Reference curves for stature and weight in British children have been available for the past 30 years, and have recently been updated. However weight by itselfis a poor indicator of fatness or obesity, and there has never been a corresponding set of reference curves to assess weight for height. Body mass index (BMI) or weight/height2 has been popular for assessing obesity in adults for many years, but its use in children has developed only recently. Here centile curves for BMI in British children are presented, from birth to 23 years, based on the same large representative sample as used to update the stature and weight references. The charts were derived using Cole's LMS method, which adjusts the BMI distribution for skewness and allows BMI in individual subjects to be expressed as an exact centile or SD score. Use of the charts in clinical practice is aided by the provision of nine centiles, where the two extremes identify the fattest and thinnest four per 1000 ofthe population. (Arch Dis Child 1995; 73: 25-29) Keywords: body mass index, growth reference, overweight, underweight. Another weight for height index suitable for the age group 4-12 years has been proposed by Chinn et al,6 based on its correlation with skinfold thickness. Defined as (weight (kg) -9)/ height (cm)3-7, it has the dual properties that its mean and coefficient of variation are both unrelated to age. This means that it does not need adjusting for age. MRC Dunn NutritionA very flexible index of overweight is provided by the power function weight/heightn, where n the power of height usually takes values in the range 1 to 3. Restricting it to whole numbers, the value for n which best adjusts weight for height, and at the same time removes most of the trend of increasing weight with age, is n=2.7 8 This leads to the body mass index (BMI) weight/height2, also known as the Quetelet index9 or the Kaup index.'0 BMI has been used widely in adults for the last 25 years as a simple summary measure of overweight," 12 but its use in childhood has developed relatively recently. Adult BMI increases fairly slowly with age, so that age independent cut offs can be used to grade obesity.'3 In children, however, BMI changes substantially with age, rising steeply in infancy, falling during the preschool years, and then rising again into adulthood. For this reason, child BMI needs to be assessed using age related reference curves.Such curves have been published for French8 14 and American'5 16 children, but they are all imperfect, either because the data are old or the age range is restricted. This paper provides up-to-date reference curves for BMI in UK children, covering the age range birth to 23 years, and presented as nine centiles. They are among the first such curves to complement existing national references for weight and height based on the same dataset. Methods SUBJECTSThe reference sample of children was obtained by combining data from 11 distinct surveys. The data were collected between 1978 and 1990, a long enough period of time for the...
Objective: To refine the diagnosis of childhood obesity by creating new sex-specific centile curves for body fat and to base these references on a simple and affordable method that could be widely adopted in clinical practice and surveys. Design: Body fat was measured by bio-impedance in 1985 Caucasian children aged 5-18 years from schools in Southern England. Smoothed centile charts were derived using the LMS method. Results: The new body fat curves reflect the known differences in the development of adiposity between boys and girls. The curves are similar by sex until puberty but then diverge markedly, with males proportionately decreasing body fat and females continuing to gain. These sex differences are not revealed by existing curves based on body mass index. We present charts in which cutoffs to define regions of 'underfat', 'normal', 'overfat' and 'obese' are set at the 2nd, 85th and 95th centiles. These have been designed to yield similar proportions of overweight/overfat and obese children to the IOTF body mass index cutoffs.Conclusions: Direct assessment of adiposity, the component of overweight that leads to pathology, represents a significant advance over body mass index. Our new charts will be published by the Child Growth Foundation for clinical monitoring of body fat, along with the software to convert individual measurements to Z-scores.
This paper reviews child and adolescent adiposity measures and associated long-term health risks. The ®rst section argues that anthropometric measures are practical for large scale epidemiological studies, particularly the body mass index. Limitations of this and other measures are presented. The second section summarises the evidence on the relationship between child and adolescent and adult adiposity. This is based on a search for relevant literature in the following computerised databases: Medline (1985±96), BIDS (EMBASE and Science Citation Index 1985±96). The literature search revealed that the child to adult adiposity relationship is now well-documented, although methodological differences hinder comparisons. Nonetheless, consistently elevated risks of adult obesity are evident for fatter children, although the prediction of adult obesity from child and adolescent adiposity measures is only moderate. Fewer studies could be identi®ed in relation to long-term health risks of child and adolescent adiposity. It is therefore dif®cult to specify categories of risk associated with childhood adiposity without more information from long-term studies. Further evidence is also required to con®rm the suggestion from some studies that adult disease risks are associated with a change in adiposity from normal weight in childhood to obesity in adulthood. However, on the basis of the evidence available, it is argued that population-based approaches to the prevention of obesity are likely to be more effective than approaches targeted at fat children. Population-based approaches are desirable, ®rst because of the poor prediction of adult obesity from child and adolescent measures, and second, because risks of adult mortality and morbidity may be elevated for individuals who become overweight after adolescence.Keywords: body mass index; obesity; measures; childhood; adolescence; tracking; morbidity; mortality; review IntroductionPrevention of obesity is a public health priority, 1 with much of the concern focusing on childhood and adolescence. 2 Child and adolescent adiposity is of particular interest because of possible long-term associations with adult disease, but evidence on long-term relationships is fragmentary and an overview is needed that clari®es how they might occur.There are three main sections to this review. The ®rst provides a summary of the basic methods used to assess child and adolescent adiposity. This key issue is included here because it is essential that appropriate measures are used, for example, to investigate trends over time and over the life course. The second section summarises the evidence on the relationship between child and adolescent and adult adiposity. This relationship is studied because of the concern that child and adolescent adiposity in¯uences adult disease primarily through its association with adiposity in adult life. Evidence is now available from several prospective and retrospective samples following subjects from childhood to adulthood. The speci®c questions of interest in this se...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.