NEW YORK, July 7, (Agencies): Measuring children’s neck circumference could provide a quick, simple way to screen them for weight problems, a new study suggests.
Such screening is recommended by the US Preventive Services Task Force, an influential panel sponsored by the government’s Agency for Healthcare Research and Quality, starting at the age of 6. Right now, doctors usually use body mass index, or BMI, to gauge whether a child (or adult) is overweight or obese. But BMI, which is a ratio of weight to height, is not a good indicator of how much body fat a person has.
Because pounds due to excess body fat — rather than larger bones or greater muscle mass — are the health concern, researchers have been looking for more precise ways to gauge fat levels. One way is to measure waist circumference, which studies suggest is better than BMI alone in assessing abdominal fat and health risks, such as high blood pressure, diabetes and heart disease, in adults.
Another tactic is to measure neck circumference — which, although less studied, seems to be a potential marker of obesity and health risks in adults.
The new study, published in the journal Pediatrics, looked at whether measuring neck circumference has any value in screening children for excess pounds and obesity.
Since BMI is not a precise indicator of body fat, adding a neck circumference measurement could improve childhood obesity screening, lead researcher Dr Olubukola Nafiu, of the University of Michigan in Ann Arbor, told Reuters Health.
And compared with waistline measurements, measuring the neck would also be quicker and more comfortable for children, Nafiu said, since they can keep all their clothes on for the latter.
Neck circumference is also more consistent in comparison to waist size — which can swell after a big lunch, for instance.
For their study, Nafiu and his colleagues measured weight, height, waist circumference and neck circumference in 1,102 children and teenagers ages 6 to 18 who were undergoing surgery at their center.
They found that neck circumference correlated well with both BMI and waist size in boys and girls, as well as younger children and teenagers.
The researchers also pinpointed “optimal” cutoff points for neck circumference that identified a majority of kids with a high BMI. For example, a 6-year-old boy with a neck circumference of greater than 28.5 centimeters — about 11.2 inches — was nearly four times more likely to be overweight or obese, based on BMI, as a 6-year-old boy with a smaller neck circumference.
In addition to helping screen for obesity, the researchers note, neck measurements might also be useful for spotting kids at risk of sleep apnea, a disorder in which tissues at the back the throat temporarily collapse during sleep to create repeated stops and starts in breathing. Obesity, particularly excess weight in the upper body, is a risk factor.
Nafiu said that in earlier studies, he and his colleagues found that children with a high BMI were at relatively greater risk of certain post-surgery problems; they tend, for instance, to take longer to wake up from anesthesia because the drugs concentrate in body fat.
In the future, Nafiu said, the researchers want to look at whether measuring neck circumference before surgery can identify children at greater risk of such problems.

Cholesterol drug: The European Union has approved a new chewable form of cholesterol blockbuster Lipitor for children 10 and up with high levels of abd cholesterol and triglycerides, a type of blood fat, Pfizer said Tuesday.
The approval includes children whose high blood fats are due to an inherited disease that causes extremely high cholesterol levels, familial hypercholesterolemia.
New York-based Pfizer Inc won US approval for Lipitor use in children 10 to 17 with that condition in 2002.
Lipitor is the world’s top-selling drug, with 2009 sales of about $13 billion, but its US patent expires at the end of November 2011. Pfizer, the world’s biggest drugmaker, will quickly lose most Lipitor revenue once generic competition hits, so the company has been trying to boost sales where possible before then.
Pfizer said last fall that it plans to apply for a six-month extension of its patent in European countries, after doing studies of Lipitor in youngsters.
As in the United States, the European Union allows drug makers to seek an additional six months of patent protection for medications if they test them in children, who generally are excluded from the drug studies performed to win approval for a new medication.
Pfizer already won such an extension for its crucial US patent on Lipitor.
For blockbuster drugs, those extensions can easily bring hundreds of millions of dollars in additional revenue. Normally, they are for drugs that are widely used by different age groups.
Until recently, cholesterol drugs have been primarily taken by adults with heart disease, but their use has expanded to younger patients as more obese, sedentary teenagers and adolescents develop heart disease and diabetes.
Lipitor is approved to lower risk of heart attack and stroke, but can cause dangerous muscle pain or weakness, and it cannot be taken by patients with liver problems or by nursing or pregnant women.

Diabetes boom: The growing popularity of Western junk food is fuelling a diabetes boom across Southeast Asia, Australian researchers warned on Wednesday.
Studies found about 11 percent of men and 12 percent of women in Vietnam’s Ho Chi Minh City had type 2 diabetes without knowing it, on top of the four percent of people who are diagnosed sufferers.
“Dietary patterns have been changing dramatically in Vietnam in recent years, particularly in the cities as they become more Westernised,” said Tuan Nguyen of Sydney’s Garvan Institute of Medical Research.
“There are fast food outlets everywhere.”
He said the findings, based on testing a random sample of 721 men and 1,421 women, mirrored the results of a similar study carried out in Thailand.
“Because of that, we feel very confident that we can extrapolate our findings to other parts of Southeast Asia including Malaysia, Singapore, Cambodia and Laos,” he said.
Type 2, the most common form of diabetes, is caused by high levels of fat and sugar in the diet and a lack of exercise, and can lead to heart disease, vision loss, limb amputation and kidney failure.
Co-author Lesley Campbell said developing countries were facing a “sad story” where they are affected by Western lifestyle diseases alongside hunger and poverty, but without the health resources to treat them.
“Unfortunately, we are watching, in just over a generation, a very rapid increase in diabetes” in developing nations, she said.
The researchers have developed a simple risk assessment for diabetes, using only blood pressure and waist-to-hip ratio, which they hope will help doctors detect those most likely to have the disease.