Gutiérez-Gómez Yareni, Kain Juliana, Uauy Ricardo, Galván Marcos, Corvalán Camila
Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Chile.
Arch Latinoam Nutr. 2009 Mar;59(1):30-7.
Historically, the anthropometric assessment of nutritional welfare programs has been targeted to assess nutritional deficiencies based on weight-to-age and height-to-age indicators. Recently, given the increase on childhood obesity, it has been also recommended the measurement of indicators of obesity (i.e., weight-to-height) and central obesity (i.e., waist circumference). However, the agreement of these indicators in preschool children is unclear. The aims of this study were: (1) assess the nutritional status of children attending the Chilean National Nursery Schools Council Program (JUNJI); (2) assess the agreement between general and central obesity anthropometric measurements in these children. In 574 girls and 580 boys, 3.0 to 5.9 years old, we measured: weight, height, waist and hip circumference, and five skinfolds. We used the WHO 2006 growth standards to estimate Z-scores. We defined general obesity as WHZ or BAZ= 2, and central obesity as waist circumference > or =90 percentile of NHANES III. The participants were on average slightly shorter but considerably heavier and obese than the reference populations. Prevalence of general obesity was close to 16% with both indicators while prevalence of central obesity reached 15%. There was good agreement among general obesity indicators and central obesity indicators (Kappa = 0.6-0.7). In summary, we found a high prevalence of obesity and central obesity among Chilean preschool children beneficiaries of a welfare program. At this age, there was a good agreement among general obesity indicators and central obesity indicators. These results suggest that waist circumferences measurements should not be incorporated to the program.
从历史上看,营养福利项目的人体测量评估旨在根据年龄别体重和年龄别身高指标来评估营养缺乏情况。最近,鉴于儿童肥胖率的上升,也有人建议测量肥胖指标(即体重身高比)和中心性肥胖指标(即腰围)。然而,这些指标在学龄前儿童中的一致性尚不清楚。本研究的目的是:(1)评估参加智利国家幼儿园理事会项目(JUNJI)的儿童的营养状况;(2)评估这些儿童中一般肥胖和中心性肥胖人体测量指标之间的一致性。在574名女孩和580名3.0至5.9岁的男孩中,我们测量了体重、身高、腰围和臀围以及五个皮褶厚度。我们使用世界卫生组织2006年生长标准来估计Z评分。我们将一般肥胖定义为WHZ或BAZ = 2,将中心性肥胖定义为腰围≥NHANES III的第90百分位数。与参考人群相比,参与者平均略矮,但体重和肥胖程度明显更高。两种指标下一般肥胖的患病率均接近16%,而中心性肥胖的患病率达到15%。一般肥胖指标和中心性肥胖指标之间存在良好的一致性(Kappa = 0.6 - 0.7)。总之,我们发现智利福利项目受益的学龄前儿童中肥胖和中心性肥胖的患病率很高。在这个年龄段,一般肥胖指标和中心性肥胖指标之间存在良好的一致性。这些结果表明,腰围测量不应纳入该项目。