Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study

Abstract

Background and Aims: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-to-height ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. Methods: Cross-sectional analysis of 8–16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. Results: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% ‘increased risk’, 9.7% ‘high risk’, 14.3% ‘very high risk’). Participants in the ‘very high risk’ group were less likely to be females (odds ratio 0.63; 95% CI: 0.52–0.76) and adolescents (0.60; 95% CI: 0.49–0.72), to practice ≥60 min/day of moderate-vigorous physical activity (MVPA) (0.73; 95% CI: 0.57–0.93), and to watch <120 min/day of total screen time on weekdays (0.61; 95% CI: 0.49–0.76). Mothers of participants in the ‘very high risk’ group were less likely to have a high educational level, be in the overweight or normal range, have never smoked or were former smokers, and watch <120 min/day of total screen time on weekends. Participants in the ‘increased’ and ‘high risk’ categories had mothers with normal weight and ≥60 min/day of MVPA. Participants in the ’high risk’ group did not achieve ≥60 min/day of MVPA and showed lower adherence to the Mediterranean diet. Conclusions: Adherence to a healthy lifestyle in children and adolescents, but also in their mothers/female caregivers during offspring’s childhood and adolescence, is associated with low BMI-WHtR disease risk.

Accelerometry-assessed daily physical activity and compliance with recommendations in Spanish children: importance of physical education classes and vigorous intensity

“…On the other hand, there is a high prevalence of overweight and obesity in children and adolescents ( NCD Risk Factor Collaboration, 2017 ; ALADINO, 2020 ; Bibiloni et al, 2022 ; Serra Majem et al, 2003 ), which increases their risk of developing diseases in adulthood ( Umer et al, 2017 ; Migueles et al, 2023 ). Therefore, having physical activity recommendations that are as tailored as possible to the biological circumstances of children and adolescents, as well as promoting programs that aid in meeting these recommendations, can play an essential role in preventing excess body weight in this population ( Gralla et al, 2016 ; Poitras et al, 2016 ; Owens, Galloway & Gutin, 2016 ; World Health Organization (WHO), 2020 ; Chaput et al, 2020 ; García-Hermoso et al, 2021 ; Migueles et al, 2023 ).…”

Lifestyle and Health-Related Quality of Life Relationships Concerning Metabolic Disease Phenotypes on the Nutrimdea Online Cohort

“…For this purpose, different indices have been developed, such as the Charlson index with a wide clinical evidence-based utility [43]. The Obesogenic Score (ObS) is an index to determine the role of lifestyle and health factors [44,45].…”

Parental adherence to healthy lifestyles in relation to the risk of obesity in offspring: A prospective cohort study in China

“…Previous studies have demonstrated that the development of obesity in children and adolescents is highly related to unhealthy lifestyle behaviors [14,15], including unhealthy dietary habits, insufficient physical activity, and prolonged sedentary behavior [16]. Parents' lifestyle behaviors have also been linked with risk of developing obesity in offspring, where maternal unhealthy diet, less physical activity, smoking, and drinking were found to be with a higher risk of obesity in offspring during early childhood [17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Potential mechanisms involve offspring imitating parental lifestyle behaviors (eg, dietary habits or physical activity behavior) [31,32], and potential effects of parental lifestyles through epigenetic inheritance [33].…”