Anthropometric indicators of nutritional status: implications for fitness, activity, and health in school-age children and adolescents from Maputo, Mozambique

Background: Studies are needed to test the relevance of the anthropometric criteria for health and well-being, particularly in developing countries. Objective: The objective of the study was to identify the relevance of anthropometric indexes as indicators of nutritional status. Design: The sample consisted of 2316 subjects (n = 1094 males, 1222 females) aged 6-18 y from Mozambique. Anthropometric variables, maturity stage, physical fitness, physical activity, and metabolic fitness were measured. Samples of blood, urine, and feces were obtained. Subjects were classified in 5 nutritional groups labeled normal, low height-for-age (stunted), low weight-for-height (wasted), low height-for-age and low weight-for-height (stunted and wasted), and overweight, according to cutoffs set by a World Health Organization expert committee. Socioeconomic status was classified according to region of residence. Results: Prevalence rates for males and females, respectively, in the nutritional groups were 3.0% and 2.3% (stunted group), 21.9% and 10.0% (wasted group), 3.0% and 0.8% (stunted and wasted group), and 4.8% and 7.7% (overweight group). With control for age, socioeconomic status, and maturity stage, the overweight group performed significantly worse than did the other groups on most of the fitness tests. Compared with the normal group, the 3 undernourished groups performed significantly worse in absolute strength tasks, better in endurance tasks, and equally in flexibility and agility. Very few differences were found in physical activity scores. The 3 undernourished groups had scores for the biochemical indicators that were similar to those of the normal group and had more favorable profiles for blood pressure and cholesterol. Conclusions: In this population, the cutoffs used to classify overweight status appear to appropriately identify potential health problems. No relevance to health was found for the lower cutoffs identifying undernourished children.