Low Diagnostic Accuracy of Body Mass Index-Based and Waist Circumference-Based References of Childhood Overweight and Obesity in Identifying Overfat among Chinese Children and Adolescents

Chen, Yiyang; Wang, Lin

doi:10.1155/2018/4570706

Cited by 7 publications

(5 citation statements)

References 37 publications

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“…A similar pattern of poor sensitivity in international cutoffs have been demonstrated in a meta-analysis of 37 studies 23 as well as individual studies in several countries. 24-26 A study conducted on South Asian children in Canada using hypertension as a biological outcome have determined BMI SDS and WC SDS cutoffs to be much lower than +2 SDS in predicting hypertension. 27 Similarly, poor sensitivity and high specificity of international cutoffs has been highlighted in studies of Australian children of both white Caucasian origin and Sri Lankan origin 9 as well as in Sri Lankan children.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Nutritional Status in Sri Lankan Children: Validity of Current Anthropometry Cutoffs?

Warnakulasuriya

Fernando

Adikaram³

et al. 2019

Asia Pac J Public Health

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Despite socioeconomic improvement, undernutrition rates stagnate in Sri Lanka, while a slow rise in obesity and noncommunicable diseases (NCD) is seen. Inability to improve undernutrition and detection of NCD could be due to overdiagnosing stunting/wasting and underdiagnosing overweight/obesity. Obesity, being a risk factor for NCDs, needs correct tools for early diagnosis. Although body mass index (BMI) is a commonly used surrogate index, the validity of universal cutoffs is questioned. Evidence shows that body composition varies with ethnic origin and cutoff value reflecting fat mass (FM) varies in different ethnic groups. This study was conducted in 12 788, 5- to 15-year-old children from 8 schools in Negombo, Sri Lanka, to identify the validity of current anthropometric cutoffs. Obesity prevalence identified by body fat content was high. International BMI cutoffs had high specificity but varied sensitivity. Locally developed BMI cutoffs had high sensitivity and specificity. Validity of internationally developed anthropometric cutoffs in South Asian children is unsatisfactory; hence, locally/regionally developed anthropometric tools should be used for screening of obesity.

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Section: Discussionmentioning

confidence: 99%

Assessment of Nutritional Status in Sri Lankan Children: Validity of Current Anthropometry Cutoffs?

Warnakulasuriya

Fernando

Adikaram³

et al. 2019

Asia Pac J Public Health

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“…Sensitivity of the WHO reference (BMI ≥ 30 kg/m 2 ) for older adults was only 14.5% for male and 23.4% for female, indicating poor efficacy of identifying obesity in this population (Batsis et al, 2016). In another research on Chinese children and adolescents, the sensitivity of BMI references for obesity varied between 12.8 and 47.3%, indicating limited accuracy of diagnosis (Chen et al, 2018). A meta-analysis provided robust evidence for accuracy of commonly used BMI values for obesity screening.…”

Section: Discussionmentioning

confidence: 95%

“…World Health Organization (WHO) has defined the cutoff points of overweight and obesity for Asian populations as 23 and 25 kg/m 2 , respectively (Barba et al, 2004). To increase accuracy and generalizability of BMI classifications, an increasing number of research has examined obesity cutoff points for different populations (Rahman and Berenson, 2010;Hunma et al, 2016;Chen et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Optimal BMI cutoff points in obesity screening for Chinese college students

Wang

Wang²,

Shi³

et al. 2022

Front. Psychol.

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ObjectiveAn accurate BMI classification system specific to the population is of great value in health promotion. Existing studies have shown that the BMI recommended cut-off value for adults is not suitable for college students. Thus, the current study aims to identify optimal BMI cutoff points in obesity screening for Chinese college students.MethodsAnthropometric assessments were performed on 6,798 college students (Male = 3,408, Female = 3,390) from three universities in Jiangsu, China. Exploratory factor analysis (EFA) was conducted to establish the standardized models to estimate anthropometry for male and female students. Further indices were derived from the assessments, including body mass index (BMI), relative fat mass (RFM), obesity degree percentage (OBD%), waist-to-hip ratio (WHR), waist circumference (WC), and body fat percentage (BF%). The anthropometric index with the highest correlation to the models for male and female students were selected as the gold standard for obesity screening. Receiver operating characteristic (ROC) curve was applied to evaluate diagnostic value of each anthropometric index according to the area under curve (AUC). Youden index maximum points determined the optimal cutoff points with the highest accuracy in obesity screening.ResultsThe anthropometric models for both male and female students consisted of three factors. Vervaeck index was selected as the gold standard for obesity screening. By comparing AUC of the anthropometric indices, we found BMI provided the highest value in obesity screening. Further analysis based on Youden index identified the optimal BMI of 23.53 kg/m2 for male and 23.41 kg/m2 for female. Compared with the universal standard recommended by World Health Organization (WHO), the adjusted BMI criteria were characterized by high sensitivity as well as specificity.ConclusionBMI is the most appropriate anthropometric index of obesity screening for Chinese college students. The optimal cutoff points were lower than the WHO reference. Evidence substantiated the adjusted BMI criteria as an effective approach to improve accuracy of obesity screening for this population.

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“…The strengths of our study included a large sample size collected from seven provinces in China, including the eastern region with a developed economy and the western region with an underdeveloped economy, which made our findings generalizable to all populations in China. Since BMI has high specificity but low sensitivity to detect excess adiposity, and fails to identify over a quarter of children with excess body fat percentage [ 43 ], we used both BMI and WC to estimate the OW/OB in offspring, which had a higher specificity and sensitivity [ 44 ]. Based on the BMI and WC, we classified three types of obesity in offspring and included the two components separately.…”

Section: Discussionmentioning

confidence: 99%

Influence of Parental and Offspring Dietary Behaviors on the Association of Overweight and Obesity between Two Generations: Results from a Cross-Sectional Analysis of Parent-Offspring Trios in China

Chen

Liu

et al. 2022

Nutrients

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Limited evidence exists on the influence of dietary behaviors on the association of overweight/obesity between parents and offspring. This study aimed to investigate the influence of dietary behaviors on the association of overweight/obesity between two generations, and puts forward strategies for preventing childhood obesity. Data were obtained from a cross-sectional survey conducted in China; a total of 40,197 parent-offspring pairs were included. Overweight/obesity was defined based on the body mass index and waist circumstance; the association of overweight/obesity between two generations was evaluated by multivariate and binary logistic regression and stratified analyses. Compared with the offspring who were free of parental overweight/obesity, the ORs of offspring with both parental overweight/obesity reached 2.66, 1.72 and 4.04 for general, simple abdominal and compound obesity. The offset effect of dietary behaviors was observed on the association between parental obesity and the offspring’s general or simple abdominal obesity, with non-significant ORs when parents or/and offspring had healthy dietary behaviors. It was difficult for a healthy diet alone to offset the high heritability and intergenerational transmission of childhood obesity caused by parental obesity. Multifaceted improvement of lifestyle behaviors, and a combination of individual and family engagement, could be targeted measures to control childhood obesity.

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Low Diagnostic Accuracy of Body Mass Index-Based and Waist Circumference-Based References of Childhood Overweight and Obesity in Identifying Overfat among Chinese Children and Adolescents

Cited by 7 publications

References 37 publications

Assessment of Nutritional Status in Sri Lankan Children: Validity of Current Anthropometry Cutoffs?

Assessment of Nutritional Status in Sri Lankan Children: Validity of Current Anthropometry Cutoffs?

Optimal BMI cutoff points in obesity screening for Chinese college students

Influence of Parental and Offspring Dietary Behaviors on the Association of Overweight and Obesity between Two Generations: Results from a Cross-Sectional Analysis of Parent-Offspring Trios in China

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