Patterns of childhood body mass index (BMI), overweight and obesity in South Asian and black participants in the English National child measurement programme: effect of applying BMI adjustments standardising for ethnic differences in BMI-body fatness associations

M T Hudda,C M Nightingale,D G Cook,P H Whincup,A S Donin,A R Rudnicka,C G Owen,H Rutter,J C K Wells

doi:10.1038/ijo.2017.272

M T Hudda, C M Nightingale + Show 7 more

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https://doi.org/10.1038/ijo.2017.272

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Abstract

Background:The National Child Measurement Programme (NCMP) records weight and height and assesses overweight-obesity patterns in English children using body mass index (BMI), which tends to underestimate body fatness in South Asian children and overestimate body fatness in Black children of presumed African ethnicity. Using BMI adjustments to ensure that adjusted BMI was similarly related to body fatness in South Asian, Black and White children, we reassessed population overweight and obesity patterns in these ethnic groups in NCMP.Methods:Analyses were based on 2012–2013 NCMP data in 582 899 children aged 4–5 years and 485 362 children aged 10–11 years. Standard centile-based approaches defined weight status in each age group before and after applying BMI adjustments for English South Asian and Black children derived from previous studies using the deuterium dilution method.Findings:Among White children, overweight-obesity prevalences (boys, girls) were 23% and 21%, respectively, in 4–5 year olds and 33% and 30%, respectively, in 10–11 year olds. Before adjustment, South Asian children had lower overweight-obesity prevalences at 4–5 years (19%, 19%) and slightly higher prevalences at 10–11 years (42%, 34%), whereas Black children had higher overweight-obesity prevalences both at 4–5 years (31%, 29%) and 10–11 years (42%, 45%). Following adjustment, overweight-obesity prevalences were markedly higher in South Asian children both at 4–5 years (39%, 35%) and at 10–11 years (52%, 44%), whereas Black children had lower prevalences at 4–5 years (11%, 12%); at 10–11 years, prevalences were slightly lower in boys (32%) but higher in girls (35%).Interpretation:BMI adjustments revealed extremely high overweight-obesity prevalences among South Asian children in England, which were not apparent in unadjusted data. In contrast, after adjustment, Black children had lower overweight-obesity prevalences except among older girls.Funding:British Heart Foundation, NIHR CLAHRC (South London), NIHR CLAHRC (North Thames).

Highlights

Childhood obesity is a major public health problem both globally[1] and in England, where approximately one-third of children aged2–15 years were recently reported to be overweight or obese using body mass index (BMI).[2]
We recently developed ethnicspecific BMI adjustments, which provide adjusted BMI values for South Asian and Black children, which have the same relation to body fatness as in White children.[17]
We have applied these BMI adjustments to recent National Child Measurement Programme (NCMP) data to obtain an improved picture of the burdens of body fatness, as reflected in adjusted overweight-obesity prevalences in South Asian and Black children and in the English child population as a whole

Summary

BACKGROUND

The National Child Measurement Programme (NCMP) records weight and height and assesses overweight-obesity patterns in English children using body mass index (BMI), which tends to underestimate body fatness in South Asian children and overestimate body fatness in Black children of presumed African ethnicity. Standard centile-based approaches defined weight status in each age group before and after applying BMI adjustments for English South Asian and Black children derived from previous studies using the deuterium dilution method. South Asian children had lower overweight-obesity prevalences at 4–5 years (19%, 19%) and slightly higher prevalences at 10–11 years (42%, 34%), whereas Black children had higher overweight-obesity prevalences both at 4–5 years (31%, 29%) and 10–11 years (42%, 45%). Overweightobesity prevalences were markedly higher in South Asian children both at 4–5 years (39%, 35%) and at 10–11 years (52%, 44%), whereas Black children had lower prevalences at 4–5 years (11%, 12%); at 10–11 years, prevalences were slightly lower in boys (32%) but higher in girls (35%). FUNDING: British Heart Foundation, NIHR CLAHRC (South London), NIHR CLAHRC (North Thames)

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