F&N Bulletin Vol 23 No 1b - United Nations University

More documents

Recommendations

Info

28 tion in public schools, at the same time as nutrition education and physical activity programs to prevent increasing obesity in private schools are apparently called for. The study also showed a decreasing Z score in height-for-age and weight-for-age with age from 8 to 10 years in both public and private schools. This trend was also reflected in the increasing prevalence of stunting and underweight with age from 8 to 10 years, particularly in public schools. If this trend is real, it may have important programmatic implications. However, it may reflect, at least in part, the start of puberty and the influence of ethnicity affecting the significance of the differences from NCHS standards. As Flegal [9] pointed out, no valid comparisons in prevalence among age and sex groups may be made using statistical approaches in defining nutritional status, because variability among these groups may be constrained by the assumptions built into the cutoffs used. Thus, in contrast to public schoolchildren where thinness (BMI less than the 5th percentile) increased with age, thinness generally decreased with age among private schoolchildren. There is a need either to examine the reference standards for use in Filipino preadolescent and adolescent children or to validate the cutoff points used. Private schoolchildren had a greater relative change in height and weight Z scores from 8 to 10 years of age than public schoolchildren, resulting in a larger increase in BMI with age. The increase in BMI with age has also been noted among American children [8]. However, the increase should be interpreted with caution because of limitations of BMI as a measure of nutritional status in older schoolchildren due to changing body composition and degree of maturity with age and the influence of ethnicity. There was an increasing prevalence of underweight and stunting with age from 8 to 10 years, but a generally decreasing prevalence of overweight, in spite of the generally increasing BMI. However, further study is needed to determine whether these trends and differences are real and not due to reference standards and cutoff points. In order to compare weight-for-height index with BMI in assessing wasting/thinness and overweight, the same group of children was analyzed using both the WHO indices [6] and those of Troiano et al. [7]. Children whose heights exceeded the limits of the NCHS/WHO weight-for-height table were excluded from the analysis. The results are shown in table 3 and figure 2. For both sexes combined, the prevalence of thinness, as defined by BMI less than the 5th percentile, was three times higher than that of wasting, as defined by weight-for-height < –2 SD in both public and private schoolchildren. Although this may be explained by the cutoffs used, perhaps the significance of thinness, as defined by BMI, is different from that of 30 25 20 % 15 10 5 0 Public schoolchildren Wasting Thinness Overweight At risk of overweight Overweight FIG. 2. Comparison of under- and overnutrition among schoolchildren according to type of school using weight-forheight Z score and BMI-for-age wasting, as defined by weight-for-height. Using the cutoff of BMI above the 85th percentile to define “at risk of overweight,” as suggested by WHO [6], gives a prevalence of overweight from one to three times as high as that obtained using weight-for-height Z scores. On the other hand, the prevalence of overweight, as defined by BMI at or above the 95th percentile, was in close agreement with that defined by weight-for-age Z scores. From our data it appears that the BMI range from at or above the 85th percentile to less than the 95th percentile could better define “risk of overweight” than the whole range of BMI at or above the 85th percentile, as recommended by WHO [6], whereas BMI at or above the 95th percentile could define “overweight,” as suggested by Troiano et al. [7]. Although it is generally agreed that BMI-for-age provides the better criterion for evaluating thinness and overweight, because it is a continuous indicator that can be calculated from childhood to adulthood, there is a need for a clearer definition of under- and overnutrition when using anthropometric cutoff points in various indices. In addition, there is a need for more complete reference standards, including greater heights in weight-for-height reference tables and younger ages in BMI-for-age tables. Acknowledgments Weight-for-height Private schoolchildren Wasting Thinness Overweight At risk of overweight Overweight This study was supported by the International Life Sciences Institute Southeast Asia (ILSI SEA) in Singapore, with supplemental funding from the Food and Nutrition Research Institute (FNRI), Department of Science and Technology, Philippines. We thank the staff of the Nutritional Monitoring BMI R. F. Florentino et al.
Nutritional status of urban primary schoolchildren. 1 29 TABLE 3. Comparison of prevalence of under- and overnutrition among schoolchildren according to age, sex, and type of school using weight-for-height Z scores and BMI-for-age Sex and At risk for age (yr) School n Stunting a Underweight b Thinness c overweight d Overweight e Male 8 Public 101 5.9 12.9 7.0 9.9 6.9 Private 89 4.4 7.9 16.9 31.4 15.7 9 Public 105 11.5 22.9 5.8 5.8 4.8 Private 92 2.2 8.7 14.1 20.6 14.1 10 Public 110 5.5 27.3 1.8 1.8 0.9 Private 86 1.2 5.8 16.4 27.9 10.5 Female 8 Public 104 1.9 14.4 2.0 5.8 2.9 Private 78 1.3 5.1 9.0 23.0 11.5 9 Public 98 3.1 18.4 0.0 3.1 0.0 Private 76 5.3 14.5 9.2 22.4 7.9 10 Public 90 2.2 22.2 2.2 3.3 1.1 Private 57 1.8 12.3 15.8 15.8 8.8 All Public 608 5.1 19.7 3.2 4.9 2.8 Private 478 2.7 8.8 13.7 24.0 11.7 a. Weight-for-height < –2 SD NCHS [7]. b. BMI < 5th percentile, Must et al. [5] BMI table. c. Weight-for-height ≥ 2 SD NCHS [7]. d. BMI ≥ 85th percentile, Must et al. [5] BMI table. e. BMI ≥ 95th percentile, Must et al. [5] BMI table. and Assessment Division of FNRI for conducting the interviews and anthropometric measurements for the study, and helping in the various tasks involved. We acknowledge the support and cooperation of the officials of the FNRI, the Regional and Division Offices of the Department of Education, Culture, and Sports, and the officials and teachers in the participating schools. We are particularly grateful to all the students and their parents who served as subjects for this study. We also thank Dr. Frederick L. Trowbridge of the ILSI Research Foundation and Dr. James O. Hill of the Center of Human Nutrition, University of Colorado, for their very valuable comments in the interpretation of results; Ms. Yeong Boon Yee of ILSI SEA for ably coordinating this multicountry project; and the study leaders in the other participating countries, Dr. Tee E-Siong, Institute of Medical Research, Malaysia, and Professor Soekirman, Bogor Agriculture University, Indonesia, for their valuable comments in the interpretation of results. References 1. Florentino RF, Villavieja GM, Molano WL, Laña RD, Cerdeña CM, Boquecosa JP, Constantino AS, Chavez MC, Abaya HSP, Raymundo BF, Nones CA. 1989–90 Regional updating of nutritional status of Filipino Children. Manila: Food and Nutrition Research Institute (FNRI), Department of Science and Technology (DOST), July 1990. 2. Villavieja GM, Laña RD, Cerdeña CM. Updating of nutritional status of Filipino children at the provincial level: Philippines 1998. Manila: FNRI, DOST, November 1999. 3. Florentino RF, Santos-Ocampo PD, Magbitang JA, Mendoza TS, Flores EG, Madrid BJ. FNRI-PPS anthropometric tables and charts for Filipino children. Manila: FNRI, DOST, 1992. 4. Jelliffe DB. The assessment of nutritional status of the community. Monograph Series No. 53. Geneva: WHO, 1966. 5. Must A, Dallal GE, Dietz WH. Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht 2 ) and triceps skinfold thickness. Am J Clin Nutr 1991;53:839–46. 6. WHO Expert Committee. Physical status: the use and interpretation of anthropometry. WHO Technical Report Series 854. Geneva: World Health Organization, 1995. 7. Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM, Johnson CL. Overweight prevalence and trends for children and adolescents: the National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adolesc Med 1995;149:1085–91.
Page 1 and 2: Contents Review articles Nuclear an
Page 3 and 4: Special Article Nuclear and isotopi
Page 5 and 6: Nuclear and isotopic techniques 5 T
Page 7 and 8: Nuclear and isotopic techniques 7 T
Page 9 and 10: Nuclear and isotopic techniques the
Page 11 and 12: Palm oil: A healthful and cost-effe
Page 13 and 14: Palm oil will be less absorbed and
Page 15 and 16: Palm oil oil at the present time is
Page 17 and 18: Palm oil crystal forms for the requ
Page 19 and 20: Palm oil myristic acid (14:0) is hi
Page 21 and 22: Palm oil 13. Kritchevsky D. Influen
Page 23 and 24: Introduction to three regional stud
Page 25 and 26: Nutritional status of urban primary
Page 27: Nutritional status of urban primary
Page 31 and 32: Regional study of nutritional statu
Page 41 and 42: Regional study of nutritional statu
Page 49 and 50: Street food vendors their consumers
Page 51 and 52: Street food vendors whereas roasted
Page 53 and 54: Street food vendors Reardon [28] co
Page 55 and 56: Street food vendors so that bad pre
Page 57 and 58: Iron and energy supplementation imp
Page 59 and 60: Iron and energy supplementation the
Page 61 and 62: Iron and energy supplementation The
Page 63 and 64: Iron and energy supplementation 63
Page 65 and 66: Toward better compliance with iron-
Page 73 and 74: Development and validation of a sho
Page 79 and 80:
Development and validation of a sho
Page 81 and 82:
Development and validation of a sho
Page 83 and 84:
Factors associated with successful
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Difference in goiter rates between
Page 91 and 92:
Difference in goiter rates Methods
Page 93 and 94:
Difference in goiter rates iodized
Page 95 and 96:
Iron-deficiency anemia in young wor
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Discussion paper What care practice
Page 109 and 110:
Letter to the Editor 109 iodized sa
Page 111 and 112:
News and notes 2001 World Food Priz
Page 113 and 114:
UNU Food and Nutrition Programme NU
Page 115:
Note for contributors The editors o
show all

F&N Bulletin Vol 23 No 1b - United Nations University

Create successful ePaper yourself

Delete template?

Save as template?