Body mass index reference curves for the UK, 1990.
TL;DR: Centile curves for BMI in British children are presented, from birth to 23 years, based on the same large representative sample as used to update the stature and weight references, derived using Cole's LMS method.
Abstract: Reference curves for stature and weight in British children have been available for the past 30 years, and have recently been updated. However weight by itself is a poor indicator of fatness or obesity, and there has never been a corresponding set of reference curves to assess weight for height. Body mass index (BMI) or weight/height has been popular for assessing obesity in adults for many years, but its use in children has developed only recently. Here centile curves for BMI in British children are presented, from birth to 23 years, based on the same large representative sample as used to update the stature and weight references. The charts were derived using Cole's LMS method, which adjusts the BMI distribution for skewness and allows BMI in individual subjects to be expressed as an exact centile or SD score. Use of the charts in clinical practice is aided by the provision of nine centiles, where the two extremes identify the fattest and thinnest four per 1000 of the population.
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TL;DR: The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.
Abstract: Objective To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points. Design International survey of six large nationally representative cross sectional growth studies. Setting Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States. Subjects 97 876 males and 94 851 females from birth to 25 years of age. Main outcome measure Body mass index (weight/height 2 ). Results For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m 2 for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2›18 years. Conclusions The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.
14,792 citations
01 Jan 2008
TL;DR: An internationally acceptable definition of child overweight and obesity is developed, specifying the measurement, the reference population, and the age and sex specific cut off points.
Abstract: Objective To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points.
3,179 citations
TL;DR: There is a growing global childhood obesity epidemic, with a large variation in secular trends across countries, and effective programs and policies are needed at global, regional and national levels to limit the problem among children.
Abstract: Objectives. Obesity has become a global epidemic but our understanding of the problem in children is limited due to lack of comparable representative data from different countries, and varying criteria for defining obesity. This paper summarises the available information on recent trends in child overweight and obesity prevalence. Methods. PubMed was searched for data relating to trends over time, in papers published between January 1980 and October 2005. Additional studies identified by citations in retrieved papers and by consultation with experts were included. Data for trends over time were found for school-age populations in 25 countries and for pre-school populations in 42 countries. Using these reports, and data collected for the World Health Organization's Burden of Disease Program, we estimated the global prevalence of overweight and obesity among school-age children for 2006 and likely prevalence levels for 2010. Results. The prevalence of childhood overweight has increased in almost all countri...
2,719 citations
TL;DR: The proposed cut-off points should help to provide internationally comparable prevalence rates of thinness in children and adolescents consistent with the WHO adult definitions.
Abstract: Objective To determine cut offs to define thinness in children and adolescents, based on body mass index at age 18 years. Design International survey of six large nationally representative cross sectional studies on growth. Setting Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States. Subjects 97 876 males and 94 851 females from birth to 25 years. Main outcome measure Body mass index (BMI, weight/height2). Results The World Health Organization defines grade 2 thinness in adults as BMI Conclusions The proposed cut-off points should help to provide internationally comparable prevalence rates of thinness in children and adolescents.
2,501 citations
TL;DR: All included studies consistently report an increased risk of overweight and obese youth becoming overweight adults, suggesting that the likelihood of persistence of overweight into adulthood is moderate for overweight and obesity youth, however, predictive values varied considerably.
Abstract: Overweight and obesity in youth are important public health concerns and are of particular interest because of possible long-term associations with adult weight status and morbidity. The aim of this study was to systematically review the literature and update evidence concerning persistence of childhood overweight. A computerized bibliographical search--restricted to studies with a prospective or retrospective longitudinal design--was conducted. Two authors independently extracted data and assessed the methodological quality of the included studies in four dimensions (i) study population and participation rate; (ii) study attrition; (iii) data collection and (iv) data analysis. Conclusions were based on a rating system of three levels of evidence. A total of 25 publications were selected for inclusion in this review. According to a methodological quality assessment, 13 studies were considered to be of high quality. The majority of these high-quality studies were published after 2001, indicating that recently published data, in particular, provide us with reliable information. All included studies consistently report an increased risk of overweight and obese youth becoming overweight adults, suggesting that the likelihood of persistence of overweight into adulthood is moderate for overweight and obese youth. However, predictive values varied considerably. Limiting aspects with respect to generalizability and methodological issues are discussed.
2,329 citations
References
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TL;DR: The LMS method summarizes the changing distribution of a measurement as it changes according to some covariate by three curves representing the median, coefficient of variation and skewness, the latter expressed as a Box-Cox power.
Abstract: Refence centile curves show the distribution of a measurement as it changes according to some covariate, often age The LMS method summarizes the changing distribution by three curves representing the median, coefficient of variation and skewness, the latter expressed as a Box-Cox power Using penalized likelihood the three curves can be fitted as cubic splines by non-linear regression, and the extent of smoothing required can be expressed in terms of smoothing parameters or equivalent degrees of freedom The method is illustrated with data on triceps skinfold in Gambian girls and women, and body weight in USA girls
2,460 citations
Journal Article•
TL;DR: It is concluded that Quetelet's formula is both a convenient and reliable indicator of obesity.
Abstract: A weight-height index of adiposity should indicate the relative fatness of subjects of differing height unless obesity is itself correlated with height. The average body fat among adult women attending a hospital outpatient clinic for obesity was 40.5 percent of body weight. The height of an unselected series of 286 of these outpatients was found to be similar to that of the general population of women of similar age, which indicates that obesity in adult women is not significantly related to height. Body composition was measured by body density, body water and body potassium in a series of 104 female and 24 male subjects aged 14-60 years. In both sexes density, water and potassium gave progressively higher estimates of body fat (kg), and there was a significant difference between the values by different methods. The average of the estimates by these three methods was taken to be the 'true' value for each individual (F kg). Regression of F/H2 on W/H2 (Quetelet's index) gave a correlation coefficient of 0.955 for women and 0.943 for men. The deviation of the body fat estimated from Quetelet's formula from the 'true' value was not much greater than that when density, water or potassium were used as a basis for estimating body fat. It is concluded that Quetelet's formula is both a convenient and reliable indicator of obesity.
1,644 citations
TL;DR: Using current data from seven sources new reference curves have been estimated from birth to 20 years for children in 1990 and it is proposed that the curves presented here should be adopted as the new UK reference curves.
Abstract: The current reference curves of stature and weight for the UK were first published in 1966 and have been used ever since despite increasing concern that they may not adequately describe the growth of present day British children. Using current data from seven sources new reference curves have been estimated from birth to 20 years for children in 1990. The great majority of the data are nationally representative. The analysis used Cole's LMS method and has produced efficient estimates of the conventional centiles and gives a good fit to the data. These curves differ from the currently used curves at key ages for both stature and weight. In view of the concerns expressed about the current curves and the differences between them and the new curves, it is proposed that the curves presented here should be adopted as the new UK reference curves.
1,439 citations
TL;DR: Race-specific and population-based 85th and 95th percentiles of BMI and TSF for people aged 6-74 y were generated from anthropometric data gathered in the National Health and Nutrition Examination Survey Survey 1 (NHANES I).
1,382 citations
1,196 citations