NUTRITIONAL STATUS OF SCHOOLCHILDREN AGED 7-18 YEARS IN BULGARIA, 2011 NATIONAL NUTRITION SURVEY
Journal Title: Българско списание за обществено здраве (Bulgarian Journal of Public Health) - Year 2016, Vol 0, Issue 2
Abstract
Background: Obesity is a serious health concern for children and adolescents in Bulgaria. National surveys of nutritional status of the population, which were conducted in the period 1998-2008, thus, involving children from different age groups, showed that the higher prevalences of overweight, including obesity are observed in children aged 7-18 years. Meanwhile, there was evidence of thinness for the relevant age and sex, especially among girls, and stunting of children in some age groups. Monitoring of anthropometric indicators of nutritional status is crucial to assess the effectiveness of the interventions to improve children’s nutrition. Purpose and tasks, design and methods: In November 2010 - March 2011 a national cross-sectional survey was conducted on a nationally representative sample of 4219 schoolchildren aged 7-18 years. Nutritional status was assessed based on anthropometric indicators. Dimensions measured are: height, weight and waist circumference by using standardized methodology and protocol of the WHO. Assessment of stunting is made on the basis of the indicator Height-for-age. By Body Mass Index (BMI) for relevant age and sex were assessed thinness, overweight and obesity of children, according to the WHO Growth Reference for children 5-19 years of age, 2007 and cut-offs of the International Obesity Task Force (IOTF), 2000 , 2007. Variance and correlation analysis of the data through the statistical program SPSS 15 and the software WHO AnthroPlus were conducted. Results: The study shows that stunting of children aged 7-18 years has been observed by a relatively low rate (1.2-2.6%). A small percentage of the children are with thinness for age and sex when the assessment is based on WHO Growth Reference (1.6%), but if using the cutoffs of the IOTF, a significant rate of thinness (7.2%) has been established, and it is especially high in girls aged 16-18 years (12.6% - 17.7%). There is a high proportion of children with overweight, including obesity, as in the application of the WHO Growth Reference the obesity prevalence is significantly higher: 30.3% of overweight, including 12.7% obesity, vs. 23.4 % of overweight, including 8.4% of obesity in applying the cut-offs of the IOTF. In boys obesity has a higher prevalence than in girls, as gender differences increase with age. High value of waist circumference (> 90P), an indicator of abdominal obesity, was observed in 9.3% of children. There were no sex and age differences. A high proportion of children with a waist circumference> 90P was observed in those with established obesity (71.2% when using the cut-offs of the IOTF, vs. 55.9% in applying the WHO Growth Reference), which significantly increases the risk of metabolic syndrome. The rate of high waist circumference is also significant in children with overweight (IOTF - 17.9%, vs. WHO - 9.7%), as it occurs in those with a BMI in the normal range (0.6-1.7%). Conclusion: In Bulgaria it has been established a double burden of risk from diseases in school- children, aged 7-18 years, related to the presence of a high prevalence both of overweight and obesity and a high rate of thinness in some age groups.
Authors and Affiliations
Stefka Petrova, Lalka Rangelova, Veselka Duleva, Maya Konstantinova, Plamen Dimitrov, Daniela Bozhilova
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