Isolated and combined presence of elevated anthropometric indices in children: prevalence and sociodemographic correlates

Barbosa Filho, Valter Cordeiro; Campos, Wagner de; Fagundes, Ricardo Rosa; Lopes, Adair da Silva; Souza, Evanice Avelino de

doi:10.1590/1413-81232015211.00262015

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Free Themes • CSCCiênc. saúde colet. 21 (1) • Jan 2016 • https://doi.org/10.1590/1413-81232015211.00262015 copy

Isolated and combined presence of elevated anthropometric indices in children: prevalence and sociodemographic correlates

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study analyzed the prevalence and sociodemographic factors associated to the isolated and combined presence of elevated anthropometric indices among children. A cross-sectional study was performed with 2,035 children (aged 6–11 years, 50.1% of girls) who were randomly selected in schools from Colombo, Brazil. Body Mass Index (BMI), Waist Circumference (WC) and Waist-to-Height Ratio (WHtR) were classified using reference values. Age, gender, type of school, shift, and residence area were potential risk factors. Binary logistic regression was used (p < 0.05). The prevalence of children with isolated presence of elevated BMI, WHtR or WC was observed in 9.4% (confidence interval [CI] of 95%: 3.3; 15.7), 8.7% (CI 95%: 1.7; 15.9) and 4.4% (CI 95%: 1.0; 7.9), 8.7% of children, respectively. The presence of one or more elevated anthropometric index was observed in 16.9% (CI 95%: 5.4; 28.5) of children. Boys (BMI), younger children (WC) and children from public schools (BMI, WC or WHtR) were high-risk subgroups to the isolated presence of elevated anthropometric indices. Children from public schools and rural areas were high-risk subgroup to the combined presence of elevated anthropometric indices. In conclusion, Public policies to combat childhood obesity may be more effective whether they targeted at children from public schools and rural areas.

Key words
Obesity; Cross-sectional study; Child health; Risk factors

Variables			All (n = 2,035)	Boys (n = 1,016)	Girls (n = 1,019)	p-value
Continuous variables, Mean (SD)
	Age (years)		8.87 (1.35)	8.86 (1.35)	8.89 (1.34)	0.66^* * P-values obtained using the t-test for independent samples.
	Body weight (kg)		29.65 (7.88)	29.61 (7.92)	29.68 (7.85)	0.85^* * P-values obtained using the t-test for independent samples.
	Height (cm)		131.23 (12.59)	131.49 (13.35)	130.99 (11.79)	0.37^* * P-values obtained using the t-test for independent samples.
	BMIC (kg/m²)		17.05 (2.95)	16.99 (2.97)	17.10 (2.92)	0.40^* * P-values obtained using the t-test for independent samples.
	WC (cm)		57.00 (6.88)	56.88 (6.98)	57.13 (6.77)	0.42^* * P-values obtained using the t-test for independent samples.
	WHtR		0.44 (0.05)	0.43 (0.05)	0.44 (0.05)	0.13^* * P-values obtained using the t-test for independent samples.
Categorical variables, n (%)
	Age groups (years)					0.67^* ***** P-values obtained using the Chi-square test for linear trends. Age groups were defined as follows: 6.00–6.99 = 6 years; 7.00–7.99= 7 years; 8.00–8.99 = 8 years; 9.00–9.99 = 9 years; 10.00–10.99 = 10 years; and 11.00–11.99 = 11 years.
		6	174 (8.6)	85 (8.3)	89 (8.8)
		7	442 (21.7)	228 (22.3)	214 (21.1)
		8	469 (23.0)	241 (23.6)	228 (22.5)
		9	453 (23.3)	221 (21.6)	232 (32.9)
		10	371 (18.2)	184 (18.0)	187 (18.5)
		11	126 (6.2)	63 (6.2)	63 (6.2)
	Grade					0.41^* ***** P-values obtained using the Chi-square test for linear trends. Age groups were defined as follows: 6.00–6.99 = 6 years; 7.00–7.99= 7 years; 8.00–8.99 = 8 years; 9.00–9.99 = 9 years; 10.00–10.99 = 10 years; and 11.00–11.99 = 11 years.
		1st	435 (21.4)	226 (22.1)	209 (20.6)
		2nd	454 (22.3)	222 (21.7)	232 (22.9)
		3rd	405 (19.9)	207 (20.3)	198 (19.5)
		4th	391 (19.2)	203 (19.9)	188 (18.6)
		5th	350 (17.2)	164 (16.0)	186 (18.4)
	Study shift					^ P-values obtained using the Chi-square test for heterogeneity.
		Morning	1,128 (55.4)	554 (54.2)	574 (56.7)
		Afternoon	907 (44.6)	468 (45.8)	439 (43.3)
	School system					0.12^ P-values obtained using the Chi-square test for heterogeneity.
		Private	746 (36.7)	358 (35.0)	388 (38.3)
		Public	1289 (63.3)	664 (65.0)	625 (61.7)
	School area					0.85^ P-values obtained using the Chi-square test for heterogeneity.
		Rural	41 (2.0)	20 (2.0)	21 (2.1)
		Urban	1,994 (98.0)	1,002 (98.0)	992 (97.9)

		IMC elevado, escore-z ≥ 2
Variables		n (%)	Crude OR (IC 95%)	p-value^ P-values obtained using binary logistic regression with crude and adjusted models.	Adjusted OR (IC 95%)^* * Odds ratio and CI 95% adjusted to other independent variables.	p-value^ P-values obtained using binary logistic regression with crude and adjusted models.
Gender				< 0.01		< 0.01
	Boys	117 (11.4)	1.0		1.0
	Girls	76 (7.5)	0.63 (0.49; 0.81)		0.63 (0.50;0.81)
Age groups (years)				0.76		0.23
	6–7	59 (9.6)	1.0		1.0
	8–9	75 (8.1)	0.84 (0.24;2.88)		0.74 (0.23;2.38)
	10–11	59 (11.9)	1.27 (0.39;4.19)		0.94 (0.37;2.43)
Study shift				0.40		0.20
	Morning	123 (10.9)	1.0		1.0
	Afternoon	70 (7.7)	0.69 (0.26;1.77)		0.62 (0.28;1.33)
School system				< 0.01		< 0.01
	Public	180 (14.0)	1.0		1.0
	Private	13 (1.7)	0.11 (0.05;0.22)		0.12 (0.05;0.25)
School area				0.12		0.33
	Urban	184 (9.2)	1.0		1.0
	Rural	9 (22.0)	2.8 (0.74;10.31)		1.72 (0.55;5.34)

		Elevated WC, ≥ 90^th
Variables		n (%)	Crude OR (IC 95%)	p-value^ P-values obtained using binary logistic regression with crude and adjusted models.	Adjusted OR (IC 95%)^* * Odds ratio and CI 95% adjusted to other independent variables.	p-value^ P-values obtained using binary logistic regression with crude and adjusted models.
Gender				0.83		0.75
	Boys	44 (4.3)	1.0		1.0
	Girls	46 (4.5)	1.05 (0.61; 1.83)		1.07 (0.87; 1.52)
Age groups (years)				0.02		0.02
	6–7	40 (6.5)	1.0		1.0
	8–9	26 (2.8)	0.41(0.24; 0.73)		0.54 (0.32; 0.90)
	10–11	24 (4.8)	0.73 (0.42; 1.25)		1.10 (0.59; 2.05)
Study shift				0.54		0.12
	Morning	54 (4.8)	1.0		1.0
	Afternoon	36 (4.0)	0.82 (0.41; 1.62)		0.63 (0.34; 1.15)
School system				< 0.01		< 0.01
	Public	84 (6.5)	1.0		1.0
	Private	6 (0.8)	0.12 (0.04; 0.28)		0.11 (0.05; 0.28)
School area				0.13		0.28
	Urban	83 (4.2)	1.0		1.0
	Rural	7 (17.1)	4.74 (0.61; 9.99)		2.61 (0.41; 9.35)

		Elevated WHtR (≥ 0.50)
Variables		n (%)	Crude OR (IC 95%)	p-value^ P-values obtained using the Chi-square test for heterogeneity.	Adjusted OR (IC 95%)^* * P-values obtained using the t-test for independent samples.	p-value^ P-values obtained using the Chi-square test for heterogeneity.
Gender						0.08
	Boys	79 (7.7)	1.0	0.13	1.0
	Girls	100 (9.9)	1.31 (0.91; 1.88)		0.83 (0.58; 1.19)
Age groups (years)						0.30
	6–7	58 (9.4)	1.0	0.57	1.0
	8–9	74 (8.0)	0.84 (0.55; 0.73)		0.84 (0.49; 1.45)
	10–11	47 (9.5)	1.00 (0.73; 1.39)		1.39 (0.96; 2.00)
Study shift						0.70
	Morning	101 (9.0)	1.0	0.88	1.0
	Afternoon	78 (8.6)	0.96 (0.52; 1.76)		0.88 (0.45; 1.72)
School system						< 0.01
	Public	169 (13.1)	1.0	< 0.01	1.0
	Private	10 (1.3)	0.10 (0.03; 0.31)		0.09 (0.02; 0.33)
School area						0.24
	Urban	168 (8.4)	1.0	0.09	1.0
	Rural	11 (26.8)	3.99 (0.79;10.12)		2.45 (0.50; 11.92)

		Combined presence of elevated anthropometric indices (BMI, WC, and/or WHtR)
Variables		n (%)	Crude OR (IC 95%)	p-value^ P-values obtained using binary logistic regression with crude and adjusted models.	Adjusted OR (IC 95%)^* * Odds ratio and CI 95% adjusted to other independent variables.	p-value^ P-values obtained using binary logistic regression with crude and adjusted models.
Gender				0.50		0.75
	Boys	179 (17.5)	1.0		1.0
	Girls	166 (16.4)	0.92 (0.73; 1.17)		0.96 (0.75; 1.22)
Age groups (years)				0.20		0.43
	6–7	107 (17.4)	1.0		1.0
	8–9	138 (15.0)	0.84 (0.50; 1.39)		0.78 (0.50; 1.21)
	10–11	100 (20.1)	1.20 (0.72; 1.99)		0.95 (0.61; 1.48)
Study shift				0.20		0.08
	Morning	204 (18.1)	1.0		1.0
	Afternoon	141 (15.5)	0.83 (0.63; 1.10)		0.77 (0.58; 1.02)
School system				< 0.01		< 0.01
	Public	322 (25.0)	1.0		1.0
	Private	23 (3.1)	0.09 (0.05; 0.18)		0.10 (0.05; 0.18)
School area				< 0.01		0.04
	Urban	329 (16.5)	1.0		1.0
	Rural	16 (39.0)	3.24 (1.72; 6.10)		1.90 (1.02; 3.54)

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[1] Collaborations

VC Barbosa Filho participated in all stages of the study, the definition and delimitation of collection, data analysis and article writing. EA Souza participated in the interpretation and discussion of results. RR Fagundes took part in the definition of the study, coordinated the data collection and contributed to the writing of the article. W Campos and AS Lopes took part in the study of problem definition and reviewed the article in its different stages. All authors approved the final version of the study.