Validation of a Body Mass Index Nomogram for Children as an Obesity Screening Tool in Young Children

Abstract

Attempting to curtail the growing epidemic of obesity is a daunting task. The American Academy of Pediatrics (AAP) obesity statement recommends early intervention.1 Prompt evaluation and treatment of early childhood obesity requires early recognition of an obese child or one who is at-risk for overweight with rapidly increasing body mass index (BMI).1 Childhood obesity is often underrecognized by medical providers.2-4 The youngest children and those at-risk for overweight are least likely to be recognized.4 There are multiple barriers to screen and treat obese children including lack of patient motivation, parent involvement, support services, time, and reimbursement.5 In addition, recognition of obesity by a medical provider depends on correct calculation and plotting of BMI.1 This calculation requires an electronic device, which may not be available. Furthermore, calculation of BMI alone is not adequate. To accurately determine a child’s weight category, BMI must then be plotted regardless of how it is determined. We hypothesize a nomogram, using height and weight to generate BMI, coupled with the BMI curve would be an acceptable alternative to screen for obesity in young children. Although a validated BMI nomogram exists for adults,6 the heights and weights are too large for young children. Thus, the objectives of this study were: to create a child-specific BMI nomogram, and to test the accuracy of that nomogram as an obesity screening tool.