ESPE Abstracts (2016) 86 P-P1-464

Central Obesity among European Preschool Children: The ToyBox-Study

Sonya Galchevaa, Mina Latevaa, Violeta Iotovaa, Odysseas Androutsosb, Yannis Maniosb, Ilse De Bourdeaudhuijc, Greet Cardonc, Piotr Sochad, Luis Morenoe, Berthold Koletzkof & on behalf of ToyBox-Study Groupb


aMedical University of Varna, Varna, Bulgaria; bHarokopio University, Athens, Greece; cGhent University, Ghent, Belgium; dChildren’s Memorial Health Institute, Warsaw, Poland; eUniversity of Zaragoza, Zaragoza, Spain; fLudwig Maximilians Universitaet Muenchen, Munich, Germany


Background: Waist circumference (WC) reflects the fat distribution and the degree of central adiposity in children, which is specifically associated with cardiovascular risk factors and useful as a component of metabolic syndrome definition in children.

Objective and hypotheses: To evaluate the distribution of WC measures among preschool children aged 3.5–5.5 years from six European countries.

Method: Cross-sectional study of a representative sample of 7527 children from six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain) (52.0% boys), aged 3.5–5.5 years (2012). Body weight, height and WC were measured using standard procedures and BMI and waist-to-height ratio (WHtR) were calculated. The overweight/obesity prevalence for each age group both for boys and girls was estimated using IOTF reference. Percentile values were defined for each age group within sex. A standardized questionnaire was used to collect information on SES and demographic data.

Results: Mean WC was 52.2±4.1 cm, significantly increasing with age as its mean values were higher in males compared to females (52.4±3.9 vs 52.0±4.2 cm, P<0.001). Greek and Spanish children had the highest WC measures, while the lowest values were found among Bulgarian preschoolers (P<0.001). Children from the lowest SES group had significantly higher WC and WHtR values compared to those with highest SES (52.7±4.1 cm and 0.484±0.034 vs 51.8±4.0 cm and 0.477±0.033, respectively, P<0.001). Abdominal obesity with WHtR above 0.5 was found in 23.6% (21.7% boys vs 25.7% girls, P<0.001). The 90th percentile value for WC was higher in girls compared to boys (57.4 vs 57.1 cm). The prevalence of overall overweight/obesity was 14.4%, with 16.3% in the low SES group vs 12.9% for the high SES.

Conclusion: The ToyBox study adds data to our knowledge on abdominal obesity among preschoolers in Europe, highlighting the need to identify new strategies to decrease it.