Association of Waist Circumference With Blood Pressure and Familial Dietary Habits in Preschool Children: A Cross-Sectional Study in Northeastern China.

Abstract

BackgroundChildhood obesity increases the risk of elevated blood pressure (BP) in children. However, which obesity indicator is most closely associated with BP remains debatable. Moreover, the familial dietary environments play important roles on obesity, but which dietary factors are strong and independent ones for childhood obesity is unclear. Our study aimed to determine the superior indices associated with BP among body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). Then, determine the independent familial dietary factors for those superior indices.Method605 children aged 2 to 6, as well as their parents were involved in this study. The children’s weights, heights, WC and BP were measured. Information on familial environments was obtained by asking the parents to complete questionnaires. BMI, WC and WHtR were standardized into their standardized z-score values and categorical variables of these three obesity indices were defined as BMI Category, WC Category and WHtR Category. Logistic regression was used to analyze the associations between standardized z-score of BMI, WC, WHtR and elevated BP. Multivariate stepwise linear regression and multivariate stepwise logistic regression were used to determine the independent factors for obesity indicators that were closely with BP.ResultsNumerical obesity indices associated with BP were, in order of decreasing association: WC, BMI and WHtR. The categorical variable that most closely associated with BP was WC Category. Parental BMI, birth weight of children, eating wheat as staple food, appetite, eating speed, snacking while watching TV, parental encouragement to eat a diverse assortment of foods and drinking milk were independent factors for WC in males or females. The risk of abdominal obesity would increase 1.375 times in males and 1.631 times in females if appetite increased one level. If eating speed increased one level, the risk of abdominal obesity would increase 1.165 times in males and 0.905 times in females. Children who drank milk greater than 6 times per week had a 0.546 times lower risk of abdominal obesity than those did not.ConclusionWC had the closest association with BP. Besides genetics, familial diet were independent factors for WC and abdominal obesity in preschool children.