The journal ‘Nutrición Hospitalaria’ has recently published the study “Waist circumference as a prognostic index of childhood abdominal obesity: findings in the Spanish population” carried out by Ana M. Puga, Teresa Partearroyo and Gregorio Varela Moreiras, professors at the Research Group of Excellence 'Nutrition for Life' and Professor Santiago Angulo from the Faculty of Pharmacy at CEU San Pablo University with Dr. Elena Sanchez Campayo, currently at the Navarra Clinic and the Spanish Nutrition Foundation. These researchers are the first to have established waist measurement cut-off points to diagnose obesity in Spanish children. As Varela explains, "this new form of measurement is a simple and valid alternative as a diagnostic criterion for abdominal obesity in children."

The study was carried out using measurements from more than 8000 children aged between 3 and 12 and has made it possible to establish waist circumference cut-off points for the diagnosis of obesity. In particular, the researchers explain that, “in boys, the established cut-off points ranged between 54.5 and 88.0 cm in the different age groups. On the other hand, in girls, the cut-off points for the diagnosis of obesity ranged between 55.2 and 82.5 cm for the different age groups analyzed”. Obesity in the child population has become a public health problem worldwide, due to the correlation with an increased risk of premature death and disability.

As the professor of Nutrition and Bromatology points out, “the problem of obesity in Spain affects all population groups. Approximately 2 out of 3 Spanish citizens suffer from excess weight”. Furthermore, Varela explains that the latest data regarding the child population indicates that approximately 40% is overweight. “Compared to the situation a generation ago the figures have tripled; and at a European level Spain is the second country after Greece in terms of the prevalence of obesity among primary school children”.

In addition, the Nutrition expert sets out that, "we have a new problem, which we call a new nutritional transition. This might occur as a consequence of changes in eating habits and physical activity resulting from the COVID-19 pandemic." Consequently, Varela highlights that, "we are talking about growing food insecurity that can lead to a less healthy and sustainable diet and, therefore, to worse consequences for health."

Different ways to measure obesity

Since the 19th century, obesity has been measured through the Body Mass Index (BMI), thanks to its excellent correlation with the percentage of body fat. However, in the paediatric population percentiles are used. The researchers emphasize that this is not the best way: “it is important to note that BMI is not capable of providing information on the distribution of body fat, and it is this which is considered the most important risk factor for cardiovascular disease and diabetes mellitus type 2, among other pathologies”. For this reason, alternative indexes have been developed. These reflect abdominal adiposity and are very easy to perform, such as waist circumference in the adult population. However, to date no such cut-off points have been established in the Spanish paediatric population, and this is the novel concept set out in this publication.

Regarding the methodology used, Varela explains that, “the study was carried out in 8,241 children aged between 3 and 12. In addition to BMI, weight, height and waist circumference were determined. The national criteria of the Faustino Orbegozo Foundation, and the international criteria of the World Health Organization and the International Obesity Task Force were used to diagnose excess weight and obestiy”. The results obtained represent a simple and potentially useful methodology both at the community and clinical level in the diagnosis of abdominal obesity in children in Spain. They will therefore be able to contribute to reducing this already highly prevalent problem in Spain.