BMI centile curves for Japanese children aged 5–17 years in 2000–2005

Growth charts for children aged 6-17 years in Shanxi, China: comparison with other cities of China and WHO

BACKGROUND

Growth charts are an important method for evaluating a child's health, growth, and nutritional status. It is essential to monitor the growth of children and adolescents using growth charts.

OBJECTIVES

To present body mass index (BMI)-for-age references reflecting children's growth in Shanxi. We also compare our new data with growth references of other cities of China and World Health Organization (WHO) growth standards.

METHODS

A stratified cluster random sampling method was used to recruit 5461 children and adolescents aged 6-17 years. Height and weight were measured and BMI was calculated. The LMS method was used to calculate the percentile values of body mass index by sex and age. Smoothed BMI-for-age growth curves were presented for both sexes and compared with reference data from other cities of China and WHO.

RESULTS

BMI centiles increased with age but with different patterns in both boys and girls. The centile curves from the 3rd to the 50th had a slight increase, while a sharp increase was seen from 11 to 17 years in boys and from 6 to 14 years in girls in the higher centiles. In comparison with other cities of China, the values for the 50th percentile are higher than those reported for children from China 2009, Shanghai, Changsha and China 2010 in both sexes. In comparison with WHO growth references, Chinese girls and boys had higher values in all percentiles, whereas curves of girls look roughly the same. The medians for BMI in Shanxi increase linearly from 6 to 17 years in boys.

CONCLUSIONS

The BMI percentiles of children aged 6-17 years in Shanxi differed significantly from the growth reference curves of other cities of China and WHO. Recommending the provision of BMI reference curves for local children and adolescents to assess their growth and development and monitor their nutritional status. Early detection of overweight and obesity in children provides a scientific basis for the prevention and control of overweight and obesity in children.

Reference growth curves to identify weight status (underweight, overweight or obesity) in children and adolescents: systematic review

The identification of somatic growth, through reference curves, can be used to create strategies and public policies to reduce public health problems such as malnutrition and obesity and to identify underweight, overweight and obesity. The purpose of this systematic review was to identify studies providing reference growth curves for weight status in children and adolescents. A systematic search was conducted in eight databases and in gray literature (Google scholar). To assess the risk of bias/methodological quality of studies, the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-sectional Studies (NHLBI) was used. Overall, 86 studies that met the inclusion criteria were included. Through the values   of reference growth curves for the identification of underweight, overweight and obesity, it was possible to verify that there is great variability among percentiles for the identification of underweight, overweight and obesity. The most prevalent percentiles for underweight were P3 and P5; for overweight, the most prevalent was P85 and the most prevalent percentiles for obesity were P95 and P97. The most prevalent anthropometric indicators were Body Mass Index (BMI), Waist Circumference (WC), Body Mass (BM) for age and height for age. Conclusion: Such data can demonstrate that the optimal growth must be reached, through the standard growth curves, but that the reference curves demonstrate a cut of the population growth, raising possible variables that can influence the optimal growth, such as an increase in the practice of physical activities and an awareness of proper nutrition.

Introducing excess body weight in childhood and adolescence and comparison with body mass index and waist-to-height ratio

BACKGROUND

Weight status in children and adolescents is commonly defined using age- and gender-corrected standard deviation scores for body mass index (BMI-SDS, also called z-scores). Values are not reliable for the extremely obese however. Moreover, paediatricians and parents may have difficulties understanding z-scores, and while percentiles are easier to gauge, the very obese have values above the 99th percentile, making distinction difficult. The notion of excess body weight (EBW) is increasingly applied in adult patients, mainly in the context of bariatric surgery. However, a clear definition is not available to date for the paediatric population.

METHODS

A simple definition of EBW for children and adolescents is introduced, with median weight as a function of height, age and gender (characterized by an asterisk): EBW (%) = 100x(weight-median weight*)/median weight*. EBW is compared with BMI-SDS and waist-to-height ratio (WHtR). Using two data sources (APV registry and German Health Interview and Examination Survey for Children and Adolescents (KiGGS)) including more than 14,000 children, the relationships between these anthropometric and various metabolic parameters are analysed for a group of overweight/obese children who have sought obesity therapy (APV), for the general paediatric population and for the subset of overweight/obese children from the general population (KiGGS).

RESULTS

The three anthropometric parameters are strongly correlated, with the linear correlation coefficients exceeding 0.8 in the general population and 0.75 in those seeking obesity therapy. Moreover, their relationship to metabolic parameters is quite similar regarding correlations and area under the curve from receiver operating characteristic analyses.

CONCLUSIONS

EBW has similar predictive value for metabolic or cardiovascular comorbidities compared with BMI and WHtR. As it is reliable at the extreme end of the obesity spectrum, easily communicable and simple to use in daily practice, it would make a very useful addition to existing tools for working with obese children and adolescents. Its usefulness in assessing weight change needs to be studied however.

Effects of eating behaviors on being overweight in japanese university students: a cross-sectional survey at the Okayama University

Being overweight is an important risk factor for lifestyle-related diseases. The objective of the present study was to examine whether eating until full, eating quickly, or both eating behaviors were associated with being overweight, defined as a body mass index (BMI) ≥ 25, in young adults. This cross-sectional survey comprised 1918 students (1139 male and 779 female students) at the Okayama University in Japan. In logistic regression analysis, eating until full was not associated with being overweight in either sex. The adjusted odds ratio of being overweight among those who reported eating quickly was 3.93 (2.45-6.31; P < .0001) for male and 1.59 (0.79-3.21; P = .193) for female students. Moreover, the adjusted odds ratio of being overweight was 2.72 (1.72-4.30; P < .001) in male students who frequently reported eating a fatty diet. The combination of eating quickly and frequently eating a fatty diet had a supra-additive effect on being overweight in the male students.

Body mass index for children aged 6-18 years in Beijing, China

BACKGROUND

Obesity constitutes one of the most important worldwide public health concerns.

AIM

To develop BMI percentile curves by age, sex and urban-rural regions for Beijing children and compare the results with Chinese national data and international references.

SUBJECTS AND METHODS

Boys (4078) and girls (4077), aged 6-18 years, were recruited from 1 September to 30 November 2005 in Beijing, China. BMI percentile curves were constructed using the LMS method.

RESULTS

BMI curves differed between boys and girls. BMI curves for urban children were higher than rural children at the upper percentile. Beijing BMI curves were higher than the Chinese national level. Beijing boys had a higher BMI in medium (6.5-14 years) and upper percentiles and a lower BMI in lower percentiles than WHO and developed references, whereas Beijing girls were lower in medium and lower percentiles, but higher compared to a WHO reference before age 15.5 years in upper percentiles.

CONCLUSIONS

Beijing children are fatter than the Chinese national level. Beijing urban children are fatter than rural Beijing children. The polarization of BMI values for Beijing boys suggests these children face a dual-burden of nutrition. Effective policies and interventions to control obesity and underweight in Chinese children are necessary.

Impact of using national v. international definitions of underweight, overweight and obesity: an example from Kuwait

OBJECTIVE

To compare the classification of overweight, obesity and underweight using international v. national approaches in Kuwaiti adolescents.

DESIGN

Assessment of underweight, overweight and obesity using a national approach (based on Kuwaiti reference data for BMI-for-age) was compared with assessments obtained using three international approaches: the Cole et al. and International Obesity Task Force (IOTF) definitions of thinness and of overweight and obesity (Cole-IOTF); WHO 2007; and US Centers for Disease Control and Prevention (CDC) 2000 reference data and definitions. The degree of agreement between the different methods was assessed using the weighted κ statistic (κw).

SETTING

Two randomly selected public intermediate schools in Kuwait City.

SUBJECTS

A total of 499 10-14-year-old Kuwaiti adolescents.

RESULTS

Prevalence of overweight and obesity using Kuwaiti reference data (36·7 %; 95 % CI 32·4, 41·1) was significantly lower than that obtained using international approaches - Cole-IOTF (44·7 %; 95 % CI 40·3, 49·2), CDC 2000 (44·9 %; 95 % CI 40·5, 49·4) and WHO 2007 (50·5 %; 95 % CI 46·0, 55·0) (P < 0·01). All three international approaches showed almost perfect agreement: IOTF v. WHO (κw = 0·82; 95 % CI 0·79, 0·85) and IOTF v. CDC (κw = 0·90; 95 % CI 0·87, 0·92). However, Kuwaiti reference data showed the lowest agreement with the three international approaches, the poorest being with WHO 2007 (κw = 0·54; 95 % CI 0·49, 0·59).

CONCLUSIONS

Caution should be exercised when using recently collected national reference data and definitions while assessing underweight, overweight and obesity for clinical and public health applications.