Moderate agreement between body mass index and measures of waist circumference in the identification of overweight among 5-year-old children; the ‘Be active, eat right’ study

BMC Pediatrics

Hein Raat²  Remy A HiraSing¹  Carry M Renders⁴  Wilma Jansen³  Ineke Vogel²  Lydian Veldhuis² 

[1] Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands;Department of Public Health, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the Netherlands;Youth Policy Department, Municipal Public Health Service Rotterdam area, Rotterdam, the Netherlands;Institute of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, the Netherlands

关键词: Prevalence;    Pediatrics;    Preschool child;    Overweight;    Waist circumference;    Body mass index;   

Others  :  1144964
DOI  :  10.1186/1471-2431-13-63

 received in 2012-12-03, accepted in 2013-04-18,  发布年份 2013

【 摘 要 】

Background

Body mass index (BMI) is a common indirect method to assess weight status among children. There is evidence that BMI data alone can underestimate overweight-related health risk and that waist circumference (WC) should also be measured. In this study we investigated the agreement between BMI and WC and BMI and the waist-height ratio (WHtR) when used to identify overweight among children.

Methods

This cross-sectional population-based study uses baseline data from 5-year-olds (n = 7703) collected by healthcare professionals for the ‘Be active, eat right’ study.

Results

According to age-specific and sex-specific cut-off points for BMI (IOTF, 2000) and WC (Fredriks et al., 2005), the prevalence of overweight (obesity included) was 7.0% and 7.1% among boys, and 11.6% and 10.1% among girls, respectively. For the WHtR the 90^th percentile was used as the cut-off point. Among boys, observed proportion of agreement between BMI and WC classification was 0.95, Cohen’s kappa 0.58 (95% CI; 0.53-0.63), and proportions of positive and negative agreement were 0.61 and 0.97, respectively. Observed proportion of agreement between BMI and WHtR classification was 0.92, Cohen’s kappa 0.46 (95% CI; 0.41-0.51), and proportions of positive and negative agreement were 0.51 and 0.95. Children identified as overweight according to WC were relatively tall, and children classified as overweight according to the WHtR only were relatively short (comparable results for girls).

Conclusions

There is moderate agreement between BMI and measures of WC on the presence of overweight among 5-year-olds. If BMI data and cut-offs continue to be used, then part of the group of children identified as overweight according to WC and the WHtR will be omitted. Follow-up of the children classified as overweight according to BMI only, WC only, and WHtR only, will give indications whether WC should be measured in addition to BMI or whether WC should only be measured in certain subgroups (e.g. relatively tall or short children) to identify and monitor overweight in children. This may improve early identification and prevention of overweight and overweight-related health problems in children.

【 授权许可】

   
2013 Veldhuis et al.; licensee BioMed Central Ltd.

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