Yanna Zhu

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.

Body Mass Index Is Better than Other Anthropometric Indices for Identifying Dyslipidemia in Chinese Children with Obesity.

Background Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are used in screening and predicting obesity in adults. However, the best identifier of metabolic complications in children with obesity remains unclear. This study evaluated lipid profile distribution and investigated the best anthropometric parameter in association with lipid disorders in children with obesity. Methods A total of 2243 school children aged 7–17 years were enrolled in Guangzhou, China, in 2014. The anthropometric indices and lipid profiles were measured. Dyslipidemia was defined according to the US Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. The association between anthropometry (BMI, WC, and WHR) and lipid profile values was examined using chi-square analysis and discriminant function analysis. Information about demography, physical activity, and dietary intake was provided by the participant children and their parents. Results Children aged 10–14 and 15–17 years old generally had higher triglyceride values but lower median concentration of total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol compared with children aged 7–9 years old (all P < 0.001). These lipid parameters fluctuated in children aged 10–14 years old. The combination of age groups, BMI, WC and WHR achieved 65.1% accuracy in determining dyslipidemic disorders. BMI correctly identified 77% of the total dyslipidemic disorders in obese children, which was higher than that by WHR (70.8%) (P< 0.05). Conclusion The distribution of lipid profiles in Chinese children differed between younger and older age groups, and the tendency of these lipid levels remarkably fluctuated during 10 to 14 years old. BMI had better practical utility in identifying dyslipidemia among school-aged children with obesity compared with other anthropometric measures.

Sugar-Sweetened Beverages Consumption Positively Associated with the Risks of Obesity and Hypertriglyceridemia Among Children Aged 7–18 Years in South China

Aims: Excessive consumption of sugar-sweetened beverages (SSBs) may increase the prevalence of obesity and other metabolic risk factors. However, data regarding the relationship between SSB consumption and metabolic risk factors are insufficient in Chinese children. Hence, we aimed to explore the association between SSB consumption and cardio-metabolic risk factors in children aged 7–18 years living in South China. Methods: A cross-sectional study was conducted in a total of 2,032 children aged 7–18 years were enrolled, including 1,013 boys and 1,019 girls. Based on a multistage cluster sampling, five elementary and four secondary schools in Guangzhou, China were included. Fasting blood glucose levels, lipid profiles, and anthropometric characteristics were evaluated. Information on demography, dietary, and physical activities were self-reported. Results: Overall, 34.7% participants were non-drinkers and 21.6% consumed more than 120 mL/day SSB. The body mass index (19.43 ± 0.18 kg/m2) and triglyceride concentration (0.96 ± 0.03 mmol/L) were higher and high-density lipoprotein concentration (1.32 ± 0.31 mmol/L) was lower in consumers than in non-consumers (all P < 0.001). Furthermore, in contrast to non-consumers, the adjusted odds ratio of SSB consumption more than 120 mL/day was 2.08 (95% CI: 1.21–3.54) for obesity, 1.83 (95% CI: 1.25–2.69) for abdominal obesity, and 1.70 (95% CI: 1.02–3.06) for hypertriglyceridemia in consumers. Conclusion: A positive association between SSB consumption and the risks of obesity and hypertriglyceridemia was observed in children living in South China, which suggests that high SSB consumption enhances the risk of cardio-metabolic risk factors and the consequent cardio-metabolic diseases.

Sugar-Sweetened Beverage Consumption and Risks of Obesity and Hypertension in Chinese Children and Adolescents: A National Cross-Sectional Analysis

We investigated the consumption of sugar-sweetened beverage (SSB) and its association with obesity and hypertension in a national sample of children and adolescents in China, where many low- and middle-income families live. Data were obtained from a 2014 national intervention program against obesity in Chinese children and adolescents aged 6-17 years. Height, weight, waist circumference, and blood pressure were measured. Information of SSB consumption, socioeconomic status, dietary intake, screen time, and physical activity were self-reported. Multivariate logistic regression was used to assess the association of SSB consumption with obesity and hypertension. A total of 66.6% of the 53,151 participants reported consuming SSB. The per capita and per consumer SSB intake were 2.84 ± 5.26 servings/week and 4.26 ± 5.96 servings/week, respectively. Boys, older children, and adolescents, and individuals with long screen time or high physical activity or low parental education level were more likely to consume SSB. Participants who were high SSB consumers had a higher odds ratio (1.133, 95% CI: 1.054-1.217) than non-consumers for having abdominal obesity after adjustment for age, sex, residence, socioeconomic status, diet, screen time, and physical activity. However, SSB consumption was not associated with general obesity or hypertension in children and adolescents. In conclusion, more than half of the children and adolescents in China consumed SSB, which was independently related to a high risk of abdominal obesity. The results of this study indicated that SSB reduction strategies and policies may be useful in preventing obesity among Chinese children and adolescents.

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