International Obesity Task Force Reference Research Articles

A contemporary description of French newborns’ growth using the Efemeris cohort

BackgroundOverweight and obesity in childhood are a major concern in developed countries. Reference growth curves are used in current practice to identify children at risk, especially at risk of overweight or obesity. National reference growth curves were published 35 years ago from children born in the 1950s to study growth from birth to adulthood. Additionally, more recent national curves exist to study birth weight and height according to gestational age. The primary objective was to describe anthropometric measurements of French children born in the 2000s and to compare them with the French references. The secondary objective was to describe overweight indicators during infancy. MethodsA total of 77,315 singletons live-born from 1 July 2004 to 31 December 2013 recorded in the Efemeris (a French cohort of women and their children) were included. The z-score means based on the French references for weight, height, and body mass index (BMI) at birth, 9 months, and 24 months were calculated. ResultsAt birth, the weight and height of the cohort did not deviate from the recent French references taking into account gestational age. At 9 and 24 months, the cohort was between 0.12 and 0.39 standard deviations (SD) heavier and between 0.70 and 0.97 SD taller than the old French reference population. Between 0 and 2 years, 28.6% of the children underwent a rapid weight gain (change in SD scores>0.67). The prevalence of overweight at 2 years was between 5 and 6% using the International obesity task force (IOTF) references. ConclusionThe distributions of the height, weight, and BMI during early childhood differ from those of children in the national growth references. Contemporary children at 2 years are taller and heavier than children born in the 1950s. Approximately one in 20 children is overweight at 2 years.

Childhood obesity classification systems and cardiometabolic risk factors: a comparison of the Italian, World Health Organization and International Obesity Task Force references

BackgroundBody Mass Index Italian reference data are available for clinical and/or epidemiological use, but no study compared the ability of this system to classify overweight and obesity and detect subjects with clustered cardiometabolic risk factors with international standards. Therefore our aim was to assess 1) the agreement among the Italian Society for Pediatric Endocrinology and Diabetology (ISPED), the World Health Organisation (WHO) and the International Obesity Task Force (IOTF) Body Mass Index cut-offs in estimating overweight or obesity in children and adolescents; 2) the ability of each above-mentioned set of cut-points to detect subjects with cardiometabolic risk factors.MethodsData of 6070 Italian subjects aged 5–17 years were collected. Prevalence of normal-weight, overweight and obesity was determined using three classification systems: ISPED, WHO and IOTF. High blood pressure, hypertriglyceridemia, low high density lipoprotein-cholesterol and impaired fasting glucose were considered as cardiometabolic risk factors.ResultsISPED and IOTF classified more subjects as normal-weight or overweight and less subjects as obese as compared to WHO (p <0.0001) in the whole sample and in groups divided by gender and age. The strength of agreement between the three methods compared to each other was excellent for overweight (including obesity) definition (k > 0.900), while it differed for obesity definition, ranging from the highest agreement between ISPED and IOTF (k 0.875) to the lowest between ISPED and WHO (k 0.664). WHO had the highest sensitivity, while ISPED and IOTF systems had the highest specificity, in identifying obese subjects with clustered cardiometabolic risk factors. Analogous results were found in subjects stratified by gender or age.ConclusionsISPED and IOTF systems performed similarly in assessing overweight and obesity, and were more specific in identifying obese children/adolescents with clustered cardiometabolic risk factors; on the contrary, the WHO system was more sensitive. Given the seriousness of the obesity epidemic, we wonder whether the WHO system should be preferable to the national standards for clinical practice and/or obesity screening.

A comparison of the 2015 Indian Academy of Pediatrics, International Obesity Task Force and World Health Organization growth references among 5–18-year-old children

Background and Rationale: The Indian Academy of Pediatrics (IAP) Growth Charts Committee has constructed revised IAP growth references for 5–18-year-old Indian children. This study was conducted with the objective of comparing these growth references with those prescribed by the International Obesity Task Force (IOTF) for Asian population and by the World Health Organization (WHO). Methods: Information about age, weight, and height was obtained from school-age children and adolescents between 5 and 18 years of age attending a health center as patients or accompanying persons. Three reference systems - the new IAP, “Asian” IOTF, and WHO-based on age- and gender-specific body mass index cutoffs were used to classify children as obese, overweight, or nonobese nonoverweight. The three reference systems were compared using weighted kappa. Results: The prevalence of overweight using new IAP, “Asian” IOTF, and WHO reference systems was 6.6%, 6.6%, and 4.0%, respectively. The prevalence of obesity using new IAP, “Asian” IOTF, and WHO reference systems was 5.0%, 5.0%, and 4.3%, respectively. The prevalence of overweight and obesity was lower when the WHO reference was used, especially for adolescents. There was an excellent agreement between new IAP and “Asian” IOTF references (weighted kappa = 0.9558, 95% confidence interval 0.9134–0.9982). Conclusions: The WHO reference may be less suitable for use in the Indian context, especially in adolescents.

Assessment of adolescent weight status: Similarities and differences between CDC, IOTF, and WHO references

ObjectiveThe research sought to determine the reliability of assessing adolescents' weight status based on three standard criteria, Centers for Disease Control and Prevention (CDC) growth charts, International Obesity Task Force (IOTF) standards, and the World Health Organization (WHO) growth references. MethodsData from the NEXT Generation Health Study US 10th grade cohort (n=2323, mean age=16.19years) starting in 2009 were used. Kappa statistics assessed agreement of assignment to weight categories. Associations of weight status with perceived body image, weight control intention, and general health were examined using linear regressions accounting for complex survey design. ResultsKappas across weight status criteria were≥.89 and agreement exceeded 90% in all analyses. For all three criteria, overweight and obese participants, compared to normal weight, were significantly more likely to indicate fatter body image, higher weight control intention, and poorer general health; small differences in the regression coefficients by classification method were observed. ConclusionThe three criteria of weight status classifications substantially agreed. Associations of weight status with selected health correlates were similar regardless of the methods. Thus, the three classifications can be considered comparable for most research and practice purposes.

Comparing the role of standard references on the prevalence of Iranian children and adolescents' overweight and obesity: A systematic review and meta-analysis.

Background:Obesity is a major risk factor for chronic diseases and has a role on high blood pressure, diabetes type II, etc., This review assesses the prevalence of Iranian children obesity and overweight for different age categories and compares the three standard definitions of obesity.Materials and Methods:To retrieve desirable studies concerning childhood anthropometric data from different area of Iran, the MEDLINE, Scopus, and different local databases such as Scientific Information database were used. The studies reported the prevalence of obesity or overweight of children < 6, 6–12, and 12–20 years old, despite differences between definitions of childhood obesity, were included in the study. We combined the reported prevalence of the overweight and obesity with regard to age and gender, and also by the different standard references which are the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) definition, and the International Obesity Task Force (IOTF) references. The analysis was carried out using STATA software.Results:Our review covered 75 articles reported the prevalence of overweight or obesity among children and adolescents for different age groups in Iran. Our meta-regression analysis showed that the prevalence of obesity and overweight did not vary significantly in gender and age categories, but different definitions provide different prevalence of overweight and obesity.Conclusion:The effective factors on obesity and overweight included administration policy and organizational, interpersonal, intrapersonal, and social factors. CDC and WHO references intended in monitoring children's growth and the IOTF cutoffs would rather provide a common set of definitions that researchers and policymakers could use for descriptive and comparative purposes.

Ghrelin, adipokines, metabolic factors in relation with weight status in school-children and results of a 1-year lifestyle intervention program.

BackgroundOverweight in Guadeloupe is a public health matter affecting children and adults. In the present study we evaluated the metabolic profile, including serum ghrelin, leptin and adiponectin levels, in normal weight, overweight and obese school children and we analyzed the potential changes in anthropometric and metabolic risk factors after a 1-year lifestyle intervention program.MethodsParameters were assessed at baseline and at 1 year. Three groups (G) were defined according the International Obesity Task Force reference values, G1: normal weight / G2: overweight / G3: obese. The lifestyle intervention included dietary counseling, regular physical activity and family support.ResultsA total of 120 children (G1: n = 44, G2: n = 39, G3: n = 37), aged 11– 15 years and 59 % girls were enrolled. Obese children showed significant lower HDL-C, adiponectin and ghrelin concentrations, higher triglycerides, fasting blood glucose, insulin and leptin levels and also higher frequencies of abdominal obesity (G1: 2.3 %, G2: 28.2 %, G3: 73 %) and insulin resistance (GI: 39 %, G2: 72 %, G3: 89 %) than the other groups. In the overall sample, the linear regressions exploring the associations of ghrelin, adiponectin and leptin with age, gender, BMI z-score, HOMA-IR and tanner stage as independent variables showed strong associations of leptin levels with weight status and insulin resistance at baseline. The models accounted for 58 % of variability in leptin levels compared with 26 and 15 % for adiponectin and ghrelin levels respectively.In 83 children who completed the program, significant decreases in BMI z-score in overweight and obese children were noted. Leptin levels decreased significantly only in the obese group whereas adiponectin concentrations increased significantly in the three groups,In obese children, a significant correlation was found between changes in BMI Z-score, and changes in leptin levels (r = 0.39; P = 0.049) but not with changes in adiponectin levels.ConclusionsAbdominal obesity and insulin resistance were highly prevalent in obese children highlighting their risk of metabolic complications in adulthood. A 1-year long lifestyle intervention was associated with improvement in BMI z-score and metabolic parameters.

Prevalence of overweight and obesity in preschool children in Thessaloniki, Greece.

Data on obesity in preschoolers are scarce in Greece, a country particularly affected by the obesity epidemic. The present study aimed to assess overweight and obesity prevalence of preschoolers in Thessaloniki, Greece, by using three different standards for defining childhood overweight and obesity. One thousand two hundred and fifty (1250) preschool children (657 boys and 593 girls) aged 2.0-6.0 years old from all public municipality kindergartens of Thessaloniki, Greece, participated in this cross-sectional survey conducted from 2009 to 2010.Body weight and height were measured and detailed anthropometry measurement was undertaken. BMI was classified to weight categories based on the CDC (US Centers for Disease Control and Prevention), IOTF (the International Obesity Task Force) and WHO (the World Health Organization) references. Rates of excess body weight varied significantly according to the different international criteria: IOTF: overweight (including obesity) 21.2%, obesity 5.8%;CDC: overweight (including obesity) 30.5%, obesity 13.5%; and WHO: overweight (including obesity) 32.6%, obesity 5%. Boys and older children were particularly affected. Overweight prevalence is high in Greek preschoolers and varies significantly according to the different criteria used, from 21.2% (IOTF reference) to 32.6% (CDC reference).

Accuracy of body mass index for age to diagnose obesity in Mexican schoolchildren.

To compare the accuracy of three BMI-forage references (World Health Organization reference, WHO; the updated International Obesity Task Force reference, IOTF; and Centers for Disease Control and Prevention (CDC) growth charts) to diagnose obesity in Mexican children. A convenience sample of Mexican schoolchildren (n = 218) was assessed. The gold standard was the percentage of body fat estimated by deuterium dilution technique. Sensitivity and specificity of the classical cutoff point of BMI-for-age to identify obesity (i.e. > 2.00 standard deviation, SD) were estimated. The accuracy (i.e. area under the curve, AUC) of three BMI-for-age references for the diagnosis of obesity was estimated with the receiver operating characteristic (ROC) curves method. The optimal cutoff point (OCP) was determined. The cutoff points to identify obesity had low (WHO reference: 57.6%, CDC: 53.5%) to very low (IOTF reference: 40.4%) sensitivities, but adequate specificities (91.6%, 95.0%, and, 97.5%, respectively). The AUC of the three references were adequate (0.89). For the IOTF reference, the AUC was lower among the older children. The OCP for the CDC reference (1.24 SD) was lower than the OCP for WHO (1.53 SD) and IOTF charts (1.47 SD). The classical cutoff point for obesity has low sensitivity--especially for the IOTF reference. The accuracy of the three references was similar. However, to obtain comparable diagnosis of obesity different cutoff points should be used depending of the reference.

Body mass index and childhood obesity classification systems: A comparison of the French, International Obesity Task Force (IOTF) and World Health Organization (WHO) references

AimThis study aims to compare three body mass index (BMI)-based classification systems of childhood obesity: the French, the International Obesity Task Force (IOTF) and the World Health Organization (WHO) references. MethodsThe study involved 1382 schoolchildren, recruited from the Lille Academic District in France in May 2009 aged 8.4±1.7 years (4.0–12.0 years). Their mean height and body mass were 131.5±10.9cm and 30.7±9.2kg, respectively, resulting in a BMI of 17.4±3.2kg/m2. The weight status was defined according to the three systems considered in this study. The agreement between these references was tested using the Cohen's kappa coefficient. ResultsThe prevalence of overweight was higher with the WHO references (20.0%) in comparison with the French references (13.8%; P<0.0001) and the IOTF (16.2%; P≤0.01). A similar result was found with obesity (WHO: 11.6% vs. IOTF: 6.7%; or French references: 6.7%; P<0.0001). Agreement between the three references ranged from “moderate” to “perfect” (0.43≤κ≤1.00; P<0.0001). Kappa coefficients were higher when the three references were used to classify children as obese (0.63≤κ≤1.00; P<0.0001) as compared to classification in the overweight (obesity excluded) category (0.43≤κ≤0.94; P<0.0001). When sex and age categories (4–6 years vs. 7–12 years) were considered to define the overweight status, the lowest kappa coefficient was found between the French and WHO references in boys aged 7–12 years (κ=0.28; P<0.0001), and the highest one in girls aged 7–12 years between the French references and IOTF (κ=0.97; P<0.0001). As for obesity, agreement between the three references ranged from 0.60 to 1.00 (P<0.0001), with the lowest values obtained in the comparison of the WHO references against French references or IOTF among boys aged 7–12 years (κ=0.60; P<0.0001). ConclusionOverall, the WHO references yield an overestimation in overweight and/or obesity within this sample of schoolchildren as compared to the French references and the IOTF. The magnitude of agreement coefficients between the three references depends on of both sex and age categories. The French references seem to be in rather close agreement with the IOTF in defining overweight, especially in 7–12-year-old children.

Age and time effects on children's lifestyle and overweight in Sweden.

BackgroundHigh physical activity, low sedentary behavior and low consumption of sugar-sweetened beverages can be markers of a healthy lifestyle. We aim to observe longitudinal changes and secular trends in these lifestyle variables as well as in the prevalence of overweight and obesity in 7-to-9-year-old schoolchildren related to gender and socioeconomic position.MethodsThree cross-sectional surveys were carried out on schoolchildren in grades 1 and 2 (7-to-9-year-olds) in 2008 (n = 833), 2010 (n = 1085), and 2013 (n = 1135). Information on children’s level of physical activity, sedentary behavior, diet, and parent’s education level was collected through parental questionnaires. Children’s height and weight were also measured. Longitudinal measurements were carried out on a subsample (n = 678) which was included both in 2008 (7-to-9-year-olds) and 2010 (9-to-11-year-olds). BMI was used to classify children into overweight (including obese) and obese based on the International Obesity Task Force reference. Questionnaire reported maternal education level was used as a proxy for socioeconomic position (SEP).ResultsLongitudinally, consumption of sugar-sweetened beverages ≥4 days/week increased from 7% to 16% in children with low SEP. Overall, sedentary behavior >4 hours/day doubled from 14% to 31% (p < 0.001) and sport participation ≥3 days/week increased from 17% to 37% (p < 0.001). No longitudinal changes in overweight or obesity were detected. In the repeated cross-sectional observations sedentary behavior increased (p = 0.001) both in high and low SEP groups, and overweight increased from 13.8% to 20.9% in girls (p < 0.05). Overall, children with high SEP were less-often overweight (p < 0.001) and more physically active (p < 0.001) than children with low SEP.ConclusionsChildren’s lifestyles changed longitudinally in a relatively short period of two years. Secular trends were also observed, indicating that 7–9-year-olds could be susceptible to actions that promote a healthy lifestyle. Socioeconomic differences were consistent and even increasing when it came to sugar-sweetened beverage consumption. Decreasing the socioeconomic gap in weight status and related lifestyle variables should be prioritized. Primary school is an arena where most children could be reached and where their lifestyle could be influenced by health promoting activities.

Prevalence of nutrition associated ponderal outcomes among school children and adolescents in Ebonyi State, South-East Nigeria

Background: The prevalence of obesity, overweight, and underweight are increasing worldwide and have posed a significant public health concern over the last decade in developed and developing countries. Monitoring the weight status of children and adolescents is paramount in assessing for cardiovascular disease risk factors. Objective: The study was conducted to evaluate the prevalence of obesity, overweight and underweight among school children and adolescents in Ebonyi state, South-East Nigeria. Materials and Methods: A cross-sectional design was adopted, 1620 subjects (849 males and 771 females) 5–18 years of age, were randomly sampled. Anthropometric measurements include height and weight, body mass index (BMI) was derived from the ratio of weight per height squared. BMI-for-age th , 85 th to th , and ≥95 th percentile were classified as underweight, overweight and obese respectively, according to the International Obesity Task Force reference. Results: The prevalence of obesity, overweight and underweight were 12.6%, 11.9% and 7.6%, respectively, in the urban subjects and 1.5%, 2.3% and 20.3%, respectively, in the rural subjects. Conclusion: The prevalence of underweight among rural school children and adolescents is high, thus a need for nutritional intervention.

Associations between body weight and depression, social phobia, insomnia, and self-esteem among Taiwanese adolescents

The aims of this cross-sectional study were to examine the associations between body weight and mental health indicators including depression, social phobia, insomnia, and self-esteem among Taiwanese adolescents in Grades 7–12. The body mass index (BMI) of 5254 adolescents was calculated based on self-reported weight and height measurements. Body weight status was determined by the age- and gender-specific International Obesity Task Force reference tables. By using participants of average weight as the reference group, the association between body weight status (underweight, overweight, and obesity) and mental health indicators (depression, social phobia, insomnia, and self-esteem) were examined by using multiple regression analysis. The possible moderating effects of sociodemographic characteristics on the association were also examined. After controlling for the effects of sociodemographic characteristics, both overweight (p < 0.05) and obese adolescents (p < 0.001) had a lower level of self-esteem than did those of average weight; however, no significant differences in depression, social phobia, or insomnia were found between those who were overweight/obese and those of average weight. No significant differences in the four mental health indicators were found between those who were underweight and those of average weight. Sociodemographic characteristics had no moderating effect on the association between body weight and mental health indicators. In conclusion, mental health and school professionals must take the association between overweight/obesity and self-esteem into consideration when approaching the issue of mental health among adolescents.

Childhood Overweight Dependence on Mother-Child Relationship.

The causes of childhood overweight are numerous and inter-related. The mother-child relationship is of great significance for the child’s health. Previous studies have found patterns of dysfunctional interaction in families with obese children. Therefore, development of childhood overweight could be due to the mother-child relationship. The aim of this study was to investigate how, and to what degree, the mother-child relationship, assessed by the mothers, was related to overweight among children aged seven to nine years. The study was a cross sectional case-controlled one. It included 111 overweight and 149 non-overweight seven to nine year old children and their mothers. Weight status was determined according to the International Obesity Task Force reference for children Body Mass Index, age and gender adjusted. An interviewer-administered questionnaire was used to categorize the mother-child relationship as: complementary, asymmetrical, symmetrical or symbiotic prototypes. There was no difference in mother-child relationships – characterized by the prototypes – between the overweight and non-overweight mother-child pairs. Therefore, we conclude that the mother-child relationship has no bearing on the child’s weight status according to the prototypes. It is suggested that it is more the culture, or the universal phenomenon of expressing love through food, than the mother-child relationship, which influences the development of childhood overweight, or that the mothers are not capable of assess the true attachment style between themselves and their children.

Comparison of Different Internationally Accepted Reference Standards to Measure Childhood Adiposity Rates in Latvia

Abstract Childhood adiposity is increasingly affecting developed and developing countries alike. Body Mass Index (BMI) is a good first approximation of body weight, but interpretation in specific patient populations may be inconsistent. The aim of this study was to compare adiposity rates using three internationally accepted weight reference standards – World Health Organisation (WHO), International Obesity Task Force (IOTF), and US Centers for Disease Control (CDC), plus a local national scale (LV), evaluating 465, 6-to-9-year old school children in Latvia. After obtaining height and weight, BMI was calculated, and the four scales were individually applied by gender and age. Highly significant differences between LV and CDC, LV and IOTF, LV and WHO were found in all age groups (P &lt; 0.01), and between WHO and IOTF reference standards (P &lt; 0.01) in 7- and 8-year olds. We conclude that reference standards should be used with great caution. Reference standards for local ethnic populations are needed to avoid disagreements between scales, as this can lead to incorrect choice of therapy; reliance on any single reference standard may not consider a patient's unique set of circumstances that have resulted in excess weight and information that is vital for a good clinical outcome.

Obesidade e sobrepeso numa amostra de adolescentes da cidade portuguesa de Leiria. Uma questão de curvas?

PurposeTo compare the prevalence of overweight and obesity in Leiria adolescents, from 2007 to 2009, using Centers for Disease Control and Prevention (CDC) Body Mass Index (BMI) criteria, with International Obesity Task Force (IOTF) and World Health Organization (WHO) cutoff. MethodsCross sectional analytical study. Population sample was composed by adolescents participating in a screening in Leiria ‐ Portugal, as part of a national screening for childhood obesity promoted by the Ambulatory Pediatric Department of the Portuguese Pediatric Society during three years. Demographic and anthropometric data were collected and BMI was calculated (ratio between weight and the square of height). Data were analyzed according to CDC BMI percentile curves, IOTF BMI cutoff and WHO BMI curves. Overweight/obesity definitions were established by the respective references. Excess weight was assigned to the sum of overweight and obesity. Statistical analysis: PASW 18®. ResultsThe study included 205 adolescents, 51.2% male, mean age 12.9 years old. According to CDC, overall overweight and obesity prevalence was 13.2% and 6.8%, respectively. By gender, male presented 15.2% and 7.6% values and females 11.0% and 6.0%, for overweight and obesity.Overweight prevalence using IOTF criteria was 16.1% and 2.4% for obesity and the values were 15.6% and 9.3% according to WHO definitions. DiscussionThe estimated obesity prevalence in the adolescent population turned out to be worrisome. Male and the younger age group showed higher values. According to IOTF, adolescentś excess weight rate was lower than national studies.Comparative analysis demonstrated lower sensitivity of IOTF references in obesity determination than CDC and WHO cutoff resulted in significantly higher prevalence of overweight and obesity, thus with an earlier detection. ConclusionThis study highlights the importance of judicious use of existing criteria, not only to determine evaluation parameters for pediatric obesity, but also to perform comparative analysis with literature data.

Prevalence of overweight, obesity and thinness among adolescents in rural and urban areas of Enugu State, Nigeria

Background: Overweight and obesity in adolescence are powerful risk factors of chronic diseases in adulthood. Objective: To determine the prevalence of overweight, obesity and thinness among adolescents in rural and urban areas of Enugu State, Nigeria. Method: A total of 500 adolescents (10-19 years) consisting of 220 males and 280 females were randomly selected from 12 study schools in the State. A structured questionnaire was used to collect data on background information of the adolescents. Anthropometric measurements (weight and height) of the adolescents were obtained, and used to calculate the Body Mass Index (BMI). The BMI were categorized into obesity, overweight, normal and thinness using the International Obesity Task Force (IOTF) reference and the WHO adult BMI classification for adolescents up to 19 years. The data obtained were coded and analyzed into means, frequencies, percentages and chi-square using the Statistical Package for Social Sciences (SPSS), version 17. Results: The prevalence of overweight, obesity and thinness among adolescents were 7.5%. 2.1% and 13.9%, respectively. The prevalence of obesity among the adolescents in urban areas was 4.1% while none of the rural adolescents was obese. There was a higher prevalence rate of obesity among males than among females. Conclusion: Obesity is creeping into traditional societies as evident in this study.

Prévalence de l’obésité et du surpoids chez les écoliers de primaire à Marrakech, Maroc

BackgroundChildhood obesity is a phenomenon of growing concern today because of its rapid growth worldwide. The aim of our study was to estimate the prevalence of overweight and obesity among school age children in Marrakech. MethodsWe conducted a cross-sectional study of a random sample of 1418 schoolchildren aged 8–15years in the public sector in Marrakech in May 2011. Trained physicians measured the weight and size of respondents. The body mass index (BMI) was calculated for each child. Overweight was assessed by comparing BMI with World Health Organization (WHO) and International Obesity Task Force (IOTF) references. Statistical analysis was performed using SPSS version 16.0 and using a macro of WHO Anthro for SPSS. ResultsThe mean age was 10.8±1.6 years. The sex ratio (girl/boy) was 1. The prevalence of overweight and obesity were 8 % (95 % CI [6.7, 9.6]) and 3 % (95 % CI [2.2, 4.1] based on WHO reference. This prevalence were respectively 12.2 % (95 % IC [10.5; 14.0]) and 5.4 % (95 % IC [4.3; 6.7]) using the IOTF reference. ConclusionIn the absence of national data, our results reflect the importance of the phenomenon in our context, hence the importance of monitoring the nutritional status on both individual and collective levels and the need to develop strategies for prevention, diagnosis and early treatment before the problem becomes more widespread.

Prévalence du surpoids chez le jeune enfant : analyse des données des bilans de santé à 3-4 ans en Haute-Garonne

To analyze anthropometric data in a sample of 3- to 4-year-old children examined by Mother and Infant Welfare in preschools in the Haute-Garonne area of France. Two consecutive school years (2007-2008 and 2008-2009) were analyzed. The samples studied included 5470 children the first year (mean age ± standard deviation: 3.9±0.4 years) and 4088 children the second year (4.0±0.4 years). Prevalence of overweight (defined according to International Obesity Task Force references) and its association with various factors (sex, age, and school location) were studied. Prevalence of overweight (including obesity) was 8.4% for the 2 years, with a prevalence of obesity of 1.8% in 2007-2008 and of 1.6% in 2008-2009. Overweight was significantly more frequent in girls than in boys (10.2% vs. 6.8% in 2007-2008 and 9.7% vs. 7.2% in 2008-2009) and in schools located in Priority Education Zones (ZEP) compared to schools in non-ZEP schools (17.9% vs. 7.1% in 2007-2008 and 15.7% vs. 7.2% in 2008-2009). This analysis will be repeated to follow the prevalence of overweight in children. These preliminary results confirm the need to focus on preventive actions, screening and care for overweight and obesity in underprivileged populations.

Prevalence of Overweight and Obesity in Chinese Preschoolers in Singapore

This study examines the prevalence of overweight and obesity in 6- to 72-month-old Chinese preschoolers in Singapore using 3 references. This was a population-based cross-sectional study of 3009 Chinese preschoolers aged 6 to 72 months from southwestern and western parts of Singapore. Overweight and obesity were defi ned by using the Center for Disease Control (CDC) (85th and 95th percentile, respectively), the International Obesity Task Force (IOTF) and the local National Health Group Polyclinics (NHGP), Singapore (90th and 97th percentile, respectively) references. The prevalence of overweight and obesity in 24 to 72 months old Chinese children were 8.1% and 7.1% (the CDC reference), 7.6% and 3.9% (the IOTF reference) and 7.5% and 5.3% (the local reference [NHGP]) respectively. For preschoolers aged 6 to 72 months, the prevalence of overweight and obesity was 7.0% and 5.3%, respectively, using the local reference. An increasing trend in the prevalence of obesity with increasing age was seen in both genders, using the CDC and IOTF references (P ≤0.001 and 0.001, respectively). The boys were more likely to be obese than the girls using the CDC reference (OR = 1.42, 95% CI, 1.02 to 1.97, P = 0.03). Our study showed a lower prevalence of overweight and obesity among Chinese preschoolers in Singapore when compared to other countries like the United States, Italy, Chile using the CDC and/or IOTF references. The CDC reference overestimated whereas the IOTF reference underestimated the prevalence of overweight and obesity for our population when compared to using the local NHGP reference.

Defining Body Fatness in Adolescents: A Proposal of the Afad-A Classification

AimsBody mass index (BMI) shows several limitations as indicator of fatness. Using the International Obesity Task Force (IOTF) reference and the World Health Organization (WHO) standard 2007 on the same dataset yielded widely different rates. At higher levels, BMI and the BMI cut-offs may be help in informing a clinical judgement, but at levels near the norm additional criteria may be needed. This study compares the prevalence of overweight and obesity using IOTF and WHO-2007 references and interprets body composition by comparing measures of BMI and body fatness (fat mass index, FMI; and waist-to-height ratio, WHtR) among an adolescent population.Methods and ResultsA random sample (n = 1231) of adolescent population (12–17 years old) was interviewed. Weight, height, waist circumference, triceps and subscapular skinfolds were used to calculate BMI, FMI, and WHtR. The prevalence of overweight and obesity were 12.3% and 15.4% (WHO standards) and 18.6% and 6.1% (IOTF definition). Despite that IOTF cut-offs misclassified less often than WHO standards, BMI categories were combined with FMI and WHtR resulting in the Adiposity & Fat Distribution for adolescents (AFAD-A) classification, which identified the following groups normal-weight normal-fat (73.2%), normal-weight overfat (2.1%), overweight normal-fat (6.7%), overweight overfat (11.9%) and obesity (6.1%), and also classified overweight at risk and obese adolescents into type-I (9.5% and 1.3%, respectively) and type-II (2.3% and 4.9%, respectively) depending if they had or not abdominal fatness.ConclusionsThere are differences between IOTF and WHO-2007 international references and there is a misclassification when adiposity is considered. The BMI limitations, especially for overweight identification, could be reduced by adding an estimate of both adiposity (FMI) and fat distribution (WHtR). The AFAD-A classification could be useful in clinical and population health to identify overfat adolescent and those who have greater risk of developing weight-related cardiovascular diseases according to the BMI category.