Abstract
Background. Obesity prevalence is rising in many developing countries, also among children. Waist circumference (WC) is a good measure of central obesity. Objectives. Our aim was to compare umbilical waist circumference (UWC) and natural waist circumference (NWC) in children between socio-economic status (SES) and between sex; to describe correlations between body mass index (BMI), UWC and NWC; and to compare waist-to-height ratio (WHtR) between stunted and non-stunted children. Study population and methods. We measured height, weight and waist circumference at the natural and at the umbilical level in 583 boys and girls aged 8 to 10 years of two different social strata in Quetzaltenango, Guatemala. Results. Mean UWC and mean NWC (cm) were significantly larger in high SES than in low SES children (66.6 vs. 62.7, p<0.001, and 62.6 vs. 59.8, p<0.001, respectively). Boys had a larger mean NWC than girls (62.8 vs. 60.3, p<0.001). The mean difference between UWC and NWC (UWC-NWC) was larger in high SES and in boys. Overall, Pearson correlation of BMI vs. NWC is high (r=0.902, p<0.001), of BMI vs. UWC is higher (r=0.919, p<0.001) and of NWC vs. UWC is highest (r=0.965, p<0.001). The proportion of WHtR≥0.500 was significantly higher in non-stunted than in stunted boys (p=0.03) and in high SES as compared with low SES children (p<0.001). Results for mean WHtR were not significant. Conclusions. Based on these results, in Quetzaltenango high SES, non-stunted schoolchildren are most likely to have a centralized body fat pattern.
Acknowledgements
We are grateful to Virginia Alvarado for her training and standardization; Gabriela Montenegro-Bethancourt for her help in obtaining permission from schools and recruitment of subjects; and to Paula Gonzalez Lopez, Monica Romero Guevara and Marcel Sac Morales, students of the University Landivar in Quetzaltenango, for their assistance in the anthropometric measurements. We also wish to thank the Departmental Director of Education for his permission, and the directors, teachers and pupils of the schools for their participation. Finally, we thank the Ditmer Foundation of the Vrije Universiteit for their student grant.