1University of Montenegro, Faculty for Sports and Physical Education, Niksic, Montenegro
2Abu Dhabi Police, Police Sports Education Center, Abu Dhabi, United Arab Emirates
Age and Gender Differences in Nutritional Status of School Children According to WHO, CDC and IOTF References: A Statewide Study from Montenegro
Nutritional status of school children has been discussed over the past decade, focusing on timely and adequate response that can positively affect the reduction of the health risks of overweight, obesity, and malnutrition. Thus, the aim of this study was to evaluate a nutritional status of healthy children from Montenegro according to three most common worldwide references. The sample of 1480 healthy school children was consisted of girls (N=733), mean age=10.98±1.38 years, mean body height BH=152.25±10.22 cm, and mean body mass BM=43.93±11.51 kg, and boys (N=747), mean age=10.95±1.41, mean BH=153.26±11.18 cm, and mean BM=46.16±13.21 kg. A nutritional status was defined by body mass index (BMI) and compared to the references developed by World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and International Obesity Task Force (IOTF). Prevalence differences relative to age and gender were analyzed as well. Results suggest that IOTF is the most appropriate method in absence of national references for growth and nutritional status. Furthermore, increase in prevalence of overweight and obese in boys was relatively high considering the time frame (5 years), while increase in girls was somewhat smaller, but nevertheless present. In total, every third (WHO) or every fourth (CDC and IOTF) child in Montenegro aged 9-13 years is either overweight or obese.
body mass index, prevalence, obesity, overweight, underweight
Bjelica, D. (2006). Sportski trening. Podgorica: Crnogorska sportska akademija.
Bjelica, D. (2010). Teorija sportskog treninga. Podgorica: Univerzitet Crne Gore.
Canadian Pediatric Endocrine Group (2018). Growth-Z software (current version 2018/05/22), a Microsoft® Excel workbook–based program that can do batch calculations for WHO and CDC parameters. From website: http://www.bcchildrens.ca/health-professionals/clinical-resources/endocrinology-diabetes/tools-calculators#Anthro--calculators
Christie, B. (2000). Doctors revise declaration of Helsinki. British Medical Journal, 321(7266), 913.
Cole, T.J., & Green, P.J. (1992). Smoothing reference centile curves: the LMS method and penalized likelihood. Statistics in medicine, 11(10), 1305-1319.
Cole, T.J., Bellizzi, M.C., Flegal, K.M., & Dietz, W.H. (2000). Establishing a standard definition for child overweight and obesity worldwide: international survey. British Medical Journal, 320(7244), 1240.
Cole, T.J., Flegal, K.M., Nicholls, D., & Jackson, A.A. (2007). Body mass index cut offs to define thinness in children and adolescents: international survey. British Medical Journal, 335(7612), 194.
de Onis, M.D., Onyango, A.W., Borghi, E., Siyam, A., Nishida, C., & Siekmann, J. (2007). Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World health Organization, 85, 660-667.
Grasgruber, P., Popovic, S., Bokuvka, D., Davidovic, I., Hrebickova, S., Ingrova, P., Potpara, P., Prce, S. & Stracarova, N. (2017). The mountains of giants: an anthropometric survey of male youths in Bosnia and Herzegovina. Royal Society Open Science, 4(4), 161054.
Jaksic, M., Martinovic, M., Belojevic, G., Kavaric, N., Asanin, B., Samardzic, M., Pantovic, S., & Boljevic, J. (2017). Prevalence of and contributing factors to overweight and obesity among the schoolchildren of Podgorica, Montenegro. Srp Arh Celok Lek, 145(1-2), 20-5.
Kuczmarski, R.J., Ogden, C.L., Guo, S.S., Grummer-Strawn, L.M., Flegal, K.M., Mei, Z., Wei, R., Curtin, L.R., Roche, A.F., & Johnson, C.L. (2002). CDC growth charts for the US: methods and development. Vital Health Stat, 11(246), 1-190.
LMS growth software (current version 2.77, 2012), a Microsoft add-in to access growth references based on the LMS method. British Medical Council. From website: http://www.healthforallchildren.com/shop-base/shop/software/lmsgrowth/
Lukaski, H. (Ed.) (2017). Body Composition. Boca Raton: CRC Press.
Martinovic, M., Belojevic, G., Evans, G.W., Lausevic, D., Asanin, B., Samardzic, M., Terzic, N., Pantovic, S., Jaksic, M., & Boljevic, J. (2015). Prevalence of and contributing factors for overweight and obesity among Montenegrin schoolchildren. The European Journal of Public Health, 25(5), 833-839.
Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., et al. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. The lancet, 384(9945), 766-781.
Popkin, B.M. (2006). Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. The American Journal of Clinical Nutrition, 84(2), 289-298.
Research Brief: “European Initiative for the Monitoring of Obesity of Children” (25.5.2016). Podgorica: Institute of Public Health. Set 25.5.2016 from the website: http://www.ijzcg.me/2016/05/obavjestenje-o-istrazivanju-evropska-inicijativa-pracenja-gojaznosti-djece/
Schroder, H., Ribas, L., Koebnick, C., Funtikova, A., Gomez, S.F., Fito, M., Perez-Rodrigo, C., & Serra-Majem, L. (2014). Prevalence of abdominal obesity in Spanish children and adolescents. Do we need waist circumference measurements in pediatric practice? PLoS One, 9(1), e87549.
Shan, X.Y., Xi, B., Cheng, H., Hou, D.Q., Wang, Y., & Mi, J. (2010). Prevalence and behavioral risk factors of overweight and obesity among children aged 2–18 in Beijing, China. International Journal of Pediatric Obesity, 5(5), 383-389.
Sharma, A.K., Metzger, D.L., Daymont, C., Hadjiyannakis, S., & Rodd, C.J. (2015). LMS tables for waist-circumference and waist-height ratio Z-scores in children aged 5-19y in NHANES III: association with cardio-metabolic risks. Pediatric Research, 78(6), 723-729.
Tambalis, K.D., Panagiotakos, D.B., Arnaoutis, G., Psarra, G., Maraki, M., Mourtakos, S., Grigorakis, D., & Sidossis, L.S. (2015). Establishing cross-sectional curves for height, weight, body mass index and waist circumference for 4 to 18 years old Greek children, using the Lambda Mu and Sigma (LMS) statistical method. Hippokratia, 19(3), 239-248.
Tuan, N.T., & Nicklas, T.A. (2009). Age, sex and ethnic differences in the prevalence of underweight and overweight, defined by using the CDC and IOTF cut points in Asian children. European Journal of Clinical Nutrition, 63(11), 1305.
Wang, Y., & Chen, H.J. (2012). Use of percentiles and z-scores in anthropometry. In Handbook of anthropometry (pp. 29-48). Springer, New York, NY.
World Health Organization (1995). Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. Geneva.
World Health Organization (2000). Obesity. Preventing and managing the global epidemic: report of a WHO consultation on obesity. WHO Technical Report Series, No. 894, WHO: Geneva.