Waist circumference, waist/height ratio, and neck circumference as parameters of central obesity assessment in children* *Study conducted at Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, MG, Brazil

Health indices for the evaluation and monitoring of health in children and adolescents in prevention and health promotion: a scoping review

BACKGROUND

Health indicators are used in different settings to monitor health outcomes. Child and adolescent health is arguably one of the most important areas for the application of indices and indicators in prevention and health promotion. Although single health indicators may be better suited to display the complexity of the health status and its determinants, a selected set of indicators will still offer a complex picture. Therefore, it is argued that a group of indicators combined into an index may offer a pragmatic tool that is easier to use in order to inform stakeholders.

METHODS

A scoping review was conducted to identify and describe health indices that monitor and evaluate health of children and adolescents and to appraise the quality and value of the identified indices that may guide the further applications of these indices in particular settings. The three bibliographic databases MEDLINE, EMBASE and PsycINFO were searched and a double screening of titles and abstracts as well as double screening of full texts was performed. Indices contained in these studies were analysed in terms of focus and composition and evaluated in terms of quality criteria.

RESULTS

The scoping review identified 36 eligible studies with 18 health indices in six thematic categories. Of the identified indices, seven indices focus on anthropometrical variables, three indices focus on special aspects of newborns and five indices focus on oral health. One index assesses "healthy lifestyle" and one "functional ability" whereas one index a combination of different aspects. Most indices are calculated by using primary health data.

CONCLUSIONS

Alone or in combination with single sets of indicators, indices in six major thematic domains may be used as pragmatic tools for monitoring children's and adolescents´ health and the evaluation of interventions in health promotion and prevention settings.

Developing waist circumference, waist-to-height ratio percentile curves for Pakistani children and adolescents aged 2-18 years using Lambda-Mu-Sigma (LMS) method

Objectives Children from different countries and with different ethnic backgrounds have a distinct pattern of central fat deposition. Therefore, it is essential to develop population-specific percentiles of waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-height ratio exponent (WHtR (exp)) for the evaluation of central obesity. The objective of this study was to develop age-and-gender-specific smoothed WC and WHtR percentile curves for the Pakistani children and adolescents aged 2-18 years. Methods A cross-sectional data-set from a multi-ethnic anthropometric survey was considered. A sample of 10,668 healthy subjects (boys = 51.92%; and girls = 48.08%), aged 2-18 years was studied. Height (cm) and WC (cm) of each subject was measured under standard procedure and WHtR & WHtR (exp) were calculated. Age-and-gender-specific smoothed curves were obtained using the lambda-mu-sigma (LMS) method and compared with percentile curves obtained from different countries. Results Except few early ages, the WC values increased with age in both sexes. Both boys and girls had approximately similar WC during 6-11 years of age and after age of 11, the boys had larger WC than the girls had. For WHtR, the centile curves showed a continuous decrease by 16 years of age and then increased gradually. WHtR of the girls in various ages were having similar or higher than those of the boys. In comparison of WC 50th and 90th percentiles with other countries, it was found that except few ages, the Pakistani children had larger WC than the other reference populations and the results of WHtR were also comparable to the other nations. Conclusions We present new reference data of WC, WHtR and WHtR (exp) using a representative sample of the Pakistani children aged 2-18 years. These reference values can be used provisionally for early detection of central obesity and its associated risks in the Pakistani children.

Neck circumference: A valuable anthropometric measurement to detect metabolic syndrome among different age groups in China

OBJECTIVES

The aim of this study was to investigate the correlation between neck circumference and metabolic syndrome in Chinese residents and to explore the cut-off points of neck circumference for metabolic syndrome in different age groups.

METHODS

In all, 4227 Chinese adults (18-90 y) were enrolled in the study and divided into 3 subgroups (young, middle-aged, and elderly) according to their ages. The compared data for the subjects included anthropometric indicators and biochemical detection indices. Neck circumference was compared with other simple anthropometric indices using receiver operating characteristic curves.

RESULTS

(1) In all, 362 of the subjects who were diagnosed with metabolic syndrome were young (16.8%), 428 were middle-aged (36.9%), and 485 were elderly people (53.1%). (2) The areas under the curve of neck circumference for metabolic syndrome for the 3 subgroups, young, middle-aged, and elderly, for males were 0.853, 0.792, and 0.828, respectively, and these values were 0.859, 0.780, and 0.725 for females, respectively. (3) Neck circumference cut-offs were 39.05, 39.45, and 38.90 cm in men and 34.15, 33.55, and 33.95 cm in women.

CONCLUSIONS

Neck circumference contributed to determining metabolic syndrome risk beyond the classical anthropometric indices among different age groups in China.