Overweight and obesity of school-age children in El Salvador according to two international systems: a population-based multilevel and spatial analysis
Abstract Background The World Health Organization (WHO-2007) and the International Obesity Task Force (IOTF-Cole) systems assess child weight status. However, derived estimations often differ. We aimed to a) compare the prevalence of overweight and obesity, b) analyze individual and contextual facto...
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BMC
2020-05-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-020-08747-w |
| _version_ | 1828428408356339712 |
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| author | Wilton Pérez Paul Melgar Ana Garcés Ana Daysi de Marquez Gerardo Merino Carolina Siu |
| author_facet | Wilton Pérez Paul Melgar Ana Garcés Ana Daysi de Marquez Gerardo Merino Carolina Siu |
| author_sort | Wilton Pérez |
| collection | DOAJ |
| description | Abstract Background The World Health Organization (WHO-2007) and the International Obesity Task Force (IOTF-Cole) systems assess child weight status. However, derived estimations often differ. We aimed to a) compare the prevalence of overweight and obesity, b) analyze individual and contextual factors associated with child weight using multilevel analysis and c) explore the spatial distribution of overweight and obesity using both classification systems. Methods We used data from the 2015/2016 National School Height and Weight Census in El Salvador. Information on 111,991 children aged 6.0–9.9 years attending the first grade was analyzed. Body mass index Z-score (BMIZ), overweight and obesity were defined with both classification systems. Weighted kappa was used to measure agreement. Child, school and municipal potential determinants of BMIZ were examined by multilevel analysis. Municipal spatial clustering of overweight and obesity was tested using Moran’s Index and Getis-ord Gi* statistics. Results The combined prevalence of overweight and obesity was higher according to the WHO system than the IOTF (30.4% vs 23.1%). The weighted kappa was 0.83. Boys, children attending urban schools, children attending private schools, and children residing in municipalities with high human development index had higher BMIZ than their counterparts. The Moran’s indexes were positives and significant. Clusters of high prevalence (above the national prevalence) of overweight and obesity were found in 29 municipalities using the WHO and IOTF systems. For obesity, 28 and 23 municipalities in clusters of high prevalence were detected using the WHO and IOTF criteria, respectively. Conclusions Overweight and obesity is high among school-age children in El Salvador. The prevalence of overweight and obesity was higher when using the WHO system, as compared to the IOTF system. Irrespective of the classification system, the multilevel and spatial analysis derived similar interpretations. These results support the need for national preventive interventions with targeting strategies to reduce overweight and obesity in school-age children. |
| first_indexed | 2024-12-10T17:17:12Z |
| format | Article |
| id | doaj.art-ebfd40e26c8f48bebc70c11110330136 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-10T17:17:12Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-ebfd40e26c8f48bebc70c111103301362022-12-22T01:40:06ZengBMCBMC Public Health1471-24582020-05-0120111110.1186/s12889-020-08747-wOverweight and obesity of school-age children in El Salvador according to two international systems: a population-based multilevel and spatial analysisWilton Pérez0Paul Melgar1Ana Garcés2Ana Daysi de Marquez3Gerardo Merino4Carolina Siu5Institute of Nutrition of Central America and Panama-INCAPInstitute of Nutrition of Central America and Panama-INCAPInstitute of Nutrition of Central America and Panama-INCAPConsejo Nacional de Seguridad Alimentaria y Nutricional-CONASANInstitute of Nutrition of Central America and Panama-INCAPInstitute of Nutrition of Central America and Panama-INCAPAbstract Background The World Health Organization (WHO-2007) and the International Obesity Task Force (IOTF-Cole) systems assess child weight status. However, derived estimations often differ. We aimed to a) compare the prevalence of overweight and obesity, b) analyze individual and contextual factors associated with child weight using multilevel analysis and c) explore the spatial distribution of overweight and obesity using both classification systems. Methods We used data from the 2015/2016 National School Height and Weight Census in El Salvador. Information on 111,991 children aged 6.0–9.9 years attending the first grade was analyzed. Body mass index Z-score (BMIZ), overweight and obesity were defined with both classification systems. Weighted kappa was used to measure agreement. Child, school and municipal potential determinants of BMIZ were examined by multilevel analysis. Municipal spatial clustering of overweight and obesity was tested using Moran’s Index and Getis-ord Gi* statistics. Results The combined prevalence of overweight and obesity was higher according to the WHO system than the IOTF (30.4% vs 23.1%). The weighted kappa was 0.83. Boys, children attending urban schools, children attending private schools, and children residing in municipalities with high human development index had higher BMIZ than their counterparts. The Moran’s indexes were positives and significant. Clusters of high prevalence (above the national prevalence) of overweight and obesity were found in 29 municipalities using the WHO and IOTF systems. For obesity, 28 and 23 municipalities in clusters of high prevalence were detected using the WHO and IOTF criteria, respectively. Conclusions Overweight and obesity is high among school-age children in El Salvador. The prevalence of overweight and obesity was higher when using the WHO system, as compared to the IOTF system. Irrespective of the classification system, the multilevel and spatial analysis derived similar interpretations. These results support the need for national preventive interventions with targeting strategies to reduce overweight and obesity in school-age children.http://link.springer.com/article/10.1186/s12889-020-08747-wEl SalvadorIOTF-ColeMultilevelObesityOverweightSchool-aged |
| spellingShingle | Wilton Pérez Paul Melgar Ana Garcés Ana Daysi de Marquez Gerardo Merino Carolina Siu Overweight and obesity of school-age children in El Salvador according to two international systems: a population-based multilevel and spatial analysis BMC Public Health El Salvador IOTF-Cole Multilevel Obesity Overweight School-aged |
| title | Overweight and obesity of school-age children in El Salvador according to two international systems: a population-based multilevel and spatial analysis |
| title_full | Overweight and obesity of school-age children in El Salvador according to two international systems: a population-based multilevel and spatial analysis |
| title_fullStr | Overweight and obesity of school-age children in El Salvador according to two international systems: a population-based multilevel and spatial analysis |
| title_full_unstemmed | Overweight and obesity of school-age children in El Salvador according to two international systems: a population-based multilevel and spatial analysis |
| title_short | Overweight and obesity of school-age children in El Salvador according to two international systems: a population-based multilevel and spatial analysis |
| title_sort | overweight and obesity of school age children in el salvador according to two international systems a population based multilevel and spatial analysis |
| topic | El Salvador IOTF-Cole Multilevel Obesity Overweight School-aged |
| url | http://link.springer.com/article/10.1186/s12889-020-08747-w |
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