01/08/2009.

Sinaiko AR, Donahue RP, Jacobs DR, Prineas RJ. Relation of weight and rate of increase in weight during childhood and adolescence to body size, blood pressure, fasting insulin, and lipids in young adults. The Minneapolis

Childrens Blood Pressure Study. Circulation 1999; 99:1471-6.

Nathan BM, Moran A. Metabolic complications of obesity in childhood and adolescence: more than just diabetes. Curr Opin Endocrinol Diabetes Obes. 2008;15:21-9.

Morrison JA, Friedman LA, Harlan WR, Harlan LC, Barton BA, Schreiber GB, et al. Development of the metabolic syndrome in black and white adolescent girls: a longitudinal assessment. Pediatrics. 2005;116:1178-82.

Botton J, Heude B, Kettaneh A, Borys JM, Lommez A, Bresson JL, et al. Cardiovascular risk factor levels and their relationships with overweight and fat distribution in children: the Fleurbaix Laventie Ville Sante II study.

Metabolism. 2007;56: 614-22.

Schisterman EF, Faraggi D, Reiser B, Trevisan M. Statistical inference for the area under the receiver operating characteristic curve in the presence of random measurement error. Am J Epidemiol. 2001;154:174-9.

Atrash HK, Carpentier R. The evolving role of public health in the delivery of health care. J. Hum. Growth Dev. 2012; 22(3): 396-399.

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Publicado

2014-12-17

Edição

v. 24 n. 3 (2014)

Seção

Pesquisa Original

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