Lu Ma

Waist Circumference is Better Than Other Anthropometric Indices for Predicting Cardiovascular Disease Risk Factors in Chinese Children—a Cross-Sectional Study in Guangzhou

AIM To determine the best anthropometric index among body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR) and to derive optimal thresholds for predicting CVD risk factors in Chinese children. METHODS A total of 2563 children aged 8-12 years were recruited in Guangzhou, China. Anthropometric indices were measured in all participants. Systolic and diastolic blood pressure (SBP and DBP, respectively), glucose, triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol (HDLC) and low-density lipoprotein cholesterol (LDL-C) were measured in a subsample of 1609 children. RESULTS In partial correlation analyses, the highest coefficients were found for WC in four risk factors in both genders. The receiver operating characteristic (ROC) analyses showed that WC was comparably consistent among the best in predicting BP and risk factor clustering, WC and WSR were the best in predicting HDL-C and TG in boys; WC, slightly better than BMI, was the best in distinguishing high BP and risk factor clustering in girls. In contrast, WHR was consistently the poorest index in both genders. Optimal age- and gender-specific thresholds to identify individual and clustering risk factors were provided; the thresholds for WC were 57.4-80.4 cm and 55.8-69.6 cm in boys and girls, respectively. CONCLUSIONS WC was the comparatively consistent and best predictor of CVD risk factors compared with WSR and BMI, although the differences were small and depended on the type of risk factor and gender, and WHR was consistently the poorest predictor in Chinese children.

Metabolic syndrome and its associated early-life factors in children and adolescents: a cross-sectional study in Guangzhou, China.

OBJECTIVE The present study aimed to investigate the prevalence of metabolic syndrome (MetS) in 7- to 17-year-old children and adolescents in China and to examine the relationship between MetS and its associated early-life factors. DESIGN Data were collected using a standard parent/guardian questionnaire in a face-to-face interview. Each participant underwent a complete anthropometric evaluation. MetS was defined according to the criteria of the International Diabetes Federation (IDF; 2007) for children and adolescents. SETTING Guangzhou, a large city in South China, September 2013. SUBJECTS A total of 1770 children and adolescents were enrolled in the study, including 913 girls (51·6%) and 857 boys (48·4%). RESULTS The overall prevalence of MetS in children and adolescents was 1·1% (n 19), which was higher in boys (1·4%) than in girls (0·8%). Multivariate analysis indicated that high birth weight was significantly associated with abdominal obesity (OR=2·86; 95% CI 1·62, 5·06) and MetS (OR=3·61; 95% CI 1·33, 9·82). Furthermore, >6 months of maternal breast-feeding was inversely associated with MetS (OR=0·39; 95% CI 0·16, 0·98). CONCLUSION Based on IDF criteria, the prevalence of MetS among southern Chinese children was significantly lower than that in other populations. High birth weight was significantly associated with abdominal obesity and MetS, and breast-feeding for longer than 6 months was inversely associated with MetS in South China.

Self-perception of weight status and its association with weight-related knowledge, attitudes, and behaviors among Chinese children in Guangzhou

Background How weight perception influences weight-related knowledge, attitudes, and behaviors in Chinese children is unknown. We investigated self-perception of body weight and its correlates, and analyzed the relationship between weight perception and weight-related knowledge, attitudes, and behaviors in children in Guangzhou, China. Methods We assessed self-reported weight perception, weight-related knowledge, attitudes, and behaviors in 3752 children aged 7–12 years. Underweight or overweight was defined using the Chinese criteria based on body mass index (BMI). Binary logistic regression analyses were performed to assess correlates of weight underestimation. Results In total, 27.3% of children underestimated and 6.7% overestimated their weight status. Weight underestimation was common among normal-weight (34.1%) and overweight children (25.3%). Older age, female sex, and child BMI z-score were negatively associated with normal-weight childrens underestimation, whereas older age, paternal obesity, maternal obesity, and child BMI z-score were negatively associated with overweight childrens underestimation. Correct answers on weight-related knowledge questions ranged from 81.5% to 98.6% and did not differ by weight perception within BMI categories. Although negative perceivers (i.e., those who perceived themselves as underweight or overweight) had a higher intention to change weight, they behaved more unhealthily on fruit intake, breakfast, screen time, and daily moderate-to-vigorous physical activities time than counterparts. Conclusion Weight underestimation was prevalent in normal-weight and overweight children in Guangzhou. Negative perceivers had stronger willingness to change weight but tended to behave more unhealthily on certain behaviors than positive perceivers. Childhood obesity interventions should incorporate health education and practical support to promote healthy eating and physical activity.

Dietary glycemic index and glycemic load and their relationship to cardiovascular risk factors in Chinese children

The purpose of this study was to examine the cross-sectional associations between dietary glycemic index (GI) and glycemic load (GL) and cardiovascular disease (CVD) risk factors in Chinese children. A total of 234 Chinese schoolchildren aged 8-11 years in Guangdong participated in the study. Dietary intake was assessed via a 3-day dietary record. Seven established cardiovascular indicators were analyzed in this study: fasting plasma glucose (FPG), fasting triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and diastolic blood pressure. Higher dietary GI was significantly associated with higher TG levels (P = 0.037) and lower HDL-C levels (P = 0.005) after adjusting for age, sex, nutritional intake, physical activity, and body mass index z score. LDL-C was found to differ across tertiles of dietary GL. The middle tertile tended to show the highest level of LDL-C. TC, FPG, and blood pressure were independent of both dietary GI and GL. Our findings suggest that higher dietary GI is differentially associated with some CVD risk factors, including lower HDL-C and higher TG, in school-aged children from south China.

Waist Circumference, Health-Related Physical Fitness, and Cardiovascular Disease Risk Factors in Chinese Adolescents

Abbreviations: CVD, cardiovascular disease; BMI, body mass index; PFI, physical fitness index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; TG, triglyceride; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; CRF, cardio respiratory fitness; MS, muscular strength; SP-AG, speed-agility; LF, low-fat; HF, high-fat; LP, low-PFI; HP, high-PFI