The influence of ethnicity, socioeconomic status and obesity intervention on body composition in UK children and adolescents

Radia, Dimple (2010) The influence of ethnicity, socioeconomic status and obesity intervention on body composition in UK children and adolescents. Doctoral thesis, London Metropolitan University.


The prevalence of childhood overweight and obesity has increased over the last twenty years. Additionally, obesity and its related morbidities are not equally distributed across the UK population with it varying between sexes, age groups, socioeconomic groups and ethnic groups.
This thesis is comprised of four studies investigating body composition and its assessment in children. The first study examined body dimensions and fatness in two groups of children from contrasting income backgrounds. Findings showed that children from the 'lower income’ were on average (for their age) shorter in height, heavier in weight with a higher BMI and %BF although abdominal fatness was similar between income groups. Thus it was concluded that in addition to greater body weight-for-age, shorter height is a second (and likely a more significant) contributor to the greater BMI, BMI z-score and overweight/obesity prevalence in lower income children. This observation of shorter height was considered to support the hypothesis of height growth limitation among children from low-income groups. The second study examined changes in a range of measures of body composition and body fat distribution and evaluated these measures in a paediatric weight management context.
This study showed that the BMI was not able to accurately reflect the underlying body compositional changes resulting from the intervention in growing obese children. In view of this limitation, it was proposed that more objective measures of body fatness such as Bioelectrical Impedance Analysis (BIA) and more sensitive measures of body fat distribution such as waist circumference be introduced as alternative methods or adjuncts to BMI The third study examined ethnicity-related variation in whole body and regional body fatness in children from Caucasian, South-Asian, African-Caribbean and Mixed Race backgrounds.
This study supports the findings of others, which observed gender-specific variations in body dimensions and composition in children across different ethnic groups. However, it was evident that exploring ethnicity-related variation in body composition is a complex issue compounded by a relatively large number of measures available to characterize body composition. Furthermore, the limitations of exploring variations in this context using the BMI were also described.
The final study generated gender- and ethnic-specific smoothed percentile curves for anthropometric measurements of body composition including waist circumference and BMI and BIA-derived variables including % Body Fat, whole body impedance and Height2/lmpedance. The curves generated showed that children across the ethnic groups varied in their age-related pattern in the direct and indirect indices of body composition.
Despite having limited practical utility at this stage, these findings provide preliminary evidence in support of further investigation into the development of ethnic-specific references in measures of body fatness.
The overall findings in this thesis indicate that overweight and obesity varies across different population groups and this variation needs to be considered in the context of national obesity policy formulation and implementation.

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