The CDC and IOTF cut points show inconsistent prevalence of underweight and overweight in Chinese, Indonesian, and Vietnamese children

Abstract

No nationally representative data from middle and low income countries have been analyzed to compare prevalence of underweight and overweight defined by the Centers for Disease Control and Prevention (CDC) and the International Obesity TaskForce (IOTF) BMI cut points. We evaluated the consistency in nutrition status classifications derived from the CDC and IOTF cut points, using data from 1600 Chinese, 11756 Indonesian, and 53826 Vietnamese children aged 2‐18 y, who participated in recent, representative surveys in China, Indonesia, and Vietnam. A smaller difference between prevalence and a higher Kappa statistic indicated a higher consistency level between the CDC and IOTF classification systems. The prevalence of underweight defined by the IOTF was higher compared to those defined by the CDC cut points (absolute differences were 6, 10, and 13% in Chinese, Indonesian, and Vietnamese boys; 10, 13, and 19% in girls). Kappa statistic values were largest in Chinese boys (0.81‐0.88) compared to those in Indonesian (0.74‐0.82) and Vietnamese (0.69‐0.79) boys. Smaller Kappa statistics were found in girls from China (0.65‐0.80), Indonesia (0.63‐0.76), and Vietnam (0.55‐0.68). With an increase in age, Kappa statistics tended to increase in boys and decrease in girls. The differential findings from the CDC and IOTF cut points suggest that a validation of the cut points by using disease risk or body fat outcomes is needed. Supported by the Vietnam Educational Foundation (VEF) and USDA.