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      Percentiles of body mass index and waist circumference for Costa Rican children and adolescents Translated title: Percentiles de índice de masa corporal y circunferencia de la cintura en niños y adolescentes de Costa Rica

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          Abstract

          Abstract Introduction: body mass index (BMI) and waist circumference (WC) are anthropometric indicators used to define overweight/obesity and to predict the risk of cardiovascular disease, respectively, in adolescents and children. Objectives: to describe and provide estimations of BMI and WC distribution according to percentiles in a sample of Costa Rican students, and to test group differences at the 50th percentile with the international references by the National Center for Health Statistics of the united States of America in 2012, 2016 and 2021. Material and methods: a cross-sectional and descriptive study was carried out with 2,684 students from 7 to 17 years of age in 64 educational centers of Costa Rica. The weight of the students was determined with a Tanita model SC-331 S, and height was measured with a SECA stadiometer, model 217, to estimate BMI. To determine abdominal circumference a measuring tape was used. All procedures were approved by the INCIENSA Scientific Ethics Committee. The statistical analysis of the data was made with the SPSS 22.0 package. Results: the first percentile distribution of BMI and WC is provided. According to BMI, 16.3 % of the student population had obesity and 26.2 % had overweight. WC values increased over the years and some significant differences were found between genders. The BMI and WC curves of Costa Rican children showed patterns similar to the three international references they were compared to. Conclusions: obesity has become the main nutritional problem in Costa Rica. The BMI and WC trend graphs proposed in this study are a useful public health tool to monitor the overweight/obesity epidemic.

          Translated abstract

          Resumen Introducción: el índice de masa corporal (IMC) y la circunferencia de la cintura (CC) son indicadores antropométricos utilizados para definir el sobrepeso/la obesidad y para predecir el riesgo de enfermedad cardiovascular, respectivamente, en la población infanto-juvenil. Objetivo: describir y proporcionar estimaciones de la distribución del IMC y la CC según percentiles en una muestra de estudiantes de Costa Rica y probar las diferencias de grupo en el percentil 50 con las referencias internacionales del Centro Nacional de Referencia de Estadísticas de Salud de los Estados unidos de América de 2012, 2016 y 2021. Materiales y métodos: estudio transversal y descriptivo realizado con 2684 estudiantes de 7 a 17 años de edad de 64 centros educativos de Costa Rica. El peso de los estudiantes se determinó con un equipo Tanita modelo SC-331 S y la talla se midió con un estadiómetro marca SECA, modelo 217, para estimar el IMC. Para determinar la circunferencia abdominal se usó una cinta métrica. Todos los procedimientos fueron aprobados por el Comité Ético Científico del INCIENSA. El análisis estadístico de los datos se realizó con el paquete informático SPSS 22.0. Resultados: se proporciona la primera distribución percentilar del IMC y de la CC. De acuerdo con el IMC, el 16,3 % de la población estudiantil presentó obesidad y el 26,2 % sobrepeso. Los valores de CC aumentan con los años y, al compararlos por sexos, se encontraron algunas diferencias significativas. Las curvas costarricenses para el IMC y la CC mostraron patrones similares a los de las tres referencias internacionales utilizadas para comparar. Conclusiones: la obesidad se ha convertido en el principal problema nutricional en Costa Rica. Las gráficas de tendencias del IMC y de la CC expuestas en el presente estudio son una herramienta útil para la salud pública con el fin de monitorear la epidemia de sobrepeso/obesidad.

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          Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation.

          To establish a unified working diagnostic tool for the metabolic syndrome (MetS) that is convenient to use in clinical practice and that can be used world-wide so that data from different countries can be compared. An additional aim was to highlight areas where more research into the MetS is needed. The International Diabetes Federation (IDF) convened a workshop held 12-14 May 2004 in London, UK. The 21 participants included experts in the fields of diabetes, public health, epidemiology, lipidology, genetics, metabolism, nutrition and cardiology. There were participants from each of the five continents as well as from the World Health Organization (WHO) and the National Cholesterol Education Program-Third Adult Treatment Panel (ATP III). The workshop was sponsored by an educational grant from AstraZeneca Pharmaceuticals. The consensus statement emerged following detailed discussions at the IDF workshop. After the workshop, a writing group produced a consensus statement which was reviewed and approved by all participants. The IDF has produced a new set of criteria for use both epidemiologically and in clinical practice world-wide with the aim of identifying people with the MetS to clarify the nature of the syndrome and to focus therapeutic strategies to reduce the long-term risk of cardiovascular disease. Guidance is included on how to compensate for differences in waist circumference and in regional adipose tissue distribution between different populations. The IDF has also produced recommendations for additional criteria that should be included when studying the MetS for research purposes. Finally, the IDF has identified areas where more studies are currently needed; these include research into the aetiology of the syndrome.
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            Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity : Extended international BMI cut-offs

            The international (International Obesity Task Force; IOTF) body mass index (BMI) cut-offs are widely used to assess the prevalence of child overweight, obesity and thinness. Based on data from six countries fitted by the LMS method, they link BMI values at 18 years (16, 17, 18.5, 25 and 30 kg m(-2)) to child centiles, which are averaged across the countries. Unlike other BMI references, e.g. the World Health Organization (WHO) standard, these cut-offs cannot be expressed as centiles (e.g. 85th). To address this, we averaged the previously unpublished L, M and S curves for the six countries, and used them to derive new cut-offs defined in terms of the centiles at 18 years corresponding to each BMI value. These new cut-offs were compared with the originals, and with the WHO standard and reference, by measuring their prevalence rates based on US and Chinese data. The new cut-offs were virtually identical to the originals, giving prevalence rates differing by < 0.2% on average. The discrepancies were smaller for overweight and obesity than for thinness. The international and WHO prevalences were systematically different before/after age 5. Defining the international cut-offs in terms of the underlying LMS curves has several benefits. New cut-offs are easy to derive (e.g. BMI 35 for morbid obesity), and they can be expressed as BMI centiles (e.g. boys obesity = 98.9th centile), allowing them to be compared with other BMI references. For WHO, median BMI is relatively low in early life and high at older ages, probably due to its method of construction. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.
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              Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report.

              To revise 1998 recommendations on childhood obesity, an Expert Committee, comprised of representatives from 15 professional organizations, appointed experienced scientists and clinicians to 3 writing groups to review the literature and recommend approaches to prevention, assessment, and treatment. Because effective strategies remain poorly defined, the writing groups used both available evidence and expert opinion to develop the recommendations. Primary care providers should universally assess children for obesity risk to improve early identification of elevated BMI, medical risks, and unhealthy eating and physical activity habits. Providers can provide obesity prevention messages for most children and suggest weight control interventions for those with excess weight. The writing groups also recommend changing office systems so that they support efforts to address the problem. BMI should be calculated and plotted at least annually, and the classification should be integrated with other information such as growth pattern, familial obesity, and medical risks to assess the child's obesity risk. For prevention, the recommendations include both specific eating and physical activity behaviors, which are likely to promote maintenance of healthy weight, but also the use of patient-centered counseling techniques such as motivational interviewing, which helps families identify their own motivation for making change. For assessment, the recommendations include methods to screen for current medical conditions and for future risks, and methods to assess diet and physical activity behaviors. For treatment, the recommendations propose 4 stages of obesity care; the first is brief counseling that can be delivered in a health care office, and subsequent stages require more time and resources. The appropriateness of higher stages is influenced by a patient's age and degree of excess weight. These recommendations recognize the importance of social and environmental change to reduce the obesity epidemic but also identify ways healthcare providers and health care systems can be part of broader efforts.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                December 2022
                : 39
                : 6
                : 1228-1236
                Affiliations
                [1] Cartago orgnameInstituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA) Costa Rica
                [3] San José orgnameUniversidad Estatal a Distancia de Costa Rica Costa Rica
                [4] San José San José orgnameUniversidad Católica de Costa Rica Costa Rica
                [2] San José orgnameCentro de Investigación en Hematología y Trastornos Afines orgdiv1Universidad de Costa Rica orgdiv2Facultad de Microbiología Costa Rica
                Article
                S0212-16112022001000005 S0212-1611(22)03900600005
                10.20960/nh.04130
                bd63b840-2534-4e81-ab4f-13c999999f09

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 21 August 2022
                : 23 March 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 39, Pages: 9
                Product

                SciELO Spain

                Categories
                Original Papers

                Obesidad,Circunferencia de la cintura,Índice de masa corporal,Costa Rica,Adolescents,Children,Waist circumference,Body mass index,Adolescentes,Niños

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