Objective To examine the relation of dietary and physical activity (PA) patterns with the body mass index (BMI), and the associations between these patterns among children. Methods A representative sample of 21 111 school students aged 6-18 years was selected by multistage random cluster sampling from 23 provinces in the Islamic Republic of Iran. PA and dietary pattern were assessed by self-administered validated questionnaires. Findings Fruit and vegetables, dairy products and snacks (salty, fatty or sweet) had a similar consumption frequency of approximately twice a day. The type of fat most frequently consumed was hydrogenated solid fat (consumed by 73.8% of families). The PA level was significantly higher among boys than girls, in rural than in urban residents, and in intermediate students than high-school students. Among boys, the frequency of consumption of vegetables and plant proteins (R² = 0.46); and among girls, the frequency of consumption of dairy products and fruits, as well as high PA level had a significant inverse association with BMI (R² = 0.57). Among boys, the low frequency of consumption of fruits, the time spent on PA and the energy expenditure; and among girls, the time spent on PA and the energy expenditure, had significant relationships with overweight. When controlling for covariates, PA levels had significant relationships with the frequency of consumption of all food groups. Conclusion Unhealthy lifestyles make Iranian young people prone to chronic diseases later in life. When examining their health benefits, the interrelationship of dietary and PA behaviours should be considered. Voir page 24 le résumé en français. En la página 25 figura un resumen en español.
IntroductionAccording to WHO estimates, by 2020, noncommunicable diseases (NCD) will account for approximately three quarters of all deaths in the developing world.1 Interest in childhood precursors to chronic diseases is increasing because the behavioural and biological risk fact t tors for chronic diseases persist from childhood into adulthood.2-4 Declining levels of physical activity (PA) as well as nutrition transition (i.e. the trend towards increased consumption of a diet high in saturated fat, sugar and refined foods, and low in fibre) among commut t nities are thought to be partly responsible for the rising rate of such risk factors worldwide. In this regard, a potential emerging public health concern in developing countries is likely to be the increasing incidence of childhood overweight, which in the future is likely to create an enormous public health burden.
8In recent years, in addition to problems in adults, the epidemiologit t cal transition has made Iranian young people prone to chronic diseases in later life. The project team obtained written informed consent from parents and oral assent from students. They selected school students by multistage random cluster sampling. Schools were stratified according to location (urban or rural), and the socioeconomic characteristics of their catchment area, taking into consi...
The findings of this study warrant the necessity of paying special attention to monitoring of the time trends in child obesity based on uniform definitions, as well as to design programmes to prevent and control associated factors.
skipping breakfast is associated with increased risk of MetS and other cardiometabooic factors in children and adolescents. Promoting the benefit of eating breakfast could be a simple and important implication to prevent these risk factors.
Establishment of a uniform set of criteria for the MetS in children is needed. Routine WC measurement in the paediatric population may be clinically useful.
Context
No universal waist circumference (WC) percentile cutoffs used have been proposed for screening central obesity in children and adolescents.
Objective
To develop international WC percentile cutoffs for children and adolescents with normal weight based on data from 8 countries in different global regions and to examine the relation with cardiovascular risk.
Design and Setting
We used pooled data on WC in 113,453 children and adolescents (males 50.2%) aged 4 to 20 years from 8 countries in different regions (Bulgaria, China, Iran, Korea, Malaysia, Poland, Seychelles, and Switzerland). We calculated WC percentile cutoffs in samples including or excluding children with obesity, overweight, or underweight. WC percentiles were generated using the general additive model for location, scale, and shape (GAMLSS). We also estimated the predictive power of the WC 90th percentile cutoffs to predict cardiovascular risk using receiver operator characteristics curve analysis based on data from 3 countries that had available data (China, Iran, and Korea). We also examined which WC percentiles linked with WC cutoffs for central obesity in adults (at age of 18 years).
Main Outcome Measure
WC measured based on recommendation by the World Health Organization.
Results
We validated the performance of the age- and sex-specific 90th percentile WC cutoffs calculated in children and adolescents (6-18 years of age) with normal weight (excluding youth with obesity, overweight, or underweight) by linking the percentile with cardiovascular risk (area under the curve [AUC]: 0.69 for boys; 0.63 for girls). In addition, WC percentile among normal weight children linked relatively well with established WC cutoffs for central obesity in adults (eg, AUC in US adolescents: 0.71 for boys; 0.68 for girls).
Conclusion
The international WC cutoffs developed in this study could be useful to screen central obesity in children and adolescents aged 6 to 18 years and allow direct comparison of WC distributions between populations and over time.
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