Anthropologic methods in the evaluation of the weight reduction process in obese children

: Childhood obesity is considered at present one of the most difficult problems in paediatrics and it is one of the major health problems of industrialized society. Growth and development of obese children is different in several aspects. The authors submit the results of an anthropometric survey implemented in 1989 to 1996 in a group of 1949 Czech obese children (720 boys and 1229 girls) aged 6 to 18 years. The patients were measured by the standard anthropometric technique according to Matrin and Saller at the beginning and end of six-week therapeutic weight reduction programme. The skinfold thickness at 14 sites was assessed by means of a Best caliper. The body composition was evaluated using Matiegka's equations. For evaluation of the weight reduction programme the paired t-test was used a criterium of the quality of the evaluated parameters. For the needs of the medical profession curves of the empirical percentiles of BMI for both sexes were plotted to evaluate the grade of obesity. From the analysis of anthropometric data using the paired t-test in 1949 probands ensues that the most valuable information as regards circumferential measurements in boys is provided by the circumference of the abdomen, the gluteal area followed by the chest circumference. In girls the results are partly different--a gluteal circumference of thigh highly dominates, gluteal circumference follows, chest circumference mesoeternal is the third. As to skinfolds the authors recommended to monitor in boys the supraileac, subscapular and abdominal skinfold. In girls the following order was assessed: supraileac, thoracic (at the level of the 10th rib) and subscapular skinfold. From the accurate assessment of the body composition of obese children subjected to weight reduction ensues our recommendation that the loss of adipose tissue should be at least seven times greater than the loss of musculature. A lower ratio should be an indication for changing the reducing treatment. Methods of direct anthropometry, incl. calipering can be unequivocally recommended as the method of first choice because of their non-invasive character.