Betül Çiçek

The relationship between sleep duration and obesity in Turkish children and adolescents

Aim: To determine the relationship between sleep duration and obesity in Turkish children and adolescents.

Percentiles and mean values for neck circumference in Turkish children aged 6-18 years.

Aim:  To provide neck circumference (NC) percentiles and mean values for Turkish children and to investigate their significance in clinical and epidemiological use.

Waist Circumference and Mid−Upper Arm Circumference in Evaluation of Obesity in Children Aged Between 6 and 17 Years

Objective: The purpose of this study was to determine the cut−off values for waist circumference (WC) and mid−upper arm circumference (MUAC) and to assess their use in screening for obesity in children. Methods: Anthropometric measurements of a total of 2621 boys and 2737 girls aged 6−17 years were analyzed. WC and MUAC values were compared with ROC analysis using body mass index (BMI) cut−off values of the International Obesity Task Force (IOTF) and using WC≥ 90th percentile.for MUAC. Results: In both genders, except for boys and girls in the 6−year age group and post−pubertal boys, the differences between area under curve (AUC) values for WC and MUAC were not significant, indicating that both indices performed equally well in predicting obesity. Sensitivity was suboptimal through age groups 6−9 years in the boys and sensitivity was suboptimal at 6, 7,14 and 17 years both in boys and girls. Conclusions: We conclude that MUAC can be a useful parameter in screening obesity and body fat distribution in children and, can be applied in epidemiological studies and in clinical practice. Conflict of interest:None declared.

Cross-sectional reference values for mid-upper arm circumference, triceps skinfold thickness and arm fat area of Turkish children and adolescents.

The aim of the study was to establish cross-sectional reference values for the mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF) and arm fat area (AFA) of Turkish children and adolescents. In total 5,553 students aged between 6 and 17 years were selected by a multistage sampling method from schools representing city centre, rural and urban areas of Kayseri, Central Anatolia. The MUAC and TSF were measured, and the arm muscle area, arm area, AFA and fat percentage (%) were calculated. The LMS method was employed to calculate the MUAC, TSF and AFA curve parameters. The MUAC, TSF, AFA and fat percentage in each age group were significantly higher in girls than in boys. In boys, the TSF 50th percentile ranged from 7.6 mm at 17 years to 9.0 mm at 11 years; whereas in girls this ranged from 9.4 mm at 6 years to 14.6 mm at 17 years. The MUAC 50th percentile ranged from 17.0 to 23.6 cm in boys, and from 15.6 cm to 20.9 cm in girls. The AFA 50th percentile measurements ranged from 4.5 cm at 6 years to 5.8 cm at 12–14 years in boys; and ranged from 7.2 cm at 6 years to 14.8 cm at 17 years in girls. The percentile distribution was more disperse towards higher TSF and AFA values in boys than in girls.

The risk analysis of arm fat area in Turkish children and adolescents.

Aim: The study examined the risk factors associated with arm fat area (AFA) in Turkish children and adolescents. Methods and samples: This study was conducted with 5358 (2621 boys, 2737 girls) children and adolescents aged 6–17 years. Height, weight, waist circumference, mid-upper arm circumference and triceps skinfold thickness were measured. Body mass index, fat percentage, waist-to-height ratio, and AFA were calculated. A questionnaire was used to obtain socio-demographic data. For age- and gender-specific AFA, three groups were created by percentiles (underweight<5th, healthy weight≥5–84.99th, overweight≥85th percentiles). Multinomial logistic regression analyses were performed to determine the risk factors. Results: For the entire group, underweight and overweight prevalences were 4.7% and 14.9%, respectively. The body-size variables increased across age in Turkish boys and girls. The most significant risk factors for AFA were shown to be appetite, sleep duration, household income, and elevator use. Conclusion: AFA can be a significant index, in combination with other well-known anthropometric indices, in determining nutritional status.

Bone mineral density and serum 25-hydroxyvitamin D level: is there any difference according to the dressing style of the female university students

Nutrition plays a role in the etiology of osteoporosis. Two of the most important nutrients for bone health are calcium and vitamin D. Plasma 25-hydroxyvitamin D [25-(OH)D] is the most sensitive clinical index of vitamin D status and has been found to be positively related to bone mineral density (BMD) in middle-aged and elderly women, and positive relations exist between the BMD of adult women and their calcium consumption throughout life. The aim of the present study was to determine relationships between BMD, serum vitamin D levels and dietary calcium intake of female young adult students who dressed in different styles. We studied two groups of volunteer female students (total=67). Students in the first group dressed in a style that exposed the skin to sunlight, students in the second group wore dresses completely covering the skin except for the face and hands. Serum 25-(OH)D levels were measured by radioimmunoassay, BMDs were determined at the lumbar spine and femoral neck by dual-energy X-ray absorptiometry, and calcium intakes were estimated with a 3-day food recording questionnaire. The serum 25-(OH)D level was significantly lower in the second group. There was no significant difference in BMD between the two groups. The dietary calcium intake of the two groups were lower than the adequate intake of 1000 mg daily for this age. There was a correlation between the serum 25-(OH)D level and BMD at the femoral neck in the first group. Our results indicate that vitamin D and calcium requirements for normal bone mineral accrual in young adults may advance until a certain age, and the covered dressing style causes vitamin D insufficiency and most of the students were under risk for osteoporosis in later life.

Oral Health, Obesity Status and Nutritional Habits in Turkish Children and Adolescents: An Epidemiological Study

BACKGROUND Studies evaluating the relationship between oral health status and obesity have provided conflicting data. Therefore, there is a great need to investigate and clarify the possible connection in a comprehensive sample. AIMS To assess the relationship of obesity and oral health status among children and adolescents aged 6 to 17 years-old. STUDY DESIGN Cross-sectional study. METHODS Data were obtained from 4,534 children and adolescents (2,018 boys and 2,516 girls). Questionnaires were sent home prior to examination; afterwards, anthropometric and dental data were collected from participants. Community Periodontal Index (CPI) and number of decayed, missing, and filled teeth in the permanent dentition (DMFT), and deciduous dentition (dmft) index were used to measure oral health status. Height, body weight, body mass index (BMI), waist circumference (WC), and body fat percentage were analyzed. RESULTS For DMFT scores, healthy (score=0) girls and boys had significantly higher BMI and WC values than unhealthy (score>1) girls and boys (p<0.05). Healthy girls had higher fat percentage values than unhealthy girls (p<0.05). In terms of CPI scores, healthy boys had lower BMI and WC values than unhealthy boys (p<0.05). According to multiple binary logistic regression results for model 1, BMI predicted DMFT scores in both genders but CPI scores only in boys. No beverage consumption predicted DMFT scores in boys, while milk consumption predicted DMFT scores in girls. No meal skipping predicted CPI scores in boys. For model 2, WC predicted DMFT scores in both genders and CPI scores only in boys. Milk consumption predicted DMFT scores only in girls. No meal skipping predicted CPI scores for both gender (p<0.05). According to DMFT, there were significant differences between the frequencies of the BMI groups (normal weight, overweight and obese) at the age of 7 (girls only), 9, 10, and 16 (boys only) years and overall (only girls) (p<0.05). According to CPI, significant differences between the frequencies of the BMI groups at the age of 16 (boys only) and 17 (girls only) were seen (p<0.05). CONCLUSION Periodontal and dental status appears to correlate with nutritional habits and obesity. Obesity and dental/periodontal diseases are multifactorial diseases that follow similar risk patterns and develop from an interaction between chronic conditions originating early in life. It is important for all health professionals to educate patients at risk about the progression of periodontal and dental diseases and the importance of proper oral hygiene.

Obesity prevalence, waist-to-height ratio and associated factors in adult Turkish males.

SUMMARY This study was performed to determine the obesity prevalence and associated risk factors in aged 20 and over years old males living in 11 towns in Kayseri, Turkey between July and August 2007. 1530 men were recruited, of which 6 were excluded because of incomplete information. Data were collected by a questionnaire. Body weight, height, waist and hip circumferences were measured. Body mass index (BMI) of 25.0-29.9 kg/m(2) was accepted as overweight and above 30 kg/m(2) as obesity, waist-to-hip ratio (WHpR) > 1.0 and waist-to-height ratio (WHtR) ≥ 0.5 were accepted as abdominal obesity. Chi-square and logistic regression tests were performed. According to BMI, overweight and obesity prevalences were 39.6% and 16.9%, respectively. Obesity prevalence was 29.9% (50-59 years) according to WHpR, 50.4% (60-69 years) according to waist circumference (WC) and 24.8% (40-49 years) according to WHtR. The logistic regression analysis revealed age of 60-69 years, being a graduate from university, being widowed and having positive familial history of obesity as risk factors of having BMI ≥ 25 kg/m(2). In conclusion, obesity is a serious issue for the males residing in Kayseri and among the anthropometric measurements WHtR is a simple and effective index to identify health related risks even in male of younger ages.:

Wrist Circumference and Frame Size Percentiles in 6-17-Year-Old Turkish Children and Adolescents in Kayseri

Objective: The aim of the current study was to provide wrist circumference (WrC) and body frame size (height/WrC) percentile values in Turkish children and adolescents aged 6-17 years. Methods: In this cross-sectional study, the data of “Determination of Anthropometric Measures of Turkish Children and Adolescents” (DAMTCA II) study in Kayseri/Turkey were used. A total of 4330 observations were recorded (1931 boys, 2399 girls). The WrC and frame size reference values were produced with generalized additive models for location, scale and shape. Results: The WrC percentiles (3rd-97th) were calculated. The frame size (height/WrC) was estimated as small, medium, and large (<15th, 15-85th, and ≥85th percentiles, respectively). For both genders, WrC linearly increased with age (13.0-16.8 cm for boys and 12.5-15.5 cm for girls). In boys and girls, the mean ± standard deviation of WrC is 13.00±0.89 cm and 12.48±0.93 cm (6 years) and increases to 16.83±1.16 and 15.58±0.86 cm (17 years), respectively. The WrC values in all age groups were higher in boys compared with girls. The increment in frame size from 6 to 17 years were 1.25 cm in boys and 0.85 cm in girls. Conclusion: WrC is a simple, easy-to-detect anthropometric index which is not subject to measurement errors. Additionally, WrC can be used both to decide about frame size and to determine metabolic risks related to obesity. We consider that this easy-to-get anthropometric index can be used both in screening procedures and clinical assessment procedure for obesity-related metabolic consequences.

Determining abdominal obesity cut-offs and relevant risk factors for anthropometric indices in Turkish children and adolescents.

Abstract Aim: To determine the ≥90th percentile values of waist circumference (WC) to calculate anthropometric measures, indices and relevant risk factors in 5358 Turkish children and adolescents. Methods: This cross-sectional study was conducted in Kayseri, Turkey, from February to April 2005. Cut-offs for body weight, height, mid-upper arm circumference (MUAC), triceps skinfold thickness, body mass index (BMI), and fat percentages were calculated for ≥90th percentile of WC. Results: According to the results of binary multiple logistic regression analysis (the backward stepwise procedure), sleep duration (boys), maternal education (boys), elevator use (boys), and appetite (boys and girls) were revealed as significant predictors of abdominal obesity, adjusted for age. Appetite was the strongest variable to be associated with abdominal obesity for both genders. Conclusions: According to receiver operating characteristic analysis, for all age groups within both genders, the best predictors to explain abdominal obesity were BMI and MUAC, respectively.