Prevalence and factors associated with central obesity in schoolchildren
               in Santa Catarina, Brazil

Feltrin, Gabriella Bettiol; Vasconcelos, Francisco de Assis Guedes de; Costa, Larissa da Cunha Feio; Corso, Arlete Catarina Tittoni

doi:10.1590/1415-52732015000100004

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Original Articles • Rev. Nutr. 28 (1) • Jan-Feb 2015 • https://doi.org/10.1590/1415-52732015000100004 copy

Prevalence and factors associated with central obesity in schoolchildren in Santa Catarina, Brazil

Prevalência e fatores associados à obesidade central em escolares de Santa Catarina

SCIMAGO INSTITUTIONS RANKINGS

Objective:

The aims of this article are to estimate the prevalence and to identify the sociodemographic factors and food consumption associated with central obesity in schoolchildren 6-10 years old of the State of Santa Catarina, Brazil.

Methods:

It consists in a cross-sectional population-based study involving 4,963 schoolchildren enrolled in the public and private sectors. The dependent variable is central obesity investigated by measuring waist circumference and classified according to percentiles/gender/age. Bivariate and multivariate analyzes were also performed.

Results:

The prevalence of central obesity was 4,9% (CI95%=4,3;5,5), being more prevalent in boys with statistical significance (p=0,003). The other variables investigated (age the schoolchildren, type of school, maternal education, protective and risk food consumption, number of daily meals) were not associated with outcome. Among the schoolchildren who had central obesity (n=243), 99.3% of the boys and 99.0% of the girls also showed overweight/obesity.

Conclusion:

The prevalence of central obesity was lower than that reported in national and international studies. In this scenario, the gender (male) variable was strongly associated with the outcome. The identified prevalence is a major concern in nutrition and medical science as the central obesity may remain in adulthood and show strong association with cardiovascular risk. It is noteworthy that there is a need for obesity prevention campaigns that encourage children and their parents to adopt a healthier life style. Finally, other studies should be conducted in order to examine potential factors linked to central obesity.

Child; Food consumption; Central obesity; Prevalence; Risk factors

Variables
	Male			Female			p-value
	n	%	(95%CI)	n	%	(95%CI)	p-value
	2,375	47.8	(46.4; 49.2)	2,588	52,1	(50,7; 53,5)
Age
≤7 years ≥8 years	603 1,772	25.3 74.6	(23.6; 27.1) (72.8; 76.3)	675 1,913	26,0 73,9	(24,3; 27,7) (72,2; 75,6)	0,563
≤7 years ≥8 years	603 1,772	25.3 74.6	(23.6; 27.1) (72.8; 76.3)	675 1,913	26,0 73,9	(24,3; 27,7) (72,2; 75,6)
Type of school
Public Private	1,885 490	79.3 20.6	(77.7; 80.9) (19.0; 22.2)	2,043 545	78,9 21,1	(77,3; 80,5) (19,4; 22,6)	0,711
Public Private	1,885 490	79.3 20.6	(77.7; 80.9) (19.0; 22.2)	2,043 545	78,9 21,1	(77,3; 80,5) (19,4; 22,6)
Mother's education level*
≥12 years ≥9 and ≤11 years ≤8 years	438 693 959	20,9 33,1 45,8	(19,2; 22,7) (31,1; 35,1) (43,7; 48,0)	513 761 1,010	22.4 33.3 44.2	(20.7; 24.1) (31.3; 35.2) (42.1; 46.2)	0.404
≥12 years ≥9 and ≤11 years ≤8 years	438 693 959	20,9 33,1 45,8	(19,2; 22,7) (31,1; 35,1) (43,7; 48,0)	513 761 1,010	22.4 33.3 44.2	(20.7; 24.1) (31.3; 35.2) (42.1; 46.2)
Intake of protective foods**
Adequate (6 times/day) Inadequate (≤5 times/day)	97 2,278	4,0 95,9	(3,2; 4,8) (95,1; 96,7)	175 2,413	6.7 93.2	(5.7; 7.7) (92.2; 94.2)	0.001
Adequate (6 times/day) Inadequate (≤5 times/day)	97 2,278	4,0 95,9	(3,2; 4,8) (95,1; 96,7)	175 2,413	6.7 93.2	(5.7; 7.7) (92.2; 94.2)
Intake of risky foods***
Adequate (≤2 times/day) Inadequate (≥3 times/day)	2,101 274	88.4 11.5	(87.1; 89.7) (10.2; 12.8)	2,281 307	88.1 11.8	(86.8; 89.3) (10.6; 13.1)	0.722
Adequate (≤2 times/day) Inadequate (≥3 times/day)	2,101 274	88.4 11.5	(87.1; 89.7) (10.2; 12.8)	2,281 307	88.1 11.8	(86.8; 89.3) (10.6; 13.1)
Number of meals
≤3 meals/day ≥4 meals/day	134 2,241	5.6 94.3	(4.7; 6.5) (93.4; 95.2)	128 2,460	4.9 95.0	(4.1; 5.7) (94.2; 95.8)	0.273
≤3 meals/day ≥4 meals/day	134 2,241	5.6 94.3	(4.7; 6.5) (93.4; 95.2)	128 2,460	4.9 95.0	(4.1; 5.7) (94.2; 95.8)

Variables
	Male				Female
	n	%	(95%CI)	p-value	n	%	(95%CI)	p-value
	2,375	5.9	(4.9; 6.8)		2,588	4.1	(3.2; 4.8)
Age
≤7 years ≥8 years	603 1,772	5.4 6.0	(3.6; 7.2) (4.9; 7.1)	0.586	675 1,913	3.4 4.2	(2.0; 4.7) (3.3; 5.1)	0.422
≤7 years ≥8 years	603 1,772	5.4 6.0	(3.6; 7.2) (4.9; 7.1)		675 1,913	3.4 4.2	(2.0; 4.7) (3.3; 5.1)
Type of school
Public Private	1,885 490	6.2 4.5	(5.1; 7.3) (2.6; 6.3)	0.138	2,043 545	4.1 4.0	(3.2; 4.9) (2.3; 5.6)	0.978
Public Private	1,885 490	6.2 4.5	(5.1; 7.3) (2.6; 6.3)		2,043 545	4.1 4.0	(3.2; 4.9) (2.3; 5.6)
Mother's education level*
≥12 years ≥9 and ≤11 years ≤8 years	438 693 959	5.5 5.9 5.9	(3.3; 7.6) (4.1; 7.6) (4.4; 7.4)	0.937	513 761 1,010	4.3 4.2 3.7	(2.5; 6.0) (2.7; 5.6) (2.5; 4.9)	0.845
≥12 years ≥9 and ≤11 years ≤8 years	438 693 959	5.5 5.9 5.9	(3.3; 7.6) (4.1; 7.6) (4.4; 7.4)		513 761 1,010	4.3 4.2 3.7	(2.5; 6.0) (2.7; 5.6) (2.5; 4.9)
Intake of protective foods**
Adequate (6 times/day) Inadequate (≤5 times/day)	97 2,278	6.1 5.8	(1.3; 11.0) (4.9; 6.8)	0.901	175 2,413	4.0 4.1	(1.0; 6.9) (3.2; 4.8)	0.968
Adequate (6 times/day) Inadequate (≤5 times/day)	97 2,278	6.1 5.8	(1.3; 11.0) (4.9; 6.8)		175 2,413	4.0 4.1	(1.0; 6.9) (3.2; 4.8)
Intake of risky foods***
Adequate (≤2 times/day) Inadequate (≥3 times/day)	2,101 274	5.8 6.6	(4.8; 6.8) (3.6; 9.5)	0.614	2,281 307	3.8 6.2	(2.9; 4.5) (3.4; 8.8)	0.044
Adequate (≤2 times/day) Inadequate (≥3 times/day)	2,101 274	5.8 6.6	(4.8; 6.8) (3.6; 9.5)		2,281 307	3.8 6.2	(2.9; 4.5) (3.4; 8.8)
Number of meals
≤3 meals/day ≥4 meals/day	134 2,241	6.8 5.8	(2.9; 11.9) (4.8; 6.7)	0.428	128 2,460	2.3 4.1	(0.3; 5.0) (3.3; 4.9)	0.314
≤3 meals/day ≥4 meals/day	134 2,241	6.8 5.8	(2.9; 11.9) (4.8; 6.7)		128 2,460	2.3 4.1	(0.3; 5.0) (3.3; 4.9)

Variables	n
		Crude analysis		Adjusted analysis*
		OR (95%CI)	p-value	OR (95%CI)	p-value
Age
≤7 years ≥8 years	603 1,772	1 1.11 (0.74; 1.65)		1 1.04 (0.68; 1.60)
≤7 years ≥8 years	603 1,772	1 1.11 (0.74; 1.65)	0.607	1 1.04 (0.68; 1.60)	0.843
Type of school
Public Private	1,885 490	1 0.70 (0.44; 1.12)		1 0.70 (0.44; 1.12)
Public Private	1,885 490	1 0.70 (0.44; 1.12)	0.126	1 0.70 (0.44; 1.12)	0.140
Mother's education level*
≥12 years ≥9 and ≤11 years ≤8 years	438 693 959	1 1.08 (0.64; 1.82) 1.09 (0.66; 1.78)	0.756*****	1 0.93 (0.53; 1.63) 0.87 (0.49; 1.55)
					0.652*****

Intake of protective foods**
Adequate (6 times/day) Inadequate (≤5 times/day)	97 2,278	1 0.94 (0.40; 2.20)	0.901	1 0.88 (0.38; 2.07)	0.786
Adequate (6 times/day) Inadequate (≤5 times/day)	97 2,278	1 0.94 (0.40; 2.20)		1 0.88 (0.38; 2.07)
Intake of risky foods***
Adequate (≤2 times/day) Inadequate (≥3 times/day)	2,101 274	1 1.14 (0.68; 1.90)	0.619	1 1.09 (0.65; 1.84)	0.723
Adequate (≤2 times/day) Inadequate (≥3 times/day)	2,101 274	1 1.14 (0.68; 1.90)		1 1.09 (0.65; 1.84)
Number of meals
≤3 meals/day ≥4 meals/day	134 2,241	1 0.76 (0.39; 1.48)		1 0.77 (0.39; 1.52)
≤3 meals/day ≥4 meals/day	134 2,241	1 0.76 (0.39; 1.48)	0.444	1 0.77 (0.39; 1.52)	0.446

Variables	n
		Crude analysis		Adjusted analysis*
		OR (95%CI)	p-value	OR (95%CI)	p-value
Age
≤7 years ≥8 years	675 1,913	1 1.26 (0.79; 2.03)	0.310	1 1.26 (0.79; 2.03)	0.321
≤7 years ≥8 years	675 1,913	1 1.26 (0.79; 2.03)		1 1.26 (0.79; 2.03)
Type of school
Public Private	2,043 545	1 0.99 (0.61; 1.60)	0.978	1 1.02 (0.63; 1.65)	0.930
Public Private	2,043 545	1 0.99 (0.61; 1.60)		1 1.02 (0.63; 1.65)
Mother's education level*
≥12 years ≥9 and ≤11 years ≤8 years	513 761 1,010	1 0.97 (0.56; 1.70) 0.87 (0.51; 1.49)	0.587*****	1 0.95 (0.51; 1.75) 0.81 (0.43; 1.55)	0.494*****


Intake of protective foods**
Adequate (6 times/day) Inadequate (≤5 times/day)	175 2,413	1 1.01 (0.46; 2.20)	0.96	1 1.05 (0.48; 2.31)	0.890
Adequate (6 times/day) Inadequate (≤5 times/day)	175 2,413	1 1.01 (0.46; 2.20)		1 1.05 (0.48; 2.31)
Intake of risky foods***
Adequate (≤2 times/day) Inadequate (≥3 times/day)	2,281 307	1 1.70. (1.01; 2.80)	0.057	1 1.68 (1.00; 2.80)	0.050
Adequate (≤2 times/day) Inadequate (≥3 times/day)	2,281 307	1 1.70. (1.01; 2.80)		1 1.68 (1.00; 2.80)
Number of meals
≤3 meals/day ≥4 meals/day	128 2,460	1 1.80 (0.56; 5.76)	0.276	1 1.99 (0.61; 6.43)	0.247
≤3 meals/day ≥4 meals/day	128 2,460	1 1.80 (0.56; 5.76)		1 1.99 (0.61; 6.43)

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[1] COLLABORATORS GB FELTRIN analyzed the data and wrote and reviewed the manuscript. LCF COSTA helped to analyze the data and review the manuscript. ACT CORSO coordinated the greater project and reviewed the manuscript. FAG VASCONCELOS helped to design and develop the greater project, supervise the dissertation project, and review the manuscript.