[Association between adiposity, inflammation and cardiovascular risk factors in school-aged Mexican children]. / Asociación entre adiposidad, inflamación y factores de riesgo cardiovascular en un grupo de escolares mexicanos.

OBJECTIVE: To evaluate the differences in inflammation markers and cardiovascular risk factors in a group of school-aged children with and without excessive adiposity. To examine the relationship between adiposity, inflammation, and cardiovascular risk factors. METHODS: Cross-sectional study of 285 school children (8-12 years old). Adiposity (body mass index, BMI, total body fat, TBF, and waist circumference), inflammatory markers (C-reactive protein [CRP], interleukin 1ß [IL-1ß], interleukin 6 [IL-6], and tumor necrosis factor-a [TNF-α]) and cardiovascular risk factors were analyzed. Mean differences were calculated and multiple regression models were made. RESULTS: Obese children had higher concentrations of CRP and IL-1ß; children with abdominal obesity also had higher CRP levels. A higher BMI was associated with higher blood pressure, and higher total cholesterol, triglycerides-TAG, and insulin concentrations, and with lower HDL-cholesterol. The CRP and IL-1ß concentrations correlated significantly with the three adiposity indices. The IL-6 concentrations were associated with TAG, and IL-1ß with HDL-cholesterol concentration, after adjustment by BMI. DISCUSSION: In a group of school-aged Mexican children, obesity increases cardiovascular risk and inflammation. Both IL-6 and IL-1ß appear to be factors involved in lipid alterations in these children. More research is needed in order to explore the role of subclinical inflammation in the development of cardiovascular alterations that have already been described in Mexican children with obesity.

The effect of exercise on cardiovascular risk markers in Mexican school-aged children: comparison between two structured group routines.

OBJECTIVE: To assess the effects of two groups of exercise routines on cardiovascular disease risk markers. MATERIAL AND METHODS: An intervention study was conducted with 319 Mexican school-aged children in which routines were implemented Monday through Friday for 12 weeks. Routine A was the reference group, with 20 min of less intense activity and routine B was the new group with 40 min of aerobic exercises. Body mass index (BMI), waist circumference, fat mass percentage (FM%), systolic and diastolic blood pressure, lipids, lipoproteins, glucose and insulin were measured before and after the intervention. RESULTS: Routine A had an effect on diastolic pressure, while routine B had an effect on BMI, FM%, blood pressure and triglycerides. Routine B had a greater effect on blood pressure than routine A. The prevalence of obesity, high blood pressure and hypertriglyceridemia decreased in both groups. CONCLUSION: Aerobic exercise is an effective health promotion strategy to reduce some cardiovascular disease risk markers.

[Validation of body composition estimation equations by bioelectric impedance in postmenopausic women with metabolic syndrome]. / Validación del uso de ecuaciones para estimar la composición corporal por análisis de impedancia bioeléctrica en mujeres postmenopáusicas con síndrome metabólico.

INTRODUCTION: Postmenopausal women have excess adiposity due to the lack of estrogens, which is related with an increase in the prevalence of metabolic syndrome (MS) risk factors. Few equations have been developed to measure body fat mass (FM) by bioelectric impedance (BIA) for Mexican women and none of the existing equations have been evaluated in Mexican postmenopausal women with MS. MATERIAL AND METHODS: We describe the association and agreement between two different BIA equations: NHANES III and Macias, et al. to estimate FM in 86 women (42-72 years old). Anthropometric and body composition measurements (BIA) were done in all women; FM was measured by densitometry (DXA). Mean differences by age group (< 55 years old and > or = 55 years old) (Student t test), correlations, simple linear regression models and agreement analysis (Bland-Altman method) were done. RESULTS: The two equations showed underestimation of % FM compared to DXA. The equation that presents the greatest correlation and agreement with the gold standard is the NHANES equation, in both age groups. CONCLUSIONS: The NHANES equation is valid to estimate FM in Mexican postmenopausal women with MS. We recommend the use of this equation in the clinical practice.

[Adherence to a medical nutrition therapy program in pregnant women with diabetes, measured by three methods, and its association with glycemic control]. / Tres métodos para medir la adherencia a un programa de terapia médica y nutricia en mujeres embarazadas con diabetes y su asociación con el control glucémico.

INTRODUCTION: The measurement of adherence to nutrition therapy is essential to evaluate if the outcomes are related to given recommendations. MATERIAL AND METHODS: The aim of this study was to describe adherence to a Medical Nutrition Therapy Program in Mexican pregnant women with diabetes, using three different methods; and evaluate its association with glycemic control. Adherence was measured with a questionnaire (0-100%), women's self-perception (0-100%) and energy intake adequacy by multiple pass 24 hour recall (85-115% of recommendation). Women were randomly assigned to two different dietary strategies. Glycemic control was determined by capillary glucose self-monitoring. RESULTS: Women analyzed in this study (n=69) had an age range of 22-42 years; 47.8% had type 2 diabetes (DM2) and 52.2% had gestational diabetes (GDM). Energy intake adequacy was higher in women with GDM (41.9% vs. 37.7%, p = 0.001). Average adherence measured with the questionnaire was 55%; no differences were found by type of diabetes. Self-perception was higher in women with DM2 (84%) when compared to women with GDM (70%) (p = 0.039). No differences were found in the three methods by study group. Optimal glycemic control was observed in 50% of women; no association was found with adherence measured with any of the three methods studied. CONCLUSIONS: The observed differences in adherences suggest that it may be recommendable to combine different measurement methods and include social and psychological factors that affect behavioral change.

[A program to improve some cardiovascular risk factors in Mexican school age children]. / Programa para mejorar marcadores de riesgo cardiovascular en escolares mexicanos.

OBJECTIVE: To assess the effect of a physical activity intervention on cardiovascular risk factors in Mexican school-age children. MATERIAL AND METHODS: Children from two public schools in Queretaro (n=360, 8-14 years old) performed a 20-minute physical activity routine every school day during 16 weeks (February-May 2006). Anthropometric, blood pressure and biochemical assessment was done before and after implementation. RESULTS: Systolic blood pressure, triglyceride and total cholesterol levels decreased significantly. The decrease in lipid and lipoprotein levels was higher in children with high baseline levels. In high-risk girls, the cardiovascular risk cluster score decreased significantly. No change in BMI, waist circumference, or insulin was observed. CONCLUSION: A simple physical activity program modified several cardiovascular risk markers in school-age children. These results may be taken as a reference to develop better intervention programs directed toward preventing the effects of children obesity.

[Validation of resting metabolic rate estimation equations in 9- to 12- year-old Mexican children with and without obesity]. / Validación del uso de fórmulas para estimar el gasto energético en reposo en niños mexicanos de 9 a 12 años de edad con y sin obesidad.

INTRODUCTION: Childhood obesity is a public health problem that has increased in the last years. The measurement of resting metabolic rate (RMR) is an important tool to establish any obesity intervention. Existing equations to estimate RMR have not been evaluated in Mexican children. MATERIAL AND METHODS: We describe the association and the agreement between the WHO, Schofield, Harris-Benedict and the Tverskaya equations to estimate the RMR in 114 students (9-12 years old) with normal weight and obesity, of two public schools in Mexico. RMR was measured by indirect calorimetry, in addition, we did an anthropometric and body composition evaluation (electrical bioimpedance method). RESULTS: The fat free mass was the variable that predicted the most variability in RMR. The WHO equation showed no significant difference in the RMR (calorimetry), while the Schofield, Harris-Benedict and the Tverskaya equations showed underestimation. The equation that presents the greatest agreement with the gold standard is the Tvershaya equation in both children with normal weight and obesity. CONCLUSIONS: The non concordant results in the RMR are explained by the differences in body composition. An equation that considers fat mass and fat free mass, as the one proposed by Tverskaya, seems to be the most appropriate equation to be used in clinical settings.

Obesity increases metabolic syndrome risk factors in school-aged children from an urban school in Mexico city.

OBJECTIVE: To characterize the nutritional status of school-aged children from an urban public school in Mexico City, Mexico, and to assess the influence of obesity on health status in a subgroup of these children. DESIGN: Cross-sectional descriptive study. A nutrition screening was done for all children, including anthropometric (ie, weight, height, and waist circumference) and blood pressure assessment. In the subgroup of children, complementary dietary and biochemical assessment (ie, glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, insulin, albumin, hemoglobin, and hematocrit levels) was done. SUBJECTS: Children from an urban school in Mexico City (N=561) aged 6 to 13 years. The representative subgroup (n=88) was selected based on age (9 to 12 years) and weight status (ie, normal, overweight, or obese). STATISTICAL ANALYSIS: Descriptive statistics, correlations, mean differences tests (analysis of variance, Kruskal-Wallis and Mann-Whitney U), and chi(2) tests (categorical variables) were done with SPSS version 13 (2005, SPSS Inc, Chicago, IL). RESULTS: In the whole school, overweight and obesity prevalence were 27.1% and 21.4%, respectively. High systolic blood pressure was seen in 8.4% of children and 6.2% of children had prehypertension. Higher hypertension risk was seen in children with body mass index > or =95th percentile and waist circumference > or =90th percentile (88 cm). Significantly higher waist circumference, systolic blood pressure, insulin resistance indexes, and triglyceride levels were found among the obese when compared with normal-weight children. CONCLUSIONS: Childhood obesity prevalence is high in Mexico and it is having an influence on children's health. It is urgent to design, implement, and evaluate specific childhood obesity prevention programs.

[Nutritional evaluation in Mexican postmenopausal women with metabolic syndrome]. / Evaluación nutricional en mujeres mexicanas posmenopáusicas con síndrome metabólico.

BACKGROUND: The posmenopausal women has higher cardiovascular risks, since their concentrations of glucose, insulin, total cholesterol, LDL cholesterol, triacilglycerides and lipoproteins are bigger, while their HDL-cholesterol decreases; this factors increases the risk of suffering metabolic syndrome. OBJECTIVE: To describe the nutritional status and cardiovascular risk of Mexican posmenopausal women with metabolic syndrome. METHODS: In a cross-sectional study, we assessed the nutritional status and cardiovascular risk factors of Mexican women (n = 93) with overweight or obesity and metabolic syndrome. RESULTS: The three most frequent met criteria for metabolic syndrome were abdominal obesity, hypertriglyceridemia and low HDL-cholesterol levels. Without considering abdominal obesity, the most common alterations during initial assessment were high LDL cholesterol levels, low HDL cholesterol levels and hypertriglyceridemia. Women with a body mass index up to 35 did not appear to have higher values than overweight and obese grade I women. We did not find differences in metabolic variables among older women or in those using hormone therapy. A high carbohydrate and saturated fat intake was observed, as well as high fat dairy and frequent non healthy cooking methods. On the other hand, intake of fruits, vegetables, and high fiber carbohydrates was low. Average physical activity was reported to be only 30 minutes a week. CONCLUSIONS: The observed dietary pattern in these women, and their inactivity level could be exacerbating their cardiovascular risk factors. The promotion of a cardioprotective dietary pattern in these women is essential and urgent.

Dietary changes associated with improvement of metabolic syndrome components in postmenopausal women receiving two different nutrition interventions.

OBJECTIVE: This study aims to examine the association between dietary changes and improvement of metabolic syndrome components in Mexican postmenopausal women receiving two different nutrition interventions. METHODS: Women (n = 118) with metabolic syndrome were randomly assigned to group 1 (n = 63; structured hypocaloric diet) or group 2 (n = 55; behavioral therapy). Metabolic and nutrition assessment was performed at baseline and after 2, 4, and 6 months of intervention. Dietary changes throughout the study and achievement of cardioprotective dietary goals were assessed at the end of the intervention. RESULTS: There was a significant increase in the number of women who met recommended servings for fruits/vegetables, low-fat dairy, and sugars in both groups. In group 1, elimination of high-energy refined grains increased the probability of having normal fasting glucose (relative risk, 1.514; 95% CI, 0.989-2.316; P = 0.035). In this group, women who met the low-fat dairy goal at the end of the study had lower diastolic blood pressure (P = 0.012) and higher high-density lipoprotein cholesterol (P = 0.001). In group 2, women who met the high-fat dairy goal had greater probability of having normal fasting glucose (relative risk, 1.915; 95% CI, 1.123-3.266; P = 0.026). In all women, exclusion of high-fat dairy decreased by 60% the probability of having impaired fasting glucose (relative risk, 0.40; 95% CI, 0.181-0.906; P = 0.028). CONCLUSIONS: Both strategies promote achievement of cardioprotective dietary goals for fruits/vegetables, sugars, soda and sweetened beverages, low-fat dairy, and high-energy refined grains, and improve some metabolic syndrome components. Elimination of high-fat dairy decreases the risk of impaired fasting glucose. Dietary strategies should be flexible and individualized based on metabolic profile.

Structured hypocaloric diet is more effective than behavioral therapy in reducing metabolic syndrome in Mexican postmenopausal women: a randomized controlled trial.

OBJECTIVE: This study aims to compare the effects of a lifestyle intervention using a behavioral therapy (BT) approach with the effects of a cardioprotective structured hypocaloric diet on metabolic syndrome in Mexican postmenopausal women. METHODS: This study is a randomized clinical trial (2006-2009) of Mexican postmenopausal women with metabolic syndrome (Adult Treatment Panel III criteria) who were recruited from the Postmenopause Clinic of the National Institute of Perinatology in Mexico City. Women were assigned to one of two groups--group 1 (structured hypocaloric diet; n = 63): energy restriction (-300 to -500 kcal/d) emphasizing cardioprotective dietary changes; and group 2 (BT; n = 55): goal setting, problem-solving, and stimulus control to achieve cardioprotective dietary and lifestyle recommendations. Metabolic syndrome prevalence, as well as weight, waist circumference, fat mass, and fasting biochemical markers (glucose and lipid profile), were measured at baseline and at 2, 4, and 6 months after the intervention. Metabolic syndrome risk (relative risk and absolute risk reduction), mean differences between groups, and logistic regression were evaluated using Statistical Package for the Social Sciences software, version 17.0. RESULTS: A total of 118 women were studied (mean [SD] age, 53.81 [6.43] y). No baseline differences were observed between groups. At the end of the study, a higher reduction in metabolic syndrome prevalence was observed in group 1 (-38.1%) compared with group 2 (-12.7%; relative risk, 0.237; 95% CI, 0.092-0.608; P = 0.003). The effect was maintained even when adjusted by age, hormone therapy and antihypertensive drug use. CONCLUSIONS: A cardioprotective structured hypocaloric diet is more effective than the BT approach in reducing metabolic syndrome after 6 months of intervention. Both strategies have positive effects on different individual cardiovascular risk factors.

Low Glycemic Index Carbohydrates versus All Types of Carbohydrates for Treating Diabetes in Pregnancy: A Randomized Clinical Trial to Evaluate the Effect of Glycemic Control.

Background. Due to the higher prevalence of obesity and diabetes mellitus (DM), more pregnant women complicated with diabetes are in need of clinical care. Purpose. Compare the effect of including only low glycemic index (GI) carbohydrates (CHO) against all types of CHO on maternal glycemic control and on the maternal and newborn's nutritional status of women with type 2 DM and gestational diabetes mellitus (GDM). Methods. Women (n = 107, ≤29 weeks of gestation) were randomly assigned to one of two nutrition intervention groups: moderate energy and CHO restriction (Group 1: all types of CHO, Group 2: low GI foods). Results. No baseline differences in clinical data were observed. Capillary glucose concentrations throughout pregnancy were similar between groups. Fewer women in Group 2 exceeded weight gain recommendations. Higher risk of prematurity was observed in women in Group 2. No differences in glycemic control were observed between women with type 2 DM and those with GDM. Conclusions. Inclusion of low GI CHO as part of a comprehensive nutrition intervention is equally effective in improving glycemic control as compared to all types of CHO. This strategy had a positive effect in preventing excessive maternal weight gain but increased the risk of prematurity.

Correlates of dietary energy sources with cardiovascular disease risk markers in Mexican school-age children.

Dietary and lifestyle changes in Mexico have been linked to an increase in chronic diseases such as obesity and cardiovascular disease. Important dietary changes such as an increase in the consumption of energy-dense foods (high in oils, animal or processed fats, and sugars) have been recently reported. The objective of this study was to identify how key dietary energy sources correlated with other indexes of cardiovascular disease in a Mexican school-age population. From 2004 to 2006, a convenience sample (n=228) of 9- to 13-year-olds, 48.2% girls and 51.8% boys, from three public urban schools were included. Anthropometric, blood pressure, and dietary assessment (two multiple pass 24-hour recalls) were done. More than half of children did not meet the fruit and vegetable recommended intake. High-fat dairy foods (14% of total energy intake), refined carbohydrates (13.5%), red/processed meat (8.5%), added sugars/desserts (7%), corn tortilla (6.5%), and soft drinks/sweetened beverages (5%) were the highest dietary energy sources consumed. In a subgroup of children (n=185), a fasting blood sample was collected for biochemical analysis. A positive association was observed between glucose and diastolic blood pressure with the intake of soft drinks/sweetened beverages, insulin concentrations and the intake of white bread, and triglyceride concentrations with the intake of added fats. Unhealthful dietary energy sources are frequently consumed by these children. Culturally competent nutrition counseling should be offered to Mexican-American children and their families with a significant risk of cardiovascular disease. Efforts should be made to design and implement nutrition education and health promotion strategies in schools.

A medical nutrition therapy program improves perinatal outcomes in Mexican pregnant women with gestational diabetes and type 2 diabetes mellitus.

UNLABELLED: Diabetes in pregnancy is a major public health problem in Mexico. Nutrition therapy is an important component of treatment. Intensive nutrition intervention has not been implemented for Mexican pregnant women with diabetes. Its effect on different types of diabetes mellitus has not been studied. PURPOSE: The authors assessed the effect of a medical nutrition therapy (MNT) program on perinatal complications in Mexico City. METHODS: Quasi-experimental design with a historical control. Women were assigned to a MNT program (n = 88) and were followed up with every 2 weeks until delivery (2004-2007). The control group (n = 86) was selected from medical charts (2001-2003) and the same inclusion criteria were used. In each group, 55% of women had type 2 diabetes mellitus and 45% had gestational diabetes. The MNT program included a moderate intake of carbohydrate (40%-45% of total energy) and reduction in energy intake, capillary glucose self-monitoring, and education. The control group received usual hospital routine care. Statistical analysis included descriptive statistics, chi-square, and multivariate logistic regression (OR, 95% CI) as indicated. RESULTS: Women in the MNT program had a lower risk of preeclampsia, fewer maternal hospitalization, and neonatal deaths in both types of diabetes. Low birth weight was less frequent only in women with gestational diabetes receiving MNT, while neonatal intensive care unit admissions were lower only in women with type 2 diabetes. CONCLUSIONS: An intensive MNT program, including counseling, education, and capillary glucose self-monitoring, has a positive effect over preeclampsia, maternal hospitalization, and neonatal death in women with diabetes in pregnancy. MNT guidelines should be implemented in Mexican health care facilities treating diabetes in pregnancy.

The effect of exercise on cardiovascular risk markers in Mexican school-aged children: comparison between two structured group routines / Efecto del ejercicio sobre marcadores de riesgo cardiovascular en escolares mexicanos: comparación entre dos rutinas grupales

Objective. To assess the effects of two groups of exercise routines on cardiovascular disease risk markers. Material and Methods. An intervention study was conducted with 319 Mexican school-aged children in which routines were implemented Monday through Friday for 12 weeks. Routine A was the reference group, with 20 min of less intense activity and routine B was the new group with 40 min of aerobic exercises. Body mass index (BMI), waist circumference, fat mass percentage (FM percent), systolic and diastolic blood pressure, lipids, lipoproteins, glucose and insulin were measured before and after the intervention. Results. Routine A had an effect on diastolic pressure, while routine B had an effect on BMI, FM percent, blood pressure and triglycerides. Routine B had a greater effect on blood pressure than routine A. The prevalence of obesity, high blood pressure and hypertriglyceridemia decreased in both groups. Conclusion. Aerobic exercise is an effective health promotion strategy to reduce some cardiovascular disease risk markers.

Objetivo. Evaluar el efecto de dos rutinas grupales de ejercicio sobre marcadores de riesgo cardiovascular. Material y métodos. Intervención en 319 escolares mexicanos. Las rutinas fueron implementadas por 12 semanas (rutina A (referencia): 20 min con ejercicios menos intensos vs rutina B (nueva): 40 min con ejercicios aeróbicos). Se midieron al inicio y al final el índice de masa corporal (IMC), masa grasa ( por cientoMG), presión arterial sistólica y diastólica, lípidos, lipoproteínas, glucosa e insulina. Resultados. La rutina A tuvo efecto sobre la presión diastólica; la B tuvo efecto sobre el IMC, por cientoMG, presión arterial y triglicéridos. La rutina B tuvo mayores efectos en la presión arterial que la rutina A. Las prevalencias de obesidad, hipertensión arterial e hipertrigliceridemia disminuyeron en ambos grupos. Conclusiones. El ejercicio aeróbico es una estrategia de promoción exitosa para reducir algunos marcadores de riesgo cardiovascular.

Programa para mejorar marcadores de riesgo cardiovascular en escolares mexicanos / A program to improve some cardiovascular risk factors in Mexican school age children

OBJETIVO: Evaluar el efecto de un programa de actividad física sobre los marcadores de riesgo cardiovascular en escolares mexicanos. MATERIAL Y MÉTODOS: Escolares de dos escuelas públicas de Querétaro (n= 360, 8-14 años) realizaron una rutina de actividad física durante 16 semanas (febrero a mayo de 2006). Se compararon mediciones antropométricas, de presión arterial y química sanguínea, antes y después de la intervención. RESULTADOS: La presión sistólica, los triacilglicéridos y el colesterol total disminuyeron de forma significativa en los escolares. La reducción de los lípidos fue mayor en los escolares con valores iniciales alterados. En niñas con riesgo cardiovascular inicial, el puntaje de conglomerado de riesgo disminuyó en grado considerable. No se observaron cambios en el IMC, circunferencia de cintura e insulina sé-rica. CONCLUSIONES: La aplicación de una rutina de ejercicio sencilla tiene efectos notorios sobre los indicadores de riesgo cardiovascular en escolares. Estos resultados pueden considerarse un modelo de intervención para paliar los efectos de la obesidad infantil.

OBJECTIVE: To assess the effect of a physical activity intervention on cardiovascular risk factors in Mexican school-age children. MATERIAL AND METHODS: Children from two public schools in Queretaro (n=360, 8-14 years old) performed a 20-minute physical activity routine every school day during 16 weeks (February-May 2006). Anthropometric, blood pressure and biochemical assessment was done before and after implementation. RESULTS: Systolic blood pressure, triglyceride and total cholesterol levels decreased significantly. The decrease in lipid and lipoprotein levels was higher in children with high baseline levels. In high-risk girls, the cardiovascular risk cluster score decreased significantly. No change in BMI, waist circumference, or insulin was observed. CONCLUSION: A simple physical activity program modified several cardiovascular risk markers in school-age children. These results may be taken as a reference to develop better intervention programs directed toward preventing the effects of children obesity.

Estudio piloto para la identificación de indicadores antropométricos asociados a marcadores de riesgo de síndrome metabólico en escolares mexicanos / Pilot study to identify anthropometric indices associated with metabolic syndrome risk markers in school-aged Mexican children

Introducción. La obesidad aumenta el riesgo de presentar hipertensión arterial, hiperinsulinemia, obesidad abdominal e hipertriacilgliceridemia en todos los estratos etarios. Debido a la necesidad de crear herramientas de tamizaje para detectar oportunamente estas comorbilidades, es necesario conocer cuáles son los indicadores antropométricos que se asocian con marcadores de riesgo de desarrollo de síndrome metabólico. Métodos. Estudio piloto en donde se realizó una evaluación antropométrica (índice de masa corporal [IMC], circunferencia de cintura, índice circunferencia de cintura/estatura) y su asociación con marcadores de riesgo de síndrome metabólico en 188 escolares de la Ciudad de México (9-12 años de edad). Resultados y conclusiones. La medición de la circunferencia de cintura demostró ser un mejor indicador de riesgo de hipertensión e hipertriacilgliceridemia con respecto al IMC; el índice circunferencia cintura/estatura fue el mejor predictor de la hipertriacilgliceridemia. En escolares con obesidad, la circunferencia de cintura explica la mitad de la variabilidad de la presión arterial.

Introduction. Obesity increases the risk of hypertension, dyslipidemia, abdominal obesity and high insulin levels. To implement effective screening tools to identify these comorbidities, there is a need to know the anthropometric factors associated with the presence of metabolic syndrome risk markers. Methods. In this pilot study, a complete nutrition evaluation was applied to 188 school-aged children (9-12 years old) from 3 urban public schools in Mexico City. Anthropometric indices (body mass, index, waist circumference and waist-to-height ratio) were associated with metabolic syndrome risk markers. Results and conclusions. Waist circumference is a better predictor of hypertension and hypertriglyceridemia than body mass index. Waist-to height ratio was the most significant predictor for hypertriglyceridemia. Waist circumference accounts for half of blood pressure variation in obese children.