Overweight and obesity prevalence among Cree youth of Eeyou Istchee according to three body mass index classification systems

Audray St-Jean,Michel Lucas,Pierre Ayotte,Salma Meziou

doi:10.1186/s12887-017-0951-4

Abstract

BackgroundLittle is known about the suitability of three commonly used body mass index (BMI) classification systems for Indigenous youth. We estimated overweight and obesity prevalence among Cree youth of Eeyou Istchee according to three BMI classification systems, assessed the level of agreement between them, and evaluated their accuracy through body fat and cardiometabolic risk factors.MethodsData on 288 youth (aged 8–17 years) were collected. Overweight and obesity prevalence were estimated with Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF) and World Health Organization (WHO) criteria. Agreement was measured with weighted kappa (κw). Associations with body fat and cardiometabolic risk factors were evaluated by analysis of variance.ResultsObesity prevalence was 42.7% with IOTF, 47.2% with CDC, and 49.3% with WHO criteria. Agreement was almost perfect between IOTF and CDC (κw = 0.93), IOTF and WHO (κw = 0.91), and WHO and CDC (κw = 0.94). Means of body fat and cardiometabolic risk factors were significantly higher (Ptrend < 0.001) from normal weight to obesity, regardless of the system used. Youth considered overweight by IOTF but obese by CDC or WHO exhibited less severe clinical obesity.ConclusionsIOTF seems to be more accurate in identifying obesity in Cree youth.

Highlights

Little is known about the suitability of three commonly used body mass index (BMI) classification systems for Indigenous youth
Overweight prevalence rates appeared to be greater with International Obesity Task Force (IOTF) criteria regardless of gender, whereas Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) proportions were similar in boys and girls
Higher estimates of obesity were obtained for both genders with WHO and CDC systems compared to IOTF

Summary

Introduction

Little is known about the suitability of three commonly used body mass index (BMI) classification systems for Indigenous youth. We estimated overweight and obesity prevalence among Cree youth of Eeyou Istchee according to three BMI classification systems, assessed the level of agreement between them, and evaluated their accuracy through body fat and cardiometabolic risk factors. Because BMI varies with growth and maturation during childhood and adolescence, age- and sex-specific cut-off points are needed for appropriate overweight and obesity classification. Three BMI classification systems are commonly used to study youth, with cut-off values published by the International Obesity Task Force (IOTF) [7], the Centers for Disease Control and Prevention (CDC) [8], and the World Health Organization (WHO) [9]. CDC growth references are based on data from five nationally representative surveys of American youth

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Discussion

Conclusion