Abstract
Body mass index (BMI) is commonly used to assess a child's weight status but it does not provide information about the distribution of body fat. Since the disease risks associated with obesity are related to the amount and distribution of body fat, measures that assess visceral or subcutaneous fat, such as waist circumference (WC), waist-to-height ratio (WHtR), or skinfolds thickness may be more suitable. The objective of this study was to develop percentile curves for BMI, WC, WHtR, and sum of 5 skinfolds (SF5) in a representative sample of Canadian children and youth. The analysis used data from 4115 children and adolescents between 6 and 19 years of age that participated in the Canadian Health Measures Survey Cycles 1 (2007/2009) and 2 (2009/2011). BMI, WC, WHtR, and SF5 were measured using standardized procedures. Age- and sex-specific centiles were calculated using the LMS method and the percentiles that intersect the adult cutpoints for BMI, WC, and WHtR at age 18 years were determined. Percentile curves for all measures showed an upward shift compared to curves from the pre-obesity epidemic era. The adult cutoffs for overweight and obesity corresponded to the 72nd and 91st percentile, respectively, for both sexes. The current study has presented for the first time percentile curves for BMI, WC, WHtR, and SF5 in a representative sample of Canadian children and youth. The percentile curves presented are meant to be descriptive rather than prescriptive as associations with cardiovascular disease markers or outcomes were not assessed.
Highlights
Childhood obesity is associated with adverse health, psychosocial, and economic outcomes in childhood and adulthood [1]
Body mass index and Waist circumference (WC) increased throughout childhood and percentile cutpoints were consistently higher in males compared to females, albeit the differences were small (Tables 2 and 3, Figs 1 and 2)
Since the data for the Canadian Health Measures Survey (CHMS) were collected during the obesity epidemic, the percentile cutpoints are higher than those from the IOTF, WHO, and CDC curves, which were based on data that were for the most part collected before the 1980s
Summary
Childhood obesity is associated with adverse health, psychosocial, and economic outcomes in childhood and adulthood [1]. Body mass index (BMI) is the most commonly used method to assess a child's weight status. The drawbacks of BMI are that it cannot differentiate between lean and fat mass and does not provide information about the distribution of body fat [2,3,4]. Since the cardiovascular disease (CVD) risks associated with obesity are related to the amount and distribution of body fat [5,6,7,8], measures that assess visceral or subcutaneous fat may provide a better risk assessment than the BMI. Waist circumference (WC) and waist-to-height ratio (WHtR) have both been shown to be associated with CVD risk in children and adults.
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