Classification of Body Fatness by Body Mass Index–for-Age Categories Among Children

Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341-3717, USA.
JAMA Pediatrics (Impact Factor: 5.73). 09/2009; 163(9):805-11. DOI: 10.1001/archpediatrics.2009.104
Source: PubMed


To examine the ability of various body mass index (BMI)-for-age categories, including the Centers for Disease Control and Prevention's 85th to 94th percentiles, to correctly classify the body fatness of children and adolescents.
The New York Obesity Research Center at St Luke's-Roosevelt Hospital from 1995 to 2000.
Healthy 5- to 18-year-old children and adolescents (N = 1196) were recruited in the New York City area through newspaper notices, announcements at schools and activity centers, and word of mouth.
Percent body fat as determined by dual-energy x-ray absorptiometry. Body fatness cutoffs were chosen so that the number of children in each category (normal, moderate, and elevated fatness) would equal the number of children in the corresponding BMI-for-age category (<85th percentile, 85th-94th percentile, and > or =95th percentile, respectively).
About 77% of the children who had a BMI for age at or above the 95th percentile had an elevated body fatness, but levels of body fatness among children who had a BMI for age between the 85th and 94th percentiles (n = 200) were more variable; about one-half of these children had a moderate level of body fatness, but 30% had a normal body fatness and 20% had an elevated body fatness. The prevalence of normal levels of body fatness among these 200 children was highest among black children (50%) and among those within the 85th to 89th percentiles of BMI for age (40%).
Body mass index is an appropriate screening test to identify children who should have further evaluation and follow-up, but it is not diagnostic of level of adiposity.

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Available from: Aviva Sopher, Jan 08, 2015
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    • "BMI (weight/height2) has been recommended by many experts as the preferred index for routine clinical measurement of overweight and obesity in children and adolescents over 2 years of age[13, 24–27]. It correlates closely with total body adiposity[28] and is a fairly specific index for defining overweight and obesity[28, 29]. Nationally recommended BMI-for-age charts, such as those presented by Hosseini et al for Iranian children, should be used to determine the appropriate BMI[15, 30]. "
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    • "Though BMI (weight/height2) has been shown to strongly correlate with Total Body Fat (TBF) in children [12,13], misclassification of OW and OB is evident. When BMI is compared to more accurate measures of adiposity such as body fat percentage measured by Dual Energy X ray Absorptiometry (DXA) high specificity but low sensitivity for BMI is found [14,15]. "
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    • "The fifth limitation was the absence of true body fat measurements through radiological techniques. However, BMI is a good surrogate for body fat in obesity in large epidemiological sample sizes [41]. The final limitation was the lack of a control group. "
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