Body Mass Index Charts Research Articles

Prevalência de excesso de peso entre estudantes de ensino fundamental de escola pública e privada em Sorocaba, São Paulo, Brasil

Objetivo: Este estudo teve como objetivo avaliar a prevalência de sobrepeso e obesidade em um grupo de estudantes e investigar se há correlacão entre IMC (índice de massa corporal) e renda familiar. Métodos: Estudo tipo transversal, realizado com 213 estudantes do ensino fundamental de escola pública (EPU) e privada (EPR), com idade entre 10 e 14 anos, aprovado pelo comitê de ética local e mediante assinatura do termo de consentimento livre e esclarecido pelos estudantes e os responsáveis por eles. Os estudantes foram pesados e medidos e o IMC foi calculado; os dados foram avaliados com base nos gráficos da OMS para IMC conforme o sexo. Os estudantes responderam ao questionário socioeconômico segundo o critério da ABEP. A análise dos dados foi realizada usando o programa SPSS. Foi adotado nível de significância de 5%. Resultados: Prevalência global de excesso de peso (sobrepeso) na amostra estudada foi de 41,3%. Na comparação dos resultados isolados, a frequência de excesso de peso foi maior em alunos da escola particular (47,3%) do que nos da escola pública (32,1%), com significância estatística (p=0,03). A frequência de excesso de peso nos meninos da EPR foi maior do que nos da EPU (23,3% versus 14,3%; p=0,05). Nas meninas, verificou-se a mesma tendência, sem, todavia, significância estatística (24,0% versus 17,9%; p=0,18). Houve correlação positiva entre IMC e renda familiar (r=0,14, p=0,04). Conclusão: Cerca de 40% dos estudantes entrevistados apresentaram excesso de peso, com prevalência maior entre os meninos da escola particular. É relevante o desenvolvimento de estratégias de prevenção da obesidade em todos os níveis da sociedade, pois há potenciais riscos à saúde na vida adulta.

Adiposity of Korean school‐age children measured by national and international growth charts

The study was conducted to explore adiposity levels of Korean children using body mass index (BMI) and comparing how three BMI charts define adiposity. The charts used were the growth standard of the Korean Centers for Disease Control and Prevention and the growth references of the World Health Organization and the International Obesity Task Force. The percentage of children at different adiposity levels varied depending on which chart was used. These discrepancies arose from the different cut-offs for adiposity and the different characteristics of the populations that were used to develop the charts. Research is needed to identify which growth charts and cut-offs for children are most associated with health risks in later life.

Evaluation of general practitioners’ assessment of overweight among children attending the five-year preventive child health examination: A cross-sectional survey

Objective. To evaluate general practitioners’ (GPs’) assessment of potential overweight among children attending the five-year preventive child health examination (PCHE) by comparing their assessment of the children's weight-for-stature with overweight defined by body mass index (BMI) according to paediatric standard definitions. Design. A cross-sectional survey. Data were obtained from a questionnaire survey of children's health in general and their growth in particular. Setting. The five-year preventive child health examination (PCHE) in general practice in the Central Denmark Region. Subjects. Children attending the five-year PCHE in general practice, regardless of their weight status. Main outcome measures. Paediatric standard definitions for childhood overweight based on BMI were used as the gold standard for categorizing weight-for-stature. Identification of overweight was analysed with regard to sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the GPs’ assessment of weight-for-stature. Results. A total of 165 GPs conducted 1138 PCHEs. GPs assessed that 171 children had a weight-for-stature above normal. Use of the Danish Standards (DS), i.e. the Danish national growth charts for BMI, as the gold standard yielded a sensitivity of 70.1% (95% CI 62.0–77.3) and a specificity of 92.4% (95% CI 90.6–93.9). The sensitivity was influenced by the GPs’ use of BMI and the presence of previous notes regarding abnormal weight development. Conclusion. At the five-year PCHE almost one-third of overweight children were assessed to be normal weight by GPs. Use of BMI and presence of notes on abnormal weight in medical records were positively associated with a higher identification. Hence, utilization of medical record data and BMI charts may refine GPs’ assessment of childhood overweight.

Knowledge, attitude, and skills of health and non health professionals treating paediatric obesity in Scotland

Background Childhood obesity has risen up the political agenda in the UK, nonetheless evidence indicts poor skills and confidence in engaging with obese children and their families amongst professionals. Aim The aim of the present study was to assess the Knowledge, Attitudes and Skills (KAS) of health and non-health professionals in two geographic areas in Scotland to evaluate the changes in KSA after one day training in paediatric obesity. Methods A semi-quantitative questionnaire was distributed among participants pre and post training. Descriptive analysis of data was undertaken to quantify the self-reported changes in KAS pre and post training. Results 42 participants (20 health and 22 non-health) completed both pre and post KAS questionnaires. The ability to diagnose obesity increased from 67.5% pre to 94.8% post training. The knowledge of childhood obesity guidelines increased from 27.5% to 82%. Self-confidence in treatment comprehension increased from 14% to 65.7%, while awareness of treatment goals increased from 30% to 80%. Confidence in the ability to discuss obesity issue with parents increased from 53.8% to 87.5%. Skills in the use of Body Mass Index (BMI) calculations and BMI charts increased from 21.9% and 29.2% to 40%. Conclusion This present study highlighted alarming gaps in the KAS of health and non health professional participating in the engagement of obese children and their families. KAS improved after attending a specific tailored training course. This training course could be a step forward to accomplishing a higher standard health care for obese children.

Nutritional status assessment of school children in Mangalore city using the multicenter growth reference study WHO 2007 Z-scores

Context: One of the the United Nation's Millennium Development Goals (MDGs) is the reduction of maternal and child mortality. The 'green revolution' has increased food supply in Asia, and hunger and under nutrition have been decreasing since 1981. However, instead of having to deal with surplus food grain, South Asia and India are still facing high levels of hunger. Although some south Indian cities are witnessing a technology boom, one in every 11 children die within the first 5 years of their lives either due to malnutrition or due to non availability of even simple technology and health care. Aim: To assess the nutritional status of schoolchildrenin Mangalore city. Settings and Design: A cross-sectional study. Materials and Methods: A total 1630 students from 11 schools were enrolled for the study. The sample size was calculated assuming the prevalence of undernourished in Mangalore city as 20% and a relative precision of 10%. Statistical Analysis: The BMI (body mass index), Z-scores, and World Health Organization (WHO) Multicentric Growth Reference Study (MGRS) growth chart was used for analysis. Results: Our study population of 1630 students comprised 830 (50.9%) males and 800 (49.1%) females. On analysis, 82 children (5.03%) were found to be undernourished, 37 (2.3%) were overweight, and 16 (1%) were obese. Undernourishment was more prevalent in boys (6.87%) than in girls (3.12%).Obesity was marginally higher among males (1.2%) as compared to females (0.8%) (P=0.003). A total of 15 boys (1.8%) and 22 girls (2.8%) were found to be overweight. Conclusions: The nutritional status of the students in our study is better than has been found in other studies. However, there are cases of under nourishment that need attention. At the same time, there is a need to deal with obesity and overweight in schoolchildren in order to prevent the impending epidemic of noncommunicable disease.

The Relation between Asthma, Body Fat Distribution and Serum Adiponectin in Obese Egyptian Children.

Childhood obesity is an emerging global public health challenge. That is because the prevalence of obesity among children and adolescents has increased greatly in all parts of the world. A number of studies have reported an inverse relation between respiratory function and various indices of obesity or fat distribution (El-Baz et al., 2009). Adiponectin, an antiinflammatory adipocytokine, circulates at lower levels in the obese, which is thought to contribute to obesity-related inflammatory disease as bronchial asthma ( Medoff et al., 2009). Aim of the work The aim of this work was to assess the correlation between the bronchial asthma, obesity, fat distribution and serum adiponectin in obese Egyptian children. Subjects and Methods The present study included a group of obese fifty (50) children (25 boys & 25 girls) without the co morbidities of the metabolic syndrome; aged 7-18 years, mean age (14.2±3.9). Obesity without the co morbidities of the metabolic syndrome was defined as a BMI above the 85th percentiles according to BMI Charts of Egyptian Growth Charts for boys and girls from 2-21 years (2002). They were compared to thirty (30) lean sex and age matched controls mean age (14.1±4.8) (15 boys & 15 girls) with BMI between the 10th and 75th percentile. Anthropometric measurements (body weight, BMI, WC and fat mass% by DEXA) were done for all children together with pulmonary function test and assessment of serum adiponectin levels. Results Weight, Waist circumference (WC), Body mass index (BMI), fat mass% and adiponectin were significant higher in obese compared to non obese groups (p 0.05 for both). A negative association of BMI with parameters of pulmonary function was found but only FEV1, FVC & FEF 25% were statistically significant(p 0.05). In the present study a negative correlation was found between fat mass % and parameters of pulmonary function but none of them was statistically significant (p>0.05 for all). A negative significant correlation was found between adiponectin and age in obese group (p>0.05) .As regard anthropometric parameters in obese group a significant negative correlation was found between adiponectin and BMI, WC & fat mass %(p 0.05). As regard of pulmonary function parameters a negative significant correlation was found between serum adiponectin and FVC and PEF %( p 0.05), While no correlation was found with FEV1FVC ratio (p>0.05). Conclusion: The increasing prevalence of overweight and obesity among Egyptian children may be an important contributor to the increasing incidence and prevalence of asthma. Adiponectin may be one of the signals linking obesity with asthma.

Ocena częstości występowania nadciśnienia tętniczego mierzonego z zastosowaniem całodobowego ambulatoryjnego monitorowania ciśnienia tętniczego (ABPM) u czternastolatków i piętnastolatków – obserwacje wstępne

IntroductionHypertension is one of the main factors resulting in the disease of cardiovascular system. Its incidence rises along with age and its significant increase of suffering from hypertension is observed in groups of adolescents. AimThe aim of this study was to present the evaluation of hypertension incidence in groups of adolescents at the age of fourteen and fifteen and defining the incidence of co-occurrence of emotional disorders, obesity and other diseases in children with hypertension. Material and methodsTo date, 959 students at the age of fourteen and fifteen were tested. The ambulatory blood pressure monitoring measurement was obtained with an Oscar 2 oscillometric device. Parents were asked to complete a survey on child and family health. The average value of systolic blood pressure (SBP), diastolic blood pressure (DBP) for the daytime and nighttime, blood pressure load and nocturnal dipping were assessed in this trial. In selected patients underwent psychological testing. In all the rated weight, height and BMI percentile using body mass index charts. Results.BP load in excess of 25% was found in 341 students which is the subject 35.55% of the studied group. Mean value of daytime SBP and DBP higher than 95 percentiles for the gender, height and age was obtained in 142 students which is 14,80% of the studied population, mean value of nighttime SBP and DBP respectively in 168 students which is 17.52% of the studied population. Both BP load in excess of 25% and the mean SBP exceeding 95 percentiles in 199 students (20.75%) was detected. In total, the abnormal result of ABPM was gained in 361 of studied population which constitutes 37.64%. A higher proportion of elevated BP and increased mean daytime and nighttime BP were observed for SBP than for DBP. In all children with ambulatory blood pressure abnormality, further trials have been. 209 patients were scheduled to be measured. In the above group the hypertension was established in 85 of studied population. In this group 30.50% of ill patient suffered from emotional disorders; the obesity was detected in 32.94% of patients; in 9.40% of patients both the obesity and emotional disorders co-occurred; in 9.40% of studied patients suffered from the disorder of thyroid gland; in 1.12% of patients the disorder of kidneys was detected. Conclusions1. Increased a frequency of prevalence of elevated blood pressure among young people in the adolescence. 2. The dominant form of hypertension in adolescents was the isolated systolic hypertension. 3. Emotional disorders and obesity often co-occured with the hypertension. 4. Patients with ambulatory blood pressure monitoring abnormal results need the confirmation of diagnosis in the further clinical trials.

P2-387 Health professionals are not systematic in obesity detection and measurement

Healthcare providers (HCPs) should identify overweight and obesity for surveillance and intervention purposes. This study aimed (a) to assess the ability of HCPs to estimate body mass index (BMI) by...

Charts Based on Body Mass Index and Waist-to-Height Ratio to Assess the Health Risks of Obesity: A Review

This review focuses on the rationale behind the charts that have been used as public health tools to assess the health risks of obesity, with special emphasis on where the boundary values are placed. A chart based on body mass index (BMI) was introduced in the 1980s to replace Tables of best weights for heights and this BMI chart (based on adult weight for height) is still very much in use today. Although the importance of the distribution of body fat, as opposed to the total amount of body fat, in determining health risks of obesity was first suggested in the 1940s, it was not until the mid 1990s that a chart based on Shape was suggested. The Ashwell ® Shape Chart was based on the use of waist-to-height ratio (WHtR) as a proxy for abdominal obesity. The chart contains three boundary values for WHtR: 0.4, 0.5 and 0.6; originally set on pragmatic decisions. Substantial evidence from a recent systematic review now supports the global boundary value WHtR of 0.5 for Consider Action. WHtR of 0.6 has been proposed for Take Action. An exciting prospect is that the same Shape Chart might be used to assess risk for adults and children in several ethnic groups. Use of the Shape Chart could also improve the efficiency for screening for cardiometabolic risk and could provide substantial cost savings in terms of obesity treatment. The public health message could not be simpler: Keep your waist circumference to less than half your height.

UAE population reference standard charts for body mass index and skinfold thickness, at ages 0–18 years

Aims To determine a range of anthropometric measurements including skinfold thickness measurements in four different areas of the body, to construct population growth charts for body mass index (BMI), skinfolds, and to compare these with growth charts from other countries. One aim was also to validate body fat charts derived from skinfold thickness.Methods A national cross-sectional growth survey of children, 0–18 years old, was conducted using multistage stratified random sampling. The sample size included at least 200 children in each age–sex group. Height, weight, biceps skinfold, triceps skinfold, subscapular skinfold, suprailiac skinfold, and mid-upper-arm circumference were measured in each child. We describe correlation, standard deviation scores relative to the other standards, and calculation of body density in the United Arab Emirates population. We determined whether any of the above is a good indicator of fatness in children.Results BMI, upper-arm circumference, sum of four skinfolds, and percentage body fat charts were constructed using the LMS method of smoothing. BMI was very significantly correlated with sum of skinfold thicknesses, and mid-upper-arm circumference. Prevalence of obesity and overweight in ages 13–17 years was respectively 9.94% and 15.16% in females and 6.08% and 14.16% in males. Derived body fat charts were found not to be accurateConclusion A national BMI, upper-arm circumference, and sum of four skinfolds chart has been constructed that can be used as a reference standard for the United Arab Emirates. Sum of four skinfold thickness charts can be used as crude determinants of adiposity in children, but derived body fat charts were shown to be inaccurate.

The Nutritional Status of Grade Eleven Students in the Medical Officer of Health Area Kalutara

Objectives: To describe the nutritional status of grade eleven school children in the Medical Officer of Health (MOH) area Kalutara. Methodology: A descriptive cross-sectional study was carried out among grade eleven school children in Type 1AB and Type 1C state schools in the MOH area Kalutara. Eighteen classes from a total of 14 schools were studied. Cluster sampling technique, probability proportionate to size was used to select the sample. The heights and weights were measured, and the Body Mass Index (BMI) was calculated for each child. The age and sex specific BMI charts developed by the National Centre for Health Statistics 2000 were used as standards. A structured, pre-tested self-administered questionnaire was used to collect the socio-demographic characteristics. Results : The prevalence of thinness ( Conclusions: Under-nutrition is a problem among grade eleven school children in the MOH area Kalutara. Almost 7% of them were at risk of overweight. Key Words: Nutritional Status; School Children DOI: 10.4038/jccpsl.v13i2.2967 Journal of the College of Community Physicians of Sri Lanka Vol.13(2) 2008 34-38

Screening for body‐weight disorders in Nigerian children using contrasting definitions

Several indices for body-weight disorders exist in scientific literature, but it is inconclusive whether or not they can yield comparable results when applied to Nigerian children. The prevalence of weight disorders in Nigerian children was examined using the Centre for Disease Control and Prevention (CDC) body mass index (BMI) for age charts and the International Obesity Task Force's (IOTF) age- and sex-specific BMI cut-off points. Participants were 2015 pupils (979 boys and 1036 girls) aged 9-12 years, attending 19 public primary schools in Makurdi, Nigeria. Stature and body mass were measured using standard techniques. Results were analysed using student t-test and Chi-squared statistics, with the probability level set at <or=0.05. CDC's BMI charts categorized 2.1%, 1.6% (boys) and 3.2%, 2.8% (girls) as overweight and obese respectively. Corresponding data for the IOTF's BMI charts were 1.7%, 0.9% (boys) and 2.6%, 2.0% (girls). CDC cut-off points indicated higher prevalence of overweight and obesity, thus suggesting the need for a single definition for evaluating measurements of body mass-for-stature in the children. However, more disconcerting is the fact that CDC charts showed a high prevalence of underweight for the boys (87.1%) and girls (79.7%). Prevalent underweight conditions in our sample need urgent intervention. The IOTF method is limited in its utility to identify children who are underweight and may be at risk of growth faltering.

Use of a Pediatrician Toolkit to Address Parental Perception of Children's Weight Status, Nutrition, and Activity Behaviors

Communication of children's weight status and targeted counseling by pediatricians may change parental perceptions or child dietary and physical activity behaviors. The aim of this study was to determine whether accuracy of parental perception of children's weight status and reports of related behaviors changed following a brief pediatrics resident intervention. Parents (N = 115) of children aged 4 to 12 years enrolled in Medicaid completed baseline questionnaires with providers about prior communication of weight status and/or body mass index (BMI), perceptions of their children's weight, and children's dietary and physical activity behaviors, and children were weighed and measured. Trained residents used a toolkit to communicate weight status to parents (via color-coded BMI charts) and counseled about mutually chosen healthy behaviors. Questionnaires were repeated at 1 and 3 months, and measurements were repeated for children with BMI > or =85%. At baseline, 42% of parents of overweight children believed their children were at healthy weight. Most (n = 96; 83%) parents completed 1-month questionnaires, and 56% completed 3-month follow-up questionnaires. Improvements in fruit and vegetable consumption, sweet drinks, unhealthy snacks, frequency of restaurant food, lower-fat milk, and screen time occurred among both overweight and healthy weight children. There were also increases in discussions with providers about weight/BMI and parental accuracy of overweight assessment. Parent accuracy of weight status and short-term childhood dietary and physical activity behavior changes improved following resident pediatrician use of a toolkit to support communication of weight status and counseling. Further research needs to determine whether accurate parental perception motivates improved behavior change or healthier BMI trajectories.

Joint Effects of Child Temperament and Maternal Sensitivity on the Development of Childhood Obesity

The interplay between child characteristics and parenting is increasingly implicated as crucial to child health outcomes. This study assessed the joint effects of children's temperamental characteristics and maternal sensitivity on children's weight status. Data from the National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development were utilized. Infant temperament, assessed at child's age of 6 months by maternal report, was categorized into three types: easy, average, and difficult. Maternal sensitivity, assessed at child's age of 6 months by observing maternal behaviors during mother-child semi-structured interaction, was categorized into two groups: sensitive and insensitive. Children's height and weight were measured longitudinally from age 2 years to Grade 6, and body mass index (BMI) was calculated. BMI percentile was obtained based on the Centers for Disease Control and Prevention's BMI charts. Children, who had a BMI ≥ the 85th percentile, were defined as overweight-or-obese. Generalized estimating equations were used to analyze the data. The proportions of children overweight-or-obese increased with age, 15.58% at 2 years old to 34.34% by Grade 6. The joint effects of children's temperament and maternal sensitivity on a child's body mass status depended on the child's age. For instance, children with difficult temperament and insensitive mothers had significantly higher risks for being overweight-or-obese during the school age phase but not during early childhood. Specific combinations of child temperament and maternal sensitivity were associated with the development of obesity during childhood. Findings may hold implications for childhood obesity prevention/intervention programs targeting parents.

Do paediatricians miss the diagnosis of obesity?

<h3>Aims</h3> To evaluate how often paediatricians recognise and manage obesity in children they see in outpatient clinics. <h3>Methods</h3> An audit of outpatient clinic consultations during a calendar month in both general paediatrics and paediatric endocrinology. All children with a body mass index (BMI) ≤ 98th percentile had their notes reviewed for evidence that the clinician had recognised their obesity, arranged appropriate investigations for hormonal causes and co morbidities and given lifestyle advice or referral to a community obesity programme. The results were fed back during a post clinic meeting. Clinicians were given written material on the National Institute for Health and Clinical Excellence (NICE) obesity guidelines and the local community obesity programme. UK BMI management charts were displayed in all clinic rooms. A repeat audit evaluated any change in obesity recognition and management. <h3>Results</h3> A total of 157 patient visits occurred during the audit period, including 21 obese children. 6/10 and 5/11 of the obese children attending the paediatric endocrinology and general clinics, respectively, were recognised as having a weight problem. Fewer than half the children were asked for appropriate family history, had a body mass index (BMI) measurement, or investigations for hormonal causes or co morbidities; apart from in the endocrinology clinic where 8/10 obese children had thyroid function tested. 3/10 in the endocrinology clinic and 3/11 in the general clinic had lifestyle advice or referrals to the obesity service. In the repeat audit 15/147 patients attending either the endocrinology or general clinics were obese. 5/9 and 2/6 in the endocrine and general clinics, respectively, were recognised as obese; no statistical change from the initial audit. There was no increase in the numbers of diagnosed obese children being investigated or offered help with weight loss. <h3>Conclusion</h3> A large proportion of the obese children attending endocrinology and general clinics in a teaching hospital are not recognised as having a weight problem and less than half are investigated or managed in accordance with NICE guidance. Feedback of the audit results, displaying BMI charts in clinic rooms, and providing written information on the NICE guidelines and referral options, did not improve the results.

Ozhirenie v detskom vozraste:vozmozhnosti primeneniya amerikanskogokonsensusa v rossiyskoy praktike

We have analyzed the opportunity to use in Russian practice An Endocrine Society Clinical Practice Guideline: Prevention and Treatment of Pediatric Obesity. The document contains exact statements on diagnostic criteria of obesity and overweight, clarification of basic principles of investigation, detailed therapeutic recommendations, considerations on obesity prophylaxis problem. All recommendations are given according to the evidence database existing to the moment of guideline development. The guidelines are found to be comfortable to use by clinicians taking in consideration a few limitations. Clarifications in international pediatric percentile body mass index charts usage, nomenclature specifications, and pharmacotherapy with drugs non-approved for children are necessary.

References for growth and pubertal development from birth to 21 years in Flanders, Belgium

Background: Due to the secular trend in length and height, growth references need to be updated regularly. Reference charts that were until recently used in Belgium are based on samples collected more than 30 years ago, and references for body mass index (BMI) and pubertal development have not been established before.Aims: To establish contemporary cross-sectional reference charts for height, weight, BMI, head circumference, and pubertal development from birth to 21 years of age, based on a representative sample of children from Flanders, Belgium.Subjects and methods: 15 989 healthy subjects of Belgian origin, 0–25 years of age, were measured in 2002–2004. Growth curves were fitted with the LMS method, and percentiles for the pubertal development were estimated with generalized additive models on status quo data from 8690 subjects aged 6–22 years of age.Results: A positive secular trend in height and weight is observed in children above 5 years of age. Adult median height has increased by 1.2 cm/decade in boys and 0.8 cm/decade in girls; median weight by 0.9 kg/decade in boys, and 1.0 kg/decade in girls, and the weight distribution became more skewed. The BMI curve is comparable to that of other populations, except for higher percentiles. This reflects the increasing prevalence of overweight and obesity. Median age at menarche (13.0 years) has not advanced any more over the past 50 years. Median ages at menarche and B2 in girls and G2 or T4 in boys are comparable to other West European estimates, but approximately 10% enter G2/T4 before 9 years of age.Conclusions: The ongoing secular trend in height and weight makes growth charts previously used in Belgium obsolete. New representative charts for growth and pubertal development are introduced. For weight monitoring, it is advised that the now-available BMI growth charts are used.

Color-Coding Improves Parental Understanding of Body Mass Index Charting

To assess parental understanding of body mass index (BMI) and BMI percentiles by using standard versus color-coded charts; to investigate how parental literacy and/or numeracy (quantitative skills) affects that understanding. A convenience sample of 163 parents of children aged 2 to 8 years at 2 academic pediatric centers completed a demographics questionnaire, the mathematics portion of the Wide Range Achievement Test (WRAT-3R), the Short Test of Functional Health Literacy in Adults (S-TOFHLA), and an "Understanding BMI" questionnaire, which included parallel BMI charting questions to compare understanding of standard versus color-coded BMI charting. Outcomes included parental-reported versus actual understanding of BMI, the odds (obtained by generalized estimating equations) of answering parallel questions correctly by using standard versus color-coded charting, and odds of answering questions correctly on the basis of numeracy and literacy. Many parents (60%) reported knowing what BMI was, but only 30% could define it even roughly correctly. When parents used color-coded charts, they had greater odds of answering parallel BMI charting questions correctly than when they used standard charts (mean, 88% vs 65% correct; pooled adjusted odds ratio, 4.32; 95% confidence interval, 3.14-5.95; P < .01). Additionally, parents with lower numeracy (K-5 level) benefited more from color-coded charts (increased from 51% to 81% correct) than did higher numeracy parents (high school level or greater), who performed well with both charts (89% vs 99% correct). Parents consistently performed better with color-coded than standard BMI charts. Color-coding was particularly helpful for lower numeracy parents. Future studies should investigate whether these results translate into the office setting and whether understanding motivates parents to implement important lifestyle changes.

Comparison of the anthropometric measurements and health risks in people with normal weight according to the body mass index-for-age charts

Aim Body mass index (BMI) at 5th-84th percentiles according to the BMI-for-age charts from Center for Diseases Control and Prevention (CDC) is considered as normal BMI for children and adolescents. However, Guo et al found that BMI at 75th-84th percentiles already had a possibility to be adult overweight and obese. This study aimed to determine anthropometric measurements, laboratory findings, and health risk differences to find an ideal BMI group according to the BMI charts. Methods Normal BMI according to adult classification from the World Health Organization (BMI at 18.5-24.9) is used as a reference group. Results &amp; Conclusion Our study showed BMI value at 50th-74th percentiles in boys and at 75th-84th percentiles in girls had higher anthropometric measurements and laboratory findings than the reference group. However, the health risks of those BMI percentiles did not significant different compared with the reference group. (Med J Indones 2009; 18: 41-7) Keywords: normoweight, adolescent, BMI-for-age charts, anthropometric measurements, health risks

Diagnosis and management of childhood obesity: A survey of general practitioners in South West Sydney

To describe general practitioners' (GPs) diagnosis and management of overweight and obesity in children, their attitudes regarding obesity and their awareness of National Health and Medical Research Council (NHMRC) clinical practice guidelines. A cross-sectional written survey of members of the Liverpool Division of General Practice (located in South West Sydney, Australia). Of 137 questionnaires sent, 85 (62%) were returned. Although the majority prescribed the correct interventions, there was variability in complications screening, ranging from 75% screening for psychosocial problems to 30% for fatty liver. Less than a third (28%) of GPs used NHMRC guidelines in their practice and only 9% used body mass index charts to correctly diagnose childhood obesity. GPs felt that childhood obesity was a significant issue and identified parental denial and lack of community support as barriers to treatment. Although NHMRC guideline adherence was far from universal, the GPs in our survey are motivated and aware of the importance of managing childhood obesity. If the primary care approach is to work, then GPs need support and education in an environment where there is greater community awareness of the impact of childhood obesity.