Body mass index in 17-year-old Israeli males of different ethnic backgrounds; national or ethnic-specific references?

Abstract

OBJECTIVE: To evaluate whether a single national reference is appropriate for assessing prevalence of overweight in heterogeneous populations, or whether ethnic-speci®c references are needed. DESIGN: A population-based study of Israeli Jewish males who underwent routine physical and clinical examinations prior to army recruitment served as the basis for the development of two types of references for body mass index (BMI): a national reference (NR) and an ethnic-speci®c reference (ER). SUBJECTS: Consecutive cohorts of all 17-y-old Jewish male recruits (n 109, 570). MEASUREMENTS: Weight, height and blood pressure values were obtained. BMI was calculated, and the 85th percentile of BMI was used as a cut-off point for overweight, using both types of references. Prevalence of hypertension among recruits was used as a biomarker to support the reliability of the ER when discrepancy in classi®cation between the two references was found. RESULTS: As compared to the NR, three ethnic groups had a BMI distribution shifted to the left (light subpopulation) and ®ve were shifted to the right (heavy sub-population). In the light sub-population, 7% of the inductees who were classi®ed as having normal weight by the NR were considered overweight by the ER and had a hypertension rate similar to that of those de®ned as overweight by both references (3.1 per 1000). In the heavy sub-population the 4% of subjects who were overweight by NR and normal by ER had hypertension rates similar to those de®ned as normal weight by both references (2.7a1000), and signi®cantly lower than that of those classi®ed as overweight by both references (10.8a1000). CONCLUSION: In heterogeneous populations, ethnic references should be used to evaluate prevalence of overweight, rather than one national reference.

Ten‐year trends in obesity among Israeli schoolchildren: 1990–2000

“…In an ethnically heterogeneous population, it may not be appropriate to use a single national reference, and an ethnic‐specific reference may be preferable. Evidence to this effect has been provided previously in Israeli military recruits, who showed distinct BMI distribution patterns based on ethnic origin 26. However, origin‐based variability has not been demonstrated in younger Israeli children, and the results of the present study do not support its existence in children aged 7–11 y.…”

Prevalence of Childhood Obesity and Undernutrition Among Urban School Children in Bangladesh

“…It has been reported previously that BMI is influenced by background SES (Lusky et al, 2000). The present study found a strong association between nutritional status and SES.…”

Ten-year trends in obesity among Israeli schoolchildren: 1990–2000

“…In an ethnically heterogeneous population, it may not be appropriate to use a single national reference, and an ethnic-specific reference may be preferable. Evidence to this effect has been provided previously in Israeli military recruits, who showed distinct BMI distribution patterns based on ethnic origin [26]. However, origin-based variability has not been demonstrated in younger Israeli children, and the results of the present study do not support its existence in children aged 7 Á/11 y.…”