Which Metric of Relative Weight Best Captures Body Fatness in Children?

Field, Alison E.; Laird, Nan M.; Steinberg, Emily; Fallon, Erica M.; Semega-Janneh, Mariama; Yanovski, Jack A.

doi:10.1038/oby.2003.182

Cited by 97 publications

(84 citation statements)

References 18 publications

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“…Therefore, BMI 85 percentiles, one of the most sensitive indicators for adiposity in children, can be useful for screening obesity, as has been suggested in another study. 7 Although intrinsically different from BMI in the method of obesity identification, PWH was a better indicator than the IOTF-BMI criteria in terms of measurement accuracy in our study. As both measures were based on the population-specific standard, we suggest that the value of the population-specific standard in defining children's obesity needs to be reconsidered.…”

Section: Discussioncontrasting

confidence: 52%

“…Previous studies comparing various criteria for anthropometric measurements in childhood with body fat measures suggested that IOTF-BMI cutoffs may have low sensitivity, 6 and that BMI percentile X85 percentile is useful for identifying children who may be over-fat. 7 Therefore, the aim of the study was twofold. First, we compared the validity of various criteria of childhood obesity in Korean pre-adolescent school children, based on the percentage body fat (PBF): the local BMI, the local PWH and the IOTF-BMI criteria.…”

Section: Introductionmentioning

confidence: 99%

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Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis

Yoo

Lee

et al. 2006

Int J Obes

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Objectives: To examine the relationships between body mass index (BMI), percentage-weight-for-height (PWH) and percentage body fat (PBF), and to compare their validity based on PBF with the BMI criteria of International Obesity Task Force (IOTF) for childhood obesity in Korean pre-adolescent school children. Design: Statistical comparative analysis for anthropometric measures. Subjects: Korean pre-adolescent children (438 boys and 454 girls, aged 8-12 years, mean BMI 19.573.4 kg/m 2 ). Measurements: Body mass index and PWH were calculated as body size indices from height and weight. Hand-to-foot bioelectrical impedance analysis (BIA) was performed to obtain PBF values, with obese children defined as PBF above 35%. Sensitivity and specificity were displayed with the gold standard of PBF, and receiver operating characteristic (ROC) curves were used to assess the performance of BMI and PWH in detecting obesity. Results: The prevalence of obesity varied by the criteria: 18.8% by Korean BMI standards for 95 percentile, 11% by the IOTF-BMI 30 kg/m 2 and 29.4% by Korean PWH cutoffs. Body mass index and PWH were significantly correlated with PBF after adjusting for age, 0.910 (Po0.01) and 0.915 (Po0.01), respectively. The sensitivity and specificity of the PWH cutoffs were 0.909 and 0.882, respectively. The local BMI 95 percentiles had lower sensitivity (0.714) and specificity (0.790). The IOTF-BMI definition showed much lower sensitivity (0.457) and higher specificity (0.990). The BMI cutoffs corresponding with the highest accuracy were smaller than IOTF-BMI 30 kg/m 2 for all age groups in both boys and girls. Conclusion: The prevalence of obesity among Korean pre-adolescent children widely varied according to the diagnostic criteria applied. Universally recommended cutoffs for children by IOTF showed the lowest sensitivity among the criteria used, and may therefore underestimate obesity in this population.

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Section: Discussioncontrasting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis

Yoo

Lee

et al. 2006

Int J Obes

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“…BMI is commonly used in adults and more recently recommended for use in children and adolescents (Power et al, 1997;Bellizzi and Dietz, 1999;Dietz and Bellizzi, 1999;Bini et al, 2000;Reilly et al, 2000;Widhalm et al, 2001). However, the assessment of weight status in young people is more complex, when using BMI to assess adiposity in children and adolescents it is essential that age-and sex-specific BMI cutoffs be used to define overweight and obesity (Widhalm et al, 2001;Field et al, 2003). Given the economic, environmental, genetic and nutrition influences on body size, having growth standards that are nationally representative is an important consideration (Livingstone, 2000).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of overweight and obesity in Irish school children, using four different definitions

et al. 2006

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Objective: To determine the prevalence of overweight and obesity in Irish children using four different weight-for-height methods and to examine secular trends from previous national data. Design: A cross-sectional survey. Weight and height were measured according to standard procedures and used to determine the prevalence of overweight and obesity using four weight-for-height methods of assessment, actual relative weight, the Centers for Disease Control and Prevention body mass index (BMI) for age charts for boys and girls, the BMI reference curves for the UK 1990 and the International Obesity Task Force age-and sex-specific BMI cutoffs. Results: The prevalence of overweight and obesity in Irish children is high, but varies considerably with each method. The prevalence of obesity in boys ranged from 4.1 to 11.2 % and in girls from 9.3 to 16.3%. Between 1990 and 2005, depending on the method used, there was a two-to-fourfold increase in obesity in children aged 8-12 years. Conclusion: It is evident given the variation displayed in the prevalence of obesity when using the different methods, that there is a discernible need for a single definition to identify the obese child in Ireland. The findings show a high prevalence of overweight and obesity in Irish school children and the increase in the prevalence of obesity over the last 15 years highlights this growing public health issue.

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“…It is much less expensive than using DEXA, airdisplacement plethysmography, or The test characteristics for use of BMI for screening for childhood obesity are generally adequate when viewed from the perspective of correlation with gold-standard methods for measuring body composition and tracking coefficients. 15 The test characteristics are less good but probably still acceptable when the objective is to predict outcomes in adulthood. 7,16 …”

Section: Benefits Of Bmimentioning

confidence: 99%

The Use of BMI in the Clinical Setting

2009

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BMI has been recommended for evaluating overweight and obesity in children and adolescents in the clinical setting. Definitions of overweight and obesity are based on percentile cutoff points. There are both strengths and limitations of BMI for this use. The strengths include the fact that BMI is cheap and relatively easy to use. The weaknesses include the fact that BMI percentiles are not widely used, and categorization of BMI percentiles may not adequately define risk of comorbid conditions. In addition, percentiles are not optimal for stratifying children and adolescents with very high BMI. Alternatives to the use of BMI and BMI percentiles include waist circumference to evaluate regional fat deposition and replacement of percentiles with z scores. Despite limitations, BMI and BMI percentiles have great utility in the clinical setting and the potential to be even more useful as BMI is used more frequently and more appropriately by primary care providers. Additional research on alternatives or adjuncts to BMI is needed.

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Which Metric of Relative Weight Best Captures Body Fatness in Children?

Cited by 97 publications

References 18 publications

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis

Prevalence of overweight and obesity in Irish school children, using four different definitions

The Use of BMI in the Clinical Setting

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