Discordance of international adiposity classifications in Australian boys and girls - the LOOK study

Richard D Telford, Ross B Cunningham, Robin M Daly, Graham J Reynolds, Antony R A Lafferty, Karen J Gravenmaker, Marc M Budge, Ahmad Javaid, Shona L Bass, Rohan M Telford
Annals of Human Biology 2008, 35 (3): 334-41

BACKGROUND: Various charts based on body mass index (BMI) and per cent body fat (%BF) are used to classify childhood body composition but outcomes may vary.

AIM: The study investigated variation in incidences of childhood obesity as depicted by four classification charts.

SUBJECTS AND METHODS: BMI and DXA-derived %BF were assessed in 741 children. Incidences of overweight and obesity were compared between two BMI charts and two bioelectrical impedance (BIA)-based %BF charts.

RESULTS: The International Obesity Task Force (IOTF)-adopted BMI chart designated 21%, 6% (boys), and 26%, 9% (girls) as overweight and obese, respectively. Corresponding figures using the USA CDC BMI chart were 27%, 11% (boys) and 27%, 12% (girls). Using a USA-derived %BF chart incidences were 17%, 2% (boys) and 21%, 8% (girls) and using a UK-derived %BF chart 51%, 24% (boys) and 53%, 36% (girls). Sensitivity of BMI varied according to the %BF reference chart.

CONCLUSIONS: In contrast to the BMI-based charts, there were considerable variations in depicted incidences of obesity between the %BF-based charts. These discordances were considered to result from previously reported variation within and between BIA and DXA %BF assessments underlying the charts. The present study highlights the need for valid, reliable, unchanging BIA and DXA procedures.

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