The Utility of Body Mass Index as a Measure of Body Fatness in Children and Adolescents: Differences by Race and Gender

Daniels, Stephen R.; Khoury, Philip R.; Morrison, John A.

doi:10.1542/peds.99.6.804

Cited by 451 publications

(341 citation statements)

References 16 publications

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“…90th percentile of subscapular skinfold). As a result, when these cut-offs were applied to the data set, participants with BMI values at or above the 85th percentile and with high subcutaneous fat were shifted from the overweight category to the obese category, resulting in lower estimates of overweight and higher estimates of obesity than those determined by other standards such as those of Must et al (1991) and Cole et al (Daniels et al, 1997;Bini et al, 2000). In the present study however, pubertal staging was not performed due to some cultural constraints.…”

Section: Discussionmentioning

confidence: 86%

Prevalence of overweight and obesity among Bahraini adolescents: a comparison between three different sets of criteria

2003

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OBJECTIVE:The aim of this study is to determine the prevalence of overweight and obesity among Bahraini adolescents using three different sets of criteria=standards. DESIGN: Cross-sectional prevalence study. SETTING: Intermediate and secondary schools in Bahrain. SUBJECTS: The study included a population-representative sample of 506 Bahraini students (249 males and 257 females) between 12 and 17 y of age. The sample was selected using multistage stratified random sampling technique. MEASUREMENT: Anthropometric measurements including weight, height and triceps and subscapular skinfolds were taken on the adolescents. Age was verified against school records. To minimize inter-observer error, weight and height were taken by one person while skinfold was taken by two trained persons (one for each sex). RESULTS: The overall prevalence of obesity among Bahraini boys and girls was high, especially in girls. Obesity was highest (21% in males and 35% in females) when the WHO recommended criteria of BMI for age and skinfolds for age percentiles were applied and lowest (15% in boys and 18% in girls) when the age and sex specific BMI cut-off values of Cole et al were used. Compared with those of WHO criteria, estimates of overweight and obesity prevalence obtained with Must et al and Cole et al were generally close. CONCLUSIONS: Our data revealed a much higher prevalence rate of obesity in the Bahraini adolescent population than was previously reported, especially among girls. The BMI reference values of Must et al and that of Cole et al gave relatively similar estimates and appear to be more practical for use in surveys aimed at estimating the prevalence of overweight and obesity among adolescents than the WHO recommended composite criteria.

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Section: Discussionmentioning

confidence: 86%

Prevalence of overweight and obesity among Bahraini adolescents: a comparison between three different sets of criteria

2003

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“…[9][10][11][12] Daniels et al 11 argue that overweight and obesity in children are important factors in accelerating pubertal development. Puberty begins by a growth burst characterized by an important increase of body fat tissues.…”

Section: Introductionmentioning

confidence: 99%

“…Puberty begins by a growth burst characterized by an important increase of body fat tissues. 11,13,14 Body fat increase is essential for sexual secondary characteristics and first menses occurrence. If the adolescent is already overweight or obese, puberty timing could be accelerated.…”

Section: Introductionmentioning

confidence: 99%

“…If the adolescent is already overweight or obese, puberty timing could be accelerated. [9][10][11][12] On the other hand, being underweight was found to stop menses in already mature women. 15,16 Since pubertal development is known to be a critical period in the development of eating disorders, particularly in girls, 17 most researchers who have studied negative effects of obesity have taken into account pubertal development.…”

Section: Introductionmentioning

confidence: 99%

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The interaction role of obesity and pubertal timing on the psychosocial adjustment of adolescent girls: longitudinal data

Tremblay

2005

Int J Obes

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OBJECTIVE:The objective of the study was to verify the hypothesis that obesity is associated with pubertal timing, as both factors interact to predict psychosocial adjustment problems in girls. SUBJECTS: We selected 811 girls who had participated in a longitudinal study on a representative sample of French Canadian children from 1986 to 1997. METHOD: Only data collected between 1993 and 1996 were analyzed. We classified the participants into three weight categories (normal, overweight, and obese) and pubertal timing (early, on-time, or late-maturing) and compared their internalized and externalized problem behavior and conflict as well as their socioeconomic status. RESULT: We found that (1) early and late-maturing girls are more at risk of being overweight during the whole period of pubertal development as demonstrated by the increasing rate of obesity in these two groups between 11 and 13 y old, and (2) there was an interaction effect between pubertal timing and obesity in predicting problem behavior and conflict. Overweight and obese girls who developed faster or slower than their peers displayed more adjustment problems at 11 and 12 y old. At 13 y old, obesity predicted adjustment problems separately without regard to pubertal timing. Our results suggest that puberty timing is a risk factor for obesity and that both pubertal timing and being overweight predict adjustment problems during all the courses of pubertal development, supporting partially our hypothesis. CONCLUSION: Programs and interventions must take into account these two factors and adolescents should be monitored throughout all the periods of pubertal development.

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“…They defined under-nutrition as age-and gender-specific BMI less than the 5th percentile of American adolescents between 1971 and 1974, as recommended by WHO Expert Committee (1995). However, the WHO-recommended BMI cut-off might not be applicable to Asian children and adolescents, given differences in race and socio-economic conditions (Chang et al, 1994;Daniels et al, 1997;Luciano et al, 1997;Schaefer et al, 1998;De Onis et al, 2001). Furthermore, no evidence of impaired health was provided to support the selection of BMI 5th percentile as the cut-off between under-nutrition and acceptable nutrition in the report by Wang et al (1998).…”

Section: Introductionmentioning

confidence: 99%

Low body weight and its association with bone health and pubertal maturation in Chinese girls

Greenfield

Fraser

et al. 2003

Eur J Clin Nutr

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Objective: To investigate the prevalence of low body weight in Beijing pubertal girls and to establish the cut-off for body mass index (BMI) for underweight for Chinese pubertal girls. Design: Cross-sectional study. Setting: Three socioeconomic areas (rural, suburban and urban) in Beijing, China. Subjects: Random sample of 1214 adolescent girls aged 12 -14 y from 13 middle schools. Results: Using a modified Chinese reference, the rate of low body weight (BMI < 18) was 32.2% (95% CI 29.6 -34.8%). Compared with desirable weight girls (BMI ¼ 18 -21), girls with low body weight had a lower bone age, delayed breast and pubic hair development, a lower rate of menarche, lower distal one-third radius and ulna bone mineral content (BMC), bone mineral density and bone width. Logistic regression showed that BMI was one of the predictors of one-third ulna BMC after adjustment for confounding variables. When comparing BMI < 18 vs BMI ¼ 18 -21, the risk of BMC being less than the median increased by 82% (odds ratio 1.82, 95% CI 1.06 -3.13). Thinness and stunting rates assessed by WHO recommended cut-offs are also reported. Conclusions: High prevalence of low body weight (BMI < 18) was found to be a major health problem among Beijing pubertal girls. BMI < 18 is confirmed as the cut-off for delayed general growth and development for Chinese girls and for screening girls at risk of lower bone mineral status.

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The Utility of Body Mass Index as a Measure of Body Fatness in Children and Adolescents: Differences by Race and Gender

Cited by 451 publications

References 16 publications

Prevalence of overweight and obesity among Bahraini adolescents: a comparison between three different sets of criteria

Prevalence of overweight and obesity among Bahraini adolescents: a comparison between three different sets of criteria

The interaction role of obesity and pubertal timing on the psychosocial adjustment of adolescent girls: longitudinal data

Low body weight and its association with bone health and pubertal maturation in Chinese girls

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