Association between WHO cut-offs for childhood overweight and obesity and cardiometabolic risk

Abstract

Objective: To examine the association between cardiovascular risk and childhood overweight and obesity using the BMI cut-offs recommended by the WHO. Design: Children were classified as normal weight, overweight and obese according to the WHO BMI-for-age reference. Blood pressure, lipids, glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and uric acid levels were compared across BMI groups. ANOVA and tests of linearity were used to assess overall mean differences across groups. Crude and adjusted odds ratios were calculated for adverse plasma levels of biochemical variables. Setting: Paediatric care centres. Subjects: Children (n 149) aged 8-18 years. Results: About 37 %, 22 % and 41 % of children were classified respectively as normal weight, overweight and obese. There were significant linear mean differences between BMI groups in systolic blood pressure, HDL-cholesterol, TAG, insulin, HOMA-IR and uric acid. Obese children were 10?6 times more likely than normal-weight children to have hypertension; OR for other associations were 60?2 (high insulin), 39?5 (HOMA-IR), 27?9 (TAG), 16?0 (HDL-cholesterol), 4?3 (LDL-cholesterol) and 3?6 (uric acid). Overweight children were more likely than normal-weight children to have hypertension (OR 5 3?5), high insulin (OR 5 28?2), high HOMA-IR (OR 5 23?3) and high TAG (OR 5 16?1). Nearly 92 % and 57 % of the obese and overweight children, respectively, had one or more risk factor. Conclusions: Obesity and overweight defined using the WHO BMI-for-age cutoffs identified children with higher metabolic and vascular risk. These results emphasize the importance of prevention of overweight and obesity in childhood to reduce cardiovascular risk.

Health promotion initiatives at school related to overweight, insulin resistance, hypertension and dyslipidemia in adolescents: a cross-sectional study in Recife, Brazil

“…Overweight and obesity are the main contributors to the burden of chronic diseases in the population [2, 3]. The concern about the occurrence of obesity is related to developing comorbidities and complications generated by overweight.…”

BMI-for-Age and Weight-for-Length in Children 0 to 2 Years

“…7,8 These charts represent ideal growth in children under optimal environmental conditions for growth and have percentile cutoffs that can be used to classify weight status 7,9 (eg, wasting, overweight, obesity) that may be practical for growth monitoring and screening. [10][11][12] Currently, it is recommended that clinicians assess weight status by calculating and plotting weightfor-length in children 0 to <2 years of age, and then transition to BMIfor-age in children 2 years of age and older. 3, 13 However, the WHO Child Growth Standards (2006) also includes BMI-for-age growth reference charts for children <2 years that were not previously available.…”

Severe obesity prevalence in 8- to 9-year-old Italian children: a large population-based study

“…Recent publications have examined the association between cardiometabolic risk and childhood overweight and obesity using different curves but no definitive statements have been made on which standards to use. 11,35,36 In Italy, the differences in the estimated prevalence of severe obesity in 8-to 9-year-old children using WHO and IOTF definitions are mainly due to the difference observed among boys (6.5% and 2.9%, respectively), whereas the prevalences among girls (2.3% and 2.5%, respectively) are similar. To understand which reference is more appropriate, attention should be focused on males.…”