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      ¿Cuántos niños hay con exceso de peso en Galicia? ¿Qué información debemos comunicar? Translated title: How many kids are there with excess weight? What information should be published?

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          RESUMEN

          Fundamentos:

          En los estudios epidemiológicos, no hay consenso sobre cuáles son las referencias que se deben emplear para caracterizar el estado ponderal de los escolares después de estimar su índice de masa corporal. El objetivo de este trabajo fue valorar como influyen diferentes criterios en la caracterización del estado ponderal de escolares gallegos de 6 a 15 años e identificar el criterio que mejor caracteriza la obesidad central.

          Métodos:

          Estudio transversal en una muestra de 7.438 escolares de 6 a 15 años representativa por sexo y edad. Se estimó la prevalencia de obesidad central y de bajo peso, normopeso, sobrepeso y obesidad utilizando los criterios de referencia de la Organización Mundial de la Salud (OMS), Cole, Orbegozo-2011 y del estudio Enkid. Para identificar el criterio que mejor caracteriza la obesidad central se calcularon valores predictivos positivos de obesidad y negativos de sobrepeso y obesidad.

          Resultados:

          La caracterización de los escolares en función de su estado ponderal varió en función de la referencia empleada con estimaciones que oscilaban en 20,4 puntos porcentuales cuando se comparaba el exceso de peso según criterios de la OMS, 41,5%, y Enkid, 21,1%. El criterio que presentó mejor capacidad predictiva de obesidad central fue el propuesto por Cole.

          Conclusiones:

          La variabilidad que se observa en la caracterización del estado ponderal de los escolares asociada al uso de distintos criterios de referencia es muy importante. Si se considera a la obesidad central como indicador de exceso de peso, la referencia de Cole es la que mejor caracteriza a los escolares, ya que es la que tiene mejor capacidad predictiva.

          ABSTRACT

          Background:

          In epidemiological studies, there is no consensus on which references should be used to characterize the weight status of schoolchildren after estimating their body mass index. The aim of this study is to evaluate the influence that different criteria have on the characterization of the weight status of Galician schoolchildren from 6 to 15 years old and to identify the criterion that best characterizes central obesity.

          Methods:

          Cross-sectional study on a sample of 7.438 schoolchildren representative by sex and age of the Galician population of 6 to 15 year olds. The prevalence of central obesity and underweight, normal weight, overweight and obesity was estimated using the reference standards of the World Health Organization (WHO), Cole, Orbegozo-2011 and the Enkid study. In order to identify the criterion that best characterizes central obesity, the positive predictive values of obesity and the negative ones of overweight and obesity were calculated.

          Results:

          The characterization of schoolchildren according to their weight status was different depending on the reference used with estimates that vary by 20.4 percentage points being prevalence of excess weight using WHO references 41.5% while with Enkid it is 21.1%. The reference with the best predictive capacity of central obesity was those proposed by Cole.

          Conclusions:

          The variability observed in the characterization of the weight status of schoolchildren associated with the use of different reference criteria is very important. If central obesity is a good indicator of excess of weight, the reference proposed by Cole would be the one with the best capacity to characterize the child and youth population, related to the best predictive capacity.

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          Most cited references23

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          Development of a WHO growth reference for school-aged children and adolescents

          OBJECTIVE: To construct growth curves for school-aged children and adolescents that accord with the WHO Child Growth Standards for preschool children and the body mass index (BMI) cut-offs for adults. METHODS: Data from the 1977 National Center for Health Statistics (NCHS)/WHO growth reference (1-24 years) were merged with data from the under-fives growth standards' cross-sectional sample (18-71 months) to smooth the transition between the two samples. State-of-the-art statistical methods used to construct the WHO Child Growth Standards (0-5 years), i.e. the Box-Cox power exponential (BCPE) method with appropriate diagnostic tools for the selection of best models, were applied to this combined sample. FINDINGS: The merged data sets resulted in a smooth transition at 5 years for height-for-age, weight-for-age and BMI-for-age. For BMI-for-age across all centiles the magnitude of the difference between the two curves at age 5 years is mostly 0.0 kg/m² to 0.1 kg/m². At 19 years, the new BMI values at +1 standard deviation (SD) are 25.4 kg/m² for boys and 25.0 kg/m² for girls. These values are equivalent to the overweight cut-off for adults (> 25.0 kg/m²). Similarly, the +2 SD value (29.7 kg/m² for both sexes) compares closely with the cut-off for obesity (> 30.0 kg/m²). CONCLUSION: The new curves are closely aligned with the WHO Child Growth Standards at 5 years, and the recommended adult cut-offs for overweight and obesity at 19 years. They fill the gap in growth curves and provide an appropriate reference for the 5 to 19 years age group.
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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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              Establishing a standard definition for child overweight and obesity worldwide: international survey.

              To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points. International survey of six large nationally representative cross sectional growth studies. Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States. 97 876 males and 94 851 females from birth to 25 years of age. Body mass index (weight/height(2)). For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m(2) for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2-18 years. The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.
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                Author and article information

                Journal
                Rev Esp Salud Publica
                Rev Esp Salud Publica
                resp
                Revista Española de Salud Pública
                Ministerio de Sanidad, Consumo y Bienestar social
                1135-5727
                2173-9110
                11 June 2018
                Jan-Dec 2018
                : 92
                : e20180626
                Affiliations
                [1 ] originalSubdirección de Información sobre Saúde e Epidemioloxía. Dirección Xeral de Innovación e Xestión da Saúde Pública. Consellería de Sanidade. Xunta de Galicia. Santiago de Compostela. España. orgdiv2Subdirección de Información sobre Saúde e Epidemioloxía orgdiv1Dirección Xeral de Innovación e Xestión da Saúde Pública orgnameConsellería de Sanidade. Xunta de Galicia Santiago de Compostela España
                [2 ] originalDepartamento de Medicina Preventiva y Salud Pública. Universidad de Santiago de Compostela. Santiago de Compostela. España. normalizedUniversidad de Santiago de Compostela orgdiv1Departamento de Medicina Preventiva y Salud Pública orgnameUniversidad de Santiago de Compostela Santiago de Compostela Spain
                [3 ] originalSubdirección de Programas de Fomento de Estilos de Vida Saudables. Dirección Xeral de Innovación e Xestión da Saúde Pública. Consellería de Sanidade. Xunta de Galicia. Santiago de Compostela. España. orgdiv2Subdirección de Programas de Fomento de Estilos de Vida Saudables orgdiv1Dirección Xeral de Innovación e Xestión da Saúde Pública orgnameConsellería de Sanidade. Xunta de Galicia Santiago de Compostela España
                Author notes
                Correspondencia: Mónica Pérez Ríos Servizo de Epidemioloxía Dirección Xeral de Saúde Pública Consellería de Sanidade, Xunta de Galicia Santiago de Compostela. España monica.perez.rios@ 123456usc.es

                Los autores declaran que no existe conflicto de intereses.

                Article
                e201806026
                11587228
                be644147-5424-4567-9bee-d80f9abc7f9c

                This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. You are free to Share (copy and redistribute the material in any medium or format) under the following terms: Attribution (You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use); NonCommercial (You may not use the material for commercial purposes); NoDerivatives (If you remix, transform, or build upon the material, you may not distribute the modified material); No additional restrictions (You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits).

                History
                : 31 October 2017
                : 21 January 2018
                : 11 June 2018
                Page count
                Figures: 2, Tables: 1, Equations: 0, References: 20, Pages: 1
                Categories
                Original Breve

                obesidad,obesidad abdominal,prevalencia,infancia,pesos y medidas corporales,obesity,abdominal obesity,prevalence,childhood,weights and measures

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