Abstract
The aim of the study was to determine the reliability of body mass index based (BMI) cutoff values in diagnosing obesity among Sri Lankan children. Height, weight, waist circumference (WC) and hip circumference (HC) in 282 children were measured. Total body water was determined by deuterium dilution and fat mass (FM) derived using age and gender specific constants. A percentage FM of 30% for girls and 25% for boys were considered as cutoff levels for obesity. Two hundred and eighty two children (M/F: 158/124) were studied and 99 (80%) girls and 72 (45.5%) boys were obese based on % body fat. Eight (6.4%) girls and nine (5.7%) boys were obese based on International Obesity Task Force (IOTF) cutoff values. Percentage FM and WC centile charts were able to diagnose a significant proportion of children as true obese children. The FM and BMI were closely associated in both girls (r = 0.82, p < 0.001) and boys (r = 0.87, p < 0.001). Percentage FM and BMI had a very low but significant association; girls (r = 0.32, p < 0.001) and boys (r = 0.68, p < 0.001). FM had a significant association with WC and HC. BMI based cutoff values had a specificity of 100% but a very low sensitivity, varying between 8% and 23.6%. BMI is a poor indicator of the percentage fat and the commonly used cutoff values were not sensitive to detect cases of childhood obesity in Sri Lankan children.
Highlights
Worldwide incidence of non-communicable diseases is increasing
Eight (6.4%) girls and nine (5.7%) boys were obese based on International Obesity Task Force (IOTF) cutoff values
Percentage fat mass (FM) and waist circumference (WC) centile charts were able to diagnose a significant proportion of children as true obese children
Summary
Worldwide incidence of non-communicable diseases is increasing. This is attributed to the increase in prevalence of obesity. Worldwide incidence of childhood obesity is estimated to be about 10% and in the AsiaPacific region is about 5% [1]. In Sri Lanka the prevalence of overweight/obesity has increased and shows regional variation. A survey showed that the overall prevalence of overweight was about 2.2% with a sector variation [2]. Among urban school children overweight prevalence was 3-5% and among rural students it was 1.7% (p
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