Waist/height ratio: A marker of nutritional alteration in preschool children"

Abstract

The prevalence of obesity in Brazil is progressively increasing among children. In obese individuals, the concentration of fat in the abdominal region is a predictive marker for future health problems. Among the indicators of central adiposity, the waist-to-height ratio (WHR) has been shown to be more sensitive for predicting future health hazards than waist circumference alone. Objective: To analyze the relationship between the WHR and the classification of nutritional status of preschool children. Methods: A cross-sectional study with 711 preschool children in daycare in Taubate, SP. The sampling was probabilistic, having the nursery as the sampling unit. The weight, height and waist circumference of each child were measured. For classifying children with excess weight (risk of overweight, overweight or obesity), or with overweight or obesity the cut-off points of the Z-scores of Body Mass Index (zBMI), proposed by the Ministry of Health (2009), were used, from the point of view of the World Health Organization. The data were analyzed using the ROC (Receiver Operator Curve). Results: The area under the curve (AUC) of WHR for excess weight was 0.851 (p< 0.0001), and for overweight or obesity together was 0.886 (p< 0.0001). Values of 0.52 and 0.54 of the WHR were the cut-off points for optimization of Sensitivity/Specificity respectively for excess weight or overweight or obesity. Conclusion: The WHR is a useful tool in basic health care for children at the beginning of preschool age, for the assessment of nutritional status and central adiposity.