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In this study, performed in the province of Pistoia (Italy), we tested whether 8-year-old children living in rural areas differed from their urban peers as far as nutritional status, dietary habits and physical activity are concerned. The study sample was randomly selected to include 50% of the children attending the third elementary class in the province of Pistoia during 2002. A total of 1006 children underwent an anthropometric evaluation and an assessment of dietary habits and physical activity by means of specific questionnaires. Of these children, 927 were born in Italy and are described in this report. The relationship between body mass index (BMI<5th percentile versus 5thor=95th percentile) and the environment (urban versus rural) was of borderline significance (P=0.051). However, the percentage of children with BMI>or=85th percentile was greater in rural (24%) than in urban (18%) areas (P=0.012). The choice of foods and the physical activity of rural children mirrored those of urban children. These data sound as an alarm in view of the current epidemics of obesity that are invading Italy and other Mediterranean countries.

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BackgroundVisceral obesity in children increases the risk of developing cardiovascular diseases. To evaluate overweight children, in addition to Body Mass Index (BMI), waist-to-height ratio (WHtR) can be used to predict cardiometabolic risk. The goal of this study is to describe WHtR in a sample of Tuscan children.MethodsA sample of children living in the province of Pistoia, Tuscany, was measured for the following anthropometric parameters: weight, height, and waist circumference. BMI and WHtR were calculated. For the latter indicator, a threshold of 0.5 was considered as a cardiovascular risk predictor. The subjects were classified into underweight, normal weight, overweight, and obese using Cole’s cut-offs.ResultsThe number of children enrolled were 1575 (821 males; 754 females), aged 6–11 years. Of them, 64.3% were normal weight, 4.9% underweight, 22.3% overweight, and 8.5% obese. Moreover, 12.8% had a WHtR ≥0.5 (85.7% males; 88.7% females). The average WHtR value was 0.45 ± 0.045, and was significantly different as per gender (F = 0.45 vs. M = 0.46). WHtR was significantly correlated with BMI (r = 0.766).ConclusionThe average WHtR value was in line with previous studies conducted among children of similar age groups. Large-scale perspective studies are needed to validate the Italian WHtR cut-offs for children.

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