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The prevalence of obesity is increasing markedly both in UK adults and children. Risks of obesity and its consequences (particularly type 2 diabetes) are particularly marked among South Asians. Earlier studies have suggested that adiposity patterns in Asian populations differ from those in Europeans, making standard weight-for-height measures misleading. However, few studies have made detailed assessments of adiposity and obesity among UK South Asian and white European children.
To examine ethnic differences in adiposity/obesity patterns and their inter-relations in UK children of South Asian and white European origin.
Design and Methods
Cross-sectional survey of children (Child Heart and Health Study in England (CHASE)) recruited from a sample of 200 Primary schools with high prevalences of children of South Asian origin in London, Birmingham and Leicester. Standardised measurements of anthropometry (weight, height, waist circumference, multiple skinfolds) and of body fat % by bioelectrical impedance were made. Ethnic origin was defined primarily by parental self-report. Statistical analyses were adjusted for age and gender and included a random effect to allow for clustering within schools. All body size measurements were log transformed with the exception of body fat %. Obesity cut-offs were defined using International Obesity Task Force guidelines.
5759 children aged 9–10 years, of whom 1490 were of white European and 1543 were of South Asian origin (overall response rate 68%).
South Asian children were lighter (% difference −2.7, 95% CI −4.3 to −1.0), had a lower body mass index (% difference −2.2, 95% CI −3.5 to −0.9) and a lower waist circumference (% difference −1.5, 95% CI −2.5 to −0.5) than white Europeans; there was no appreciable difference in height. However, South Asian children had a higher body fat % (mean difference 1.7, 95% CI 1.0 to 2.4) and a higher combined skinfold thickness (% difference 5.1, 95% CI 1.4 to 9.0). For a given BMI, mean body fat % among South Asians was 2.3% (95% CI 2.0% to 2.7%) higher; this difference varied only slightly by gender and ethnic subcategory. The unadjusted prevalence of obesity based on body mass index was 0.1% lower among South Asians than white Europeans, but when based on body fat % was 9% higher.
Patterns of adiposity/obesity differ between UK children of South Asian and white European origin and may have adverse long-term health consequences. However, the differences are not well represented by simple measures based on weight and height alone.