Tag: 6/3/24

Categories : Metabolic Disorders PaediatricsTags :

Waist-to-height Ratio Superior to BMI for Detecting Fat Obesity in Children and Adolescents

On By ModernMedia
Photo by Andres Ayrton on Pexels

A simple measure of obesity in children and adolescents that could replace body mass index (BMI) has been identified in a new study as waist circumference-to-height ratio. This measure detected excess fat mass and distinguished fat mass from muscle mass in children and adolescents more accurately than BMI. The study was conducted in collaboration between the University of Bristol in the UK, the University of Exeter in the UK, and the University of Eastern Finland, and the results were published in Pediatric Research.

The prevalence of childhood and adolescent obesity has reached an epidemic proportion and is affecting nearly 1 in 4 children in the current decade.

Unfortunately, obesity in the young population has been associated with cardiovascular, metabolic, neurological, musculoskeletal diseases and premature death in adulthood.

Accurately detecting overweight and obesity in children is critical to initiating timely interventions.

For nearly a generation, weight-to-height ratio charts and BMI for age and sex have been used to diagnose children with obesity.

However, these surrogate assessment tools are inaccurate in childhood and adolescence since they do not distinguish fat mass from muscle mass.For instance, two children with similar BMI might have different proportions of fat and muscle mass which makes obesity diagnosis difficult.

Expensive tools such as the dual-energy Xray absorptiometry (DEXA) scan accurately measures fat and muscle content of the body, but this device is not readily available in primary health care centres.

Recently, the American Academy of Pediatrics (AAP) published a clinical guideline on childhood obesity and requested urgent research on inexpensive and accurate alternative measures of obesity.

Emerging studies in adults appear to suggest that waist circumference-to-height ratio predicts premature death better than BMI and could be a potential added tool to BMI measure in improving the diagnosis of obesity.

However, there has been no former evaluation of how much waist circumference-to-height ratio measurements agree with DEXA-measured fat mass and muscle mass during growth from childhood to young adulthood.

In addition, the threshold of waist circumference-to-height ratio needed to detect excess fat in children is not clear, hence this study.

The current study is the largest and the longest follow-up DEXA-measured fat mass and muscle mass study in the world using the University of Bristol’s Children of the 90s data (also known as the Avon Longitudinal Study of Parents and Children). The study included 7,237 children (51% females) aged 9 years who were followed-up until age 24 years.

Their BMI and waist circumference-to-height ratio were measured at ages 9, 11, 15, 17, and 24 years.

When different devices measure a variable with an exact resemblance, it is described as perfect agreement of the devices with a score of 100%. For example, two DEXA scans from different manufacturers would measure fat mass with a near-perfect agreement of 99 to 100%.

Waist circumference-to-height ratio had a very high agreement of 81 — 89% with DEXA-measured total body fat mass and trunk fat mass, but a low agreement with muscle mass (24 — 39%). BMI had a moderate agreement with total fat mass and trunk fat mass (65 — 72%) and muscle mass (52 — 58%). Since BMI had a moderate agreement with DEXA-measured muscle mass, it is difficult to specify whether BMI measures excess fat or muscle mass.

The optimal waist circumference-to-height ratio cut points that predicted the 95th percentile of total fat mass in males was 0.53 and 0.54 in females.

This cut point detected 8 out of 10 males and 7 out of 10 females who truly had excess DEXA-measured fat.

The cut point also identified 93 out of 100 males and 95 out of 100 females who truly do not have excess fat.

“This study provides novel information that would be useful in updating future childhood obesity guidelines and policy statements. The average waist circumference-to-height ratio in childhood, adolescence, and young adulthood is 0.45, it does not vary with age and among individuals like BMI. Waist circumference-to-height ratio might be preferable to BMI assessment in children and adolescent clinics as an inexpensive tool for detecting excess fat. Parents should not be discouraged by the BMI or weight of their children but can inexpensively confirm whether the weight is due to increase in excess fat by examining their kid’s waist circumference-to-height ratio,” says Andrew Agbaje, an award-winning physician and pediatric clinical epidemiologist at the University of Eastern Finland.

Source: University of Eastern Finland

Categories : Cardiovascular DiseaseTags :

Sweetened Drinks Linked to Higher Atrial Fibrillation Risk

On By ModernMedia
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An analysis of UK Biokank data showed that adults who reported drinking two litres or more of sugar- or artificially sweetened drinks per week had a higher risk of atrial fibrillation compared with adults who drank fewer such beverages, according to new research published in Circulation: Arrhythmia and Electrophysiology, a peer-reviewed journal of the American Heart Association.

The study also found that drinking one litre or less per week of pure, unsweetened juice, such as orange or vegetable juice, was associated with a lower risk of atrial fibrillation (AFib). However, the study could not confirm whether the sweetened drinks caused AFib, yet the association remained after accounting for a person’s genetic susceptibility to the condition.

Consuming sweetened drinks has been linked to Type 2 diabetes and obesity in previous research. This large study of health data in the UK Biobank is among the first to assess a possible link between sugar- or artificially sweetened beverages and AFib.

“Our study’s findings cannot definitively conclude that one beverage poses more health risk than another due to the complexity of our diets and because some people may drink more than one type of beverage,” said lead study author Ningjian Wang, MD, PhD, a researcher at the Shanghai Ninth People’s Hospital and Shanghai Jiao Tong University School of Medicine in Shanghai, China. “However, based on these findings, we recommend that people reduce or even avoid artificially sweetened and sugar-sweetened beverages whenever possible. Do not take it for granted that drinking low-sugar and low-calorie artificially sweetened beverages is healthy, it may pose potential health risks.”

The researchers reviewed data from dietary questionnaires and genetic data for more than 200 000 adults free of AFib at the time they enrolled in the UK Biobank, between 2006 and 2010. During the nearly 10-year follow-up period, there were 9362 cases of AFib among the study participants.

The analysis found:Compared to people who did not consume any sweetened drinks, there was a 20% increased risk of atrial fibrillation among people who said they drank more than 2 litres per week of artificially sweetened beverages; and a 10% increased risk among participants who reported drinking 2 litres per week or more of sugar-sweetened beverages.

People reporting 1 litre or less of pure fruit juice each week had an 8% lower risk of atrial fibrillation.

Participants who consumed more artificially sweetened beverages were more likely to be female, younger, have a higher body mass index and a higher prevalence of Type 2 diabetes.

Participants who consumed more sugar-sweetened beverages were more likely to be male, younger, have a higher body mass index, a higher prevalence of heart disease and lower socioeconomic status.

Those who drank sugar-sweetened beverages and pure juice were more likely to have a higher intake of total sugar than those who drank artificially sweetened drinks.

Smoking may have also affected risk, with smokers who drank more than two litres per week of sugar-sweetened beverages having a 31% higher risk of AFib, whereas no significant increase risk was noted for former smokers or people who never smoked.

“These novel findings on the relationships among atrial fibrillation risk and sugar- and artificially sweetened beverages and pure juice may prompt the development of new prevention strategies by considering decreasing sweetened drinks to help improve heart health,” Wang said.

Researchers also evaluated whether a genetic susceptibility to AFib was a factor in the association with sweetened beverages. The analysis found the AFib risk was high with the consumption of more than 2 litres of artificially sweetened drinks per week regardless of genetic susceptibility.

Source: American Heart Association