The validity of body mass index criteria in obese school-aged children.
ABSTRACT Childhood obesity is a medical and social problem in Japan. The number of obese children has been increasing steadily since 1980 according to a survey on school health statistics. However, more simple and reliable criteria for assessment of obesity in children are required. The aim of this study was to establish gender- and age-specific body mass index (BMI) cutoff values for evaluation of obesity in school-aged children. A total of 100,587 elementary school, junior and senior high school students, aged 6 to 17 years, comprised the study population, in whom BMI was measured. The BMI cutoff values were calculated by using the receiver operating characteristic (ROC) analysis in the degree of obesity of 20% or greater as definition of obesity. The validity of the determined cutoff values of BMI was then compared with the Rohrer index, the International Obesity Task Force (IOTF) data and the percentile method. The sensitivity and specificity of the BMI cutoff values were over 93% in both boys and girls of all ages, thereby providing criteria that are highly diagnostic in all ages. The Rohrer Index and BMI 95th percentile values tended to underestimate obesity, while the IOTF criteria tended to overestimate it. In conclusion, the BMI cutoff values determined in the present study enable us to detect obese individuals with extremely high precision, and thus may represent an instrument with superior diagnostic capabilities to those of the existing instruments currently being used for assessment of pediatric obesity.
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ABSTRACT: To investigate trends in frequency of obese children in Japan over two decades, the frequency of obese children who grow into obese adults and predictive factors for adult obesity. Annual cross-sectional studies for 22 y (1974-1995) with a follow-up study. Cross-sectional: Cumulatively 13,186 obese (% of standard body weight (SBW): > or = 120%) schoolchildren including 3158 extremely obese (> or = 140% of SBW) children out of 203,088 schoolchildren (age: 6-14 y) in Izumiohtsu City, Osaka, Japan. Follow-up: 151 initially obese children (initial age: 6-14 y and age at follow-up: 20-35 y) who lived in Izumiohtsu City. Control: 3552 Japanese men and 4631 Japanese women (age: 20-35 y). Cross-sectional: height, weight, trunk circumference, skin-fold thickness, blood pressure and blood biochemicals. Follow-up: height, weight, trunk circumference, skin-fold thickness during childhood, and body height and weight at follow-up. Adulthood obesity: > or = 120% of the average body mass indices (BMI) of the controls. Frequency of obese children increased from 5% to more than 10%, and that of extremely obese children increased from 1% to more than 2% during these 22 y. These increases were most prominent in the schoolboys aged 9-11 y. Prevalence of hyperglycemia and hyperlipidemia in the extremely obese children did not change, and that of hypertension and abnormal liver function gradually decreased during these two decades. After coming of age, 32.2% of the initially obese boys (relative risk: 5.3) and 41.0% of the initially obese girls (relative risk: 6.7) remained obese. BMI, percentage of the SBW and skin-fold thickness at the biceps during childhood were significantly larger in currently-obese girls. Positive correlations were demonstrated between these variables and percentage SBW at follow-up. Childhood obesity is increasing in Japan, especially in boys aged 9-11 y. Approximately 32% of the obese boys and 41% of the obese girls grow into obese adults, and the degree of obesity is a predictive factor for adult obesity.International Journal of Obesity 10/1997; 21(10):912-21. · 5.22 Impact Factor
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ABSTRACT: The International Poverty and Health Network was created in December 1997 after a series of conferences organised by the World Health Organisation (WHO) with the aim of integrating health into plans to eradicate poverty. Its formation was a response to the evidence of the persistent and growing burden of human suffering due to poverty. This is a worldwide (members from 46 countries) network of people and organisations from health, business, non-governmental organisations, and government who seek to influence policy to protect and improve the health of the world's poor, particularly the poorest in all countries. The network urges that a balance must be struck between social development and growth in income; between the human and financial dimensions of poverty; and between redistribution and market reforms. Its aspiration is to achieve a balance between biomedical and social approaches; between community based health development and a response to individuals; between prevention of disease, promotion of health, and treatment; and between physical and mental health. The more people who join the greater the likely impact of the network.This editorial has already been published in the BMJ (2000;320:1–2) and on Medscape and it is hoped that a version will appear in many other medical journals. International signatories appear on the BMJ's website, www.bmj.com.BMJ 01/2000; 320(7226):1-2. · 14.09 Impact Factor
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ABSTRACT: To assess tracking for body weight from childhood to adulthood in obese Japanese children who were treated for obesity, investigate the relation between the changes in body weight status and morbidity, and identify correlates of the changes in body weight status. Twelve-year retrospective cohort study. A sample of 276 subjects (age 23.9+/-4.1, 176 males and 100 females) who responded to a questionnaire mailed in 1998 to 1047 children (age 10.6+/-2.2) treated for obesity at Mie National Hospital in Japan between 1976 and 1992. Based on height and weight from medical records during childhood, the relative weight (RW; weight expressed as a percentage of the standard body weight for age, height, and sex) was calculated. Degrees of childhood obesity were based on RW: slight obesity (120% < or = RW<130%; n=17), moderate obesity (130% < or = RW <150%; n=131), and severe obesity (RW > or = 150%; n=128). Adult body mass index (BMI), which was obtained from the mailed questionnaires, was classified as normal, overweight and obese according to the WHO/NIH criteria. Body weight tracking by degree of obesity was evaluated. Subjects with severe obesity during childhood (n=128) were examined for their weight status in adulthood, prevalence of chronic diseases in adulthood, and factors such as parental obesity, dietary and exercise habits and obesity treatment during childhood. Childhood obesity tracked into adulthood obesity or overweight in 54.7% of all cases. Severely obese children (36.7%) were more likely to be obese as an adult than moderately obese children (16.8%). The prevalence of adult obesity tended to be greater in boys with moderate childhood obesity than in girls (29.7% in boys vs 14.9% in girls, P=0.058). Among the severely obese children who became normal-weight adults, the prevalence of chronic diseases was about one-fifth of those who remained obese in adulthood (P=0.041). Four factors were associated with changes in body weight status: maternal BMI at entry (P=0.044), the changes in dietary and exercise habits after treatment (P=0.014, P=0.030, respectively), and satisfaction with obesity treatment in childhood (P=0.035). Severely obese children have a higher risk of becoming obese adults even when they received obesity treatment in childhood. The risk of adulthood obesity was twice as high in moderately obese boys than in girls. On the other hand, many cases of childhood obesity can be corrected with obesity treatment, which in turn can decrease the risk for adult chronic diseases.International Journal of Obesity 07/2002; 26(6):770-7. · 5.22 Impact Factor