Diagnostic accuracy of tri-ponderal mass index and body mass index in estimating overweight and obesity in South African children (original) (raw)
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African Journal of Primary Health Care & Family Medicine
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South African Journal of Clinical Nutrition
Background: Childhood obesity has become a growing global epidemic. In South Africa, overweight and obesity during childhood and adolescence are rising. The objectives of this study were (i) to estimate the prevalence of overweight and obesity among selected students in Cofimvaba, a rural settlement in Eastern Cape province, South Africa, and (ii) to assess the accuracy of the mid-upper arm circumference (MUAC) and ultrasound triceps skin-fold thickness (TSF) methods of predicting these health parameters Methods: A cross-sectional study was conducted on 211 students (109 girls and 102 boys) selected randomly from five public schools in Cofimvaba and aged 6-19 years. The weight, height, MUAC and TSF were determined by standard techniques. Data obtained were subjected to descriptive statistics, Pearson correlations and receiver operating characteristic (ROC) curve analysis. P < 0.05 was considered statistically significant. Result: Overall 1.9% (1.8% girls and 2.0% boys) of the respondents were underweight, 14.8% (21.1% and 7.8% boys) were overweight and 2.8% (4.6% girls and 1.0% boys) were obese. The prevalence of overweight and obesity was significantly higher (p < 0.05) in girls than boys during adolescence but there was no gender difference in children (6-9 years). Most of the students (80.6%) had a healthy weight, with boys being significantly (p < 0.05) healthier than girls. The BMI showed significant strong correlations with MUAC (r = 0.926; p < 0.001) and TSF (r = 0.643; p < 0.001). ROC curve analysis gave an area under the curve (AUC) of 0.795 (95% CI, 0.761-0.889) and 0.835 (95% CI, 0.771-0.899) for MUAC and TSF respectively. Conclusion: The study found a high prevalence of overweight children in the sample and a low prevalence of stunting and underweight. The adolescent girls are at a higher risk of being overweight and obese than the boys. MUAC and TSF can adequately predict overweight and obesity among the selected students.
2020
Background: The aim of this paper is to investigate whether BMI and fat percentage classification criteria, would classify a sample in similar criteria’s. Methods: A cross-sectional study with a stratified random sampling included 602 rural boys (7–13 years old). Fat percentage criteria classification and BMI was measured Maturity, age and peak height velocity (PHV) were indirectly determined. Statistical techniques included descriptive, Pearson product correlation, the Kappa agreement test and the McNemar’s test. The level of statistical significance was set at p ≤ 0.05. Results: All age groups presented statistically significant high correlations between BMI and fat percentage, and low to medium correlations between fat percentage and maturity age (MA). Measurement of agreement between BMI and fat percentage classifications showed poor to fair agreements for all age groups, with the exception of the eight-year old group which presented a moderate agreement. Conclusion: Classificat...
BMC Pediatrics, 2020
Background The aim of this paper was to investigate whether BMI and fat percentage classification criteria, would classify a sample of 7–13 year old boys from a rural background in similar nutritional categories. Methods A cross-sectional study with a stratified random sampling included 601 rural boys (7–13 years old). Fat percentage criteria classification and BMI were calculated and compared. Maturity status, and age at peak height velocity (PHV) were indirectly determined. Statistical techniques included descriptive statistics, Pearson product correlation coefficients, the Kappa agreement test and the McNemar’s test. The level of statistical significance was set at p ≤ 0.05. Results All age groups presented with statistically significant high correlations between BMI and fat percentage, and low to medium correlations between fat percentage and maturity age (MA). Measurement of agreement between BMI and fat percentage classifications showed poor to fair agreements for all age grou...
Obesity and overweight in South African primary school children – the Health of the Nation Study
Objectives. To determine the prevalence of overweight and obesity in a sample of South African children aged 6 - 13 years. Design. Random sampling of schools within each provincial and socio-economic category. Setting. Primary school children from 5 South African provinces. Subjects. 10 195 (5 611 male and 4 584 female) primary school children. Outcome measure. Height and weight were measured and body mass index (BMI) (weight (kg)/height (m)2) was calculated for each grouping (age x gender x ethnic group). Cut-off points for BMI defining obese and overweight for gender and age (6 - 13 years) were calculated in accordance with international standards Results. There were significant differences in height and mass between the different ethnic groups and genders. This trend was not evident for the BMI values. The prevalence of obesity within the sample was 3.2% for boys and 4.9% for girls, whereas overweight prevalence was 14.0% for boys and 17.9% for girls. When the contribution of each ethnic group was adjusted to the demographics of South Africa these values were only slightly different. The prevalence of obesity and overweight among boys was 2.4% and 10.9% respectively, while obese and overweight girls comprised 4.8% and 17.5%, respectively. Conclusions. South African children show trends of obesity and overweight, similar to values in developed countries about 10 years ago. Intervention strategies to combat an increasingly sedentary lifestyle may need to be developed for the South African context.
Predictors of obesity and cardiometabolic disease risk in South African children
South African Journal of Child Health, 2017
Background. Obesity is a major public health problem in developed countries, and is also a growing concern in developing nations. This study assessed the predictors of overweight and obesity in South African (SA) children and adolescents, and examined the extent to which these dependent measures correlate with cardiometabolic disease (CMD) risk. Objectives. To assess the predictors of overweight and obesity in SA children and adolescents. Methods. A total of 1 361 (boys, n=678; girls, n=683) children aged 9 - 11 (boys, n=455; girls, n=411) and adolescents aged ≥12 - 13 (boys, n=288; girls n= 267) participated in the study. The children’s anthropometric and physiological measurements were taken. Body mass index (BMI) was calculated and used to classify the children as underweight, of normal weight overweight or obese, as well as to screen them for CMD risk. Results. Findings indicated that 81.2%, 17.4%, 0.9 and 0.5% of the children (<12 years old) were underweight, of normal weigh...
Body fat percentage of urban South African children: implications for health and fitness
The West Indian medical journal, 2013
To explore gender and racial profiling of percentage body fat of 1136 urban South African children attending public schools in Pretoria Central. This is a cross-sectional survey of 1136 randomly selected children (548 boys and 588 girls) aged 9-13 years in urban (Pretoria Central) South Africa. Body mass, stature, skinfolds (subscapular and triceps) were measured. Data were analysed using descriptive statistics (means and standard deviations). Differences in the mean body fat percentage were examined for boys and girls according to their age group/race, using independent t-test samples. Girls had a significantly (p = 0.001) higher percentage body fat (22.7 ± 5.7%, 95% CI = 22.3, 23.2) compared to boys (16.1 ± 7.7%, 95% CI = 15.5, 16.8). Percentage body fat fluctuated with age in both boys and girls. Additionally, girls had significantly (p = 0.001) higher percentage body fat measurements at all ages compared to boys. Viewed racially, black children (20.1 ± 7.5) were significantly (p...
South African Journal of Sports Medicine, 2016
Objectives. To determine the prevalence of overweight and obesity among grade 1 learners, taking into account age, gender, race and school socioeconomic profile. Methods. The study is based on the baseline prevalence of overweight and obesity as part of the ongoing 6-year longitudinal NW Child Health Integrated Learning and Development (NW-CHILD) study. Stratified random sampling was used to identify 20 schools from four educational districts across all five quintiles of schools in the North West Province (NWP) of South Africa (SA). A total of 816 (419 boys, 397 girls) grade 1 learners with a mean age of 6.80 (standard deviation 0.39) years participated in the study, including 567 black learners, 218 white learners and 31 learners from other race groups. Standard anthropometric techniques and international body mass index (BMI) cut-off points for children were used to determine overweight and obesity. Results. A combined prevalence of overweight and obesity (Ow/Ob) of 11.1% was foun...
Journal of Health, Population and Nutrition, 2009
The purpose of this observational prospective cohort study was to investigate the development and tracking of body mass index (BMI) of Ellisras rural children from preschool age into late adolescence from the Ellisras Longitudinal Growth and Health Study. Heights and weights of children were measured according to the standard procedures recommended by the International Society for the Advancement of Kinanthropometry twice a year from 1996 to 2003. In total, 2,225 children-550 preschool and 1,675 primary school-aged 3-10 years (birth cohorts 1993 to 1986) were enrolled at baseline in 1996 and followed through out the eight-year periodic surveys. In 2003, 1,771 children-489 preschool and 1,282 primary school-were still in the study. The prevalence of overweight was significantly higher among girls (range 1.6-15.5%) compared to boys (range 0.3-4.9%) from age 9.1 years to 14.9 years. The prevalence of thinness (severe, moderate, and mild) ranged from 7.1% to 53.7% for preschool children and from 8.0% to 47.6% for primary school children. Both preschool and primary school children showed a significant association between the first measurements of BMI and the subsequent measurement which ranged from B=0.2 (95% confidence interval [CI] 0.1-0.4) to B=0.8 (95% CI 0.6-0.9) for preschool and B=0.2 (95% CI 0.1-0.3) to B=0.7 (95% CI 0.6-0.8) for primary children. A significant tracking of BMI during 4-12 years of life was more consistent for preschool children (B=0.6 (95% CI 0.6-0.7) and for primary school children (B=0.6 (95%CI 0.5-0.6). Investigation of nutritional intake and physical activity patterns will shed light on how healthy these children are and their lifestyle.
BMC Obesity, 2015
Background: Widespread trends of increasing child obesity are reported in developing countries. This longitudinal NW-CHILD study investigated changes in overweight and obesity over a three year period among 574 children between the ages 6 and 9 (282 boys, 292 girls; 407 black, 143 white) in South Africa (SA), taking into consideration sex, race and school type. Stratified random sampling was used to identify 20 schools, across 5 school SES levels (quintiles), in 4 educational districts of the North West Province of SA. Standard anthropometric techniques and international age adjusted BMI cutoff points for children were used to determine overweight and obesity, 3-years apart. Mixed models were used to analyse the effects of sex, race and socioeconomic status (SES) of the school. Results: Overall obesity increased over 3-years by 4% from 12.5% at baseline to 16.7% during follow-up. Obesity increased significantly in both white (4.2%) and black (2.0%) children, although overall prevalence in the final year was double (27.3%) in white children compared to black children (13.3%). Prevalence in obesity increased more in boys (3.2%) compared to girls (2.4%), although girls showed a higher overall prevalence (18.5%). SES effects were significant where children in schools associated with higher SES, had the highest rate of increase and the highest prevalence of obesity. A significant change towards an unhealthy BMI was found in 9.2% of the group over the 3-year period, although a small percentage (3.0%) also transitioned towards a healthier BMI. Conclusions: Overall obesity prevalence rose significantly from 6-9-years. Obesity, compared to overweight, increased more during this period. Prevalence and rate of increase differed markedly in different sexes, race and SES, masking the extent of the problem. Shifting towards an unhealthy BMI was more common than obtaining a healthier BMI over the 3-year period. It also demonstrated the difficulty of breaking the cycle of obesity, once it had started. Early prevention strategies are needed based on the trends established in this study, with special attention to white children living in high SES regions, and black children in economic transition.