UNDERWEIGHT, OVERWEIGHT, GENERAL AND CENTRAL OBESITY IN 5-YEAR-OLD CHILDREN FROM NORTH MACEDONIA
The objective of this study is to investigate the distribution of underweight, overweight, and the general and central obesity in 5-year-old children from North Macedonia, through the use of the anthropometric indices, BMI for general and WHR for central or abdominal obesity. In this study, a total of 248 children (124 boys and 124 girls) are investigated. Anthropometric indicators are measured using a standard protocol. We select four parameters to measure (weight and height) and two circumferences (waist WC and hip HC). The following indices are taken into consideration: Body mass index (BMI) and waist-to-hip ratio (WHR). The percentile distribution of the tested variables was done by gender. Some anthropometric parameters (weight, height, and BMI) have shown significant sex-specific differences in favour of boys, with exception of circumference and WHR. Overweight occurs in 5.65% of the boys and 12.1% of the girls, and obesity occurs in 10.48% of boys and 4.84% of the girls. The underweight is 4.84 % of the boys and 5.64% of the girls. Central or abdominal obesity across cut-off points (WHR and WC-for-age >=90th percentile) occurs in 13.7 % and 12.9 % of the boys and 12.1 % and 10.48% of the girls respectively. Central obesity, as well as general obesity, is more frequent in boys than girls. These results and the determination of BMI, WC, and WHR cut-off values can be used for estimating underweight, overweight, general, and central obesity and consequences associated with it in children aged 5 years from North Macedonia.
Keywords: BMI, WC, WHR, children, overweight, central obesity, underweight.
2. Zafirova B, Todorovska L. Anthropometric parameters of growth and nutritional status in children aged 6 to 7 years in R. Macedonia. Adv med Sci 2009;54(20):289-95.
3. Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2–19 years: United States, 1963–1965 through 2017–2018. NCHS Health E-Stats. 2020.
4. Zafirova et al. Anthropometric indices for estimating overweight and obesity in school-aged children from North Macedonia.JMS 2021;4(2):154-164.
5. World Health Organization [WHO]. (2017). Obesity and Overweight. Available at:
6. Avalos C, Díaz C, Martínez A, Bancalari R, Zamorano J, Harbin F, Cerda V, Fernández M, Cavada G, Arteaga J, Valenzuela M, Toro M, García H. Waist circumference percentiles in children and adolescents between 6 and 14 years from Santiago, Chile. Endocrinol Nutr. 2012; 59(5):296-303.
7. Chen, G., Yan, H., Hao, Y. et al. Comparison of various anthropometric indices in predicting abdominal obesity in Chinese children: a cross-sectional study. BMC Pediatr 2019; (19): 127.
8. Mladenova S et al. Prevalence of underweight, overweight, general and central obesity among 8-15-years old Bulgarian children and adolescents (Smolyan region, 2012-204). Nutr.Hosp.2015;31(6):2419-2427.
9. Avalos C, Díaz C, Martínez A, Bancalari R, Zamorano J, Harbin F, Cerda V, Fernández M, Cavada G, Arteaga J, Valenzuela M, Toro M, García H. Waist circumference percentiles in children and adolescents between 6 and 14 years from Santiago, Chile. Endocrinol Nutr. 2012; 59(5):296-303.
10. Kristen Cashin and Lesley Oot. Guide to anthropometry.
A Practical Tool for Program Planners, Managers and Implementers. 2018. https://www.fantaproject.org/sites/default/files/resources/FANTA-Anthropometry-Guide-May2018.pdf
11. Zafirova B et all.Evaluation of Sex-Specific Differences of Anthropometric Variables That Were Used as Indicators of Nutritional Status in Macedonian Children. JMS. 2018; 1 (1): 25-30.
12. California Department of Health Care Services, Systems of Care Division Child Health and Disability Prevention Program, Health Assessment Anthropometric mesaurements Guidelines Mar 2016 https://www.dhcs.ca.gov/services/chdp/Documents/HAG/4AnthropometricMeasure.pdf
13. de Onis M, Onyango AW, Borghi E, Nishida AS, Siekman J. Development of a WHO growth
reference for school-aged children and adolescents. Bull WHO. 2007;85(9):649-732.
14. World Health Organisation. Obesity. In: World Health Organisation; 2016. http://www.who.int/topics/obesity/en.
15. Using the BMI-for-Age Growth Charts CDC https://www.cdc.gov/nccdphp/ dnpa/growthcharts/ training/modules/module1/text/module1print.pdf.
16. Zimmet P, Alberti G, Kaufman F, et al. ; International Diabetes Federation Task Force on Epidemiology and Prevention of Diabetes. The metabolic syndrome in children and adolescents. Lancet. 2007;369(9579):2059–2061.
17. Vaman Khadilkar, Sangeeta Yadav et all. IAP Growth Charts for Height, Weight and Body Mass
Index for 5- to 18-year-old Indian Children.Indian Pediatr 2015; 20 (52): 47-55.
18. CDC table for calculated BMI values for selected heights and weights for ages 2–20 years. National Health and Nutrition Examination Survey. 2000; Available from: http://www.cdc.gov/
19. Cole TJ, Bellizzi CM, Flegal MK, Dietz HW. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240-6.
20. Body Composition in Children and Adolescents Residing in Southern Europe: Prevalence of Overweight and Obesity According to Different International References. Available from: https://www.researchgate.net/publication/330811755_Body_Composition_
21. Unalan D, Senol V, Bayat M, Mazicioglu MM, Ozturk A, Kurtoglu S, Hatipoglu N, Ustunbas HB. Change in waist circumference over 3 years in Turkish children and adolescents. Ann Hum Biol. 2013 Sep-Oct;40(5):419-25.
22. Muhammad Asif et al. Evaluation of anthropometric parameters of central obesity in Pakistani children aged 5-12 years, using receiver operating characteristic (ROC )analysis. JPEM 2108; 31 (19).
23. Magalhea EI et al. Waist circumference, waist/height ratio and neck circumference as parameters of central obesity assessment in children. RevPaul de Pediatr 2014;32:273-82.
24. Asif M, Aslam M, Altaf S, Mustafa S. Developing waist circumference, waist-to-height ratio percentile curves for Pakistani children and adolescents aged 2-18 years using Lambda-Mu-Sigma (LMS) method. J Pediatr Endocrinol Metab. 2020 Jul 6:/j/jpem.ahead-of-print/jpem-2019-0527/jpem-2019-0527.xml.
25. Xi B, Zong X, Kelishadi R, Litwin M, Hong YM, Poh BK, Steffen LM, Galcheva SV, Herter-Aeberli I, Nawarycz T, Krzywińska-Wiewiorowska M, Khadilkar A, Schmidt MD, Neuhauser H, Schienkiewitz A, Kułaga Z, Kim HS, Stawińska-Witoszyńska B, Motlagh ME, Ruzita AT, Iotova VM, Grajda A, Ismail MN, Krzyżaniak A, Heshmat R, Stratev V, Różdżyńska-Świątkowska A, Ardalan G, Qorbani M, Świąder-Leśniak A, Ostrowska-Nawarycz L, Yotov Y, Ekbote V, Khadilkar V, Venn AJ, Dwyer T, Zhao M, Magnussen CG, Bovet P. International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years. J Clin Endocrinol Metab. 2020 Apr 1;105(4):e1569–83.