Body mass index vs deuterium dilution method for establishing childhood obesity prevalence, Ghana, Kenya, Mauritius, Morocco, Namibia, Senegal, Tunisia and United Republic of Tanzania

Diouf, Adama; Adom, Theodosia; A, Aouidet; Hamdouchi, Asmaa El; Joonas, Noorjehan; Loechl, Cornelia; Leyna, Germana; Mbithe, Dorcus; Moleah, Thabisile; Monyeki, M.A.; Nashandi, Hilde Liisa; Somda, Serge; Reilly, John J.

doi:10.2471/blt.17.205948

Cited by 25 publications

(38 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These include the methods of body composition assessment, the cut-offs to define excess percent body fat in the evaluation of the BMI-criteria, and characteristics of the reference population such as ethnicity, maturity, and gender [16][17][18][19][20]. The low-to-moderate sensitivity and high specificity reported in the present study are generally consistent with the literature [11,17,[21][22][23][24]. Furthermore, BMI underestimated adiposity in South Asian children while among children of African origin, body fat was overestimated [18,19].…”

Section: Discussionsupporting

confidence: 85%

“…The present results suggest that it is appropriate to develop country-and population-specific BMI cut-offs to improve diagnosis of childhood obesity instead of the universal references. For example while the present cut-offs for WHO (0.86 for boys and 0.68 for girls) is similar to that reported in an African sample [11], in an Asian population the corresponding cut-offs were 1.86 for boys and 1.38 for girls [17].…”

Section: Discussionsupporting

confidence: 83%

“…Among African children, the evidence is limited. A 2018 pooled analysis of data from a relatively large sample of African school children aged 8-11 years from eight countries reported low sensitivity (29.7%) and high specificity (99.7%) for the WHO BMI definition [11], using deuterium oxide method as reference criterion for body fat [11]. In comparison to the aforementioned African study, the present study reported higher sensitivity (59.4%) but with similar specificity (98.7%).…”

Section: Discussioncontrasting

confidence: 43%

“…Most studies among children and adolescents in Africa apply BMI-based criteria to estimate overweight and obesity [9]. Nonetheless, at the continental level, the diagnostic accuracy of the published BMI references to detect excess body fat among children is largely unknown; only few studies have compared the BMI criteria against a criterion measure of body fat [10,11]. The present study aims to evaluate the diagnostic accuracies of the three international BMI the CDC, IOTF, and WHO based criteria in defining obesity using deuterium dilution as a criterion method in a sample of Ghanaian primary school children.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Diagnostic Accuracy of Body Mass Index in Defining Childhood Obesity: Analysis of Cross-Sectional Data from Ghanaian Children

Adom

Kengne

Villiers

et al. 2019

IJERPH

Self Cite

View full text Add to dashboard Cite

Background: Screening methods for childhood obesity are based largely on the published body mass index (BMI) criteria. Nonetheless, their accuracy in African children is largely unknown. The diagnostic accuracies of the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the International Obesity Taskforce (IOTF) BMI-based criteria in defining obesity using deuterium dilution as a criterion method in a sample of Ghanaian children are presented. Methods: Data on anthropometric indices and percent body fat were collected from 183 children aged 8–11 years. The sensitivity, specificity, and predictive values were calculated. The overall performance of the BMI criteria was evaluated using the receiver operating characteristics area under the curve (AUC). Results: Overall sensitivity of WHO, CDC, and IOTF were 59.4% (40.6–76.3), 53.1% (34.7–70.9), and 46.9% (29.1–65.3) respectively. The overall specificity was high, ranging from 98.7% by WHO to 100.0% by IOTF. The AUC were 0.936 (0.865–1.000), 0.924 (0.852–0.995), and 0.945 (0.879–1.000) by the WHO, CDC, and IOTF criteria respectively for the overall sample. Prevalence of obesity by the WHO, CDC, IOTF, and deuterium oxide-derived percent body fat were 11.5%, 10.4%, 8.2%, and 17.5% respectively, with significant positive correlations between the BMI z-scores and percent body fat. Conclusions: The BMI-based criteria were largely specific but with moderate sensitivity in detecting excess body fat in Ghanaian children. To improve diagnostic accuracy, direct measurement of body fat and other health risk factors should be considered in addition to BMI.

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 83%

Section: Discussioncontrasting

confidence: 43%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic Accuracy of Body Mass Index in Defining Childhood Obesity: Analysis of Cross-Sectional Data from Ghanaian Children

Adom

Kengne

Villiers

et al. 2019

IJERPH

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, since body fatness is difficult to measure, simpler proxies for body fatness are usually preferred for defining obesity in studies and national surveys. 1,5,6 The WHO recommends that the best simple proxy for obesity prevalence is BMI, with obesity defined as BMI≥30.0 kg/m 2 in adults or a BMI-for-age Z score ≥2.00 in adolescents (up to and including age 19.0 years as defined by the WHO).…”

Section: Introductionmentioning

confidence: 99%

<p>Classification Accuracy of Body Mass Index for Excessive Body Fatness in Kuwaiti Adolescent Girls and Young Adult Women</p>

Hammadi¹,

Reilly²

2020

DMSO

Self Cite

View full text Add to dashboard Cite

Purpose: Adolescent obesity, as defined by BMI, is amongst the highest in the world in Kuwait. This study aimed to determine the extent to which BMI might be underestimating obesity as defined by excessive fatness in Kuwaiti female adolescents and young adults. Methods: A total of 400 apparently healthy Kuwaiti female university students (mean age 18.0 years, SD 0.6) were recruited. Excessive fatness was defined as body fat percentage ≥30, measured using the Tanita model TBF-310 Bio-impedance system with the manufacturer's equation. Obesity was defined as recommended by the WHO in adult participantsthose aged ≥19.1 yearsas BMI≥30 kg/m 2. In the adolescent participants (age <19.1 years) obesity was defined as recommended by the WHO as a BMI-forage Z score of ≥2.00. The accuracy of BMI-defined obesity to identify excessively fat individuals was determined by estimating the prevalence of obesity using high BMI and prevalence of excessive fatness, and by calculating sensitivity and specificity and predictive values. Results: Median BMI was 27.8 kg/m 2 (range 15.1-51.2) and median body fat percentage was 32.0 (range 5.0-54.0). The prevalence of excessive fatness was 62% (247/400 individuals were excessively fat), while the prevalence of obesity according to BMI was 42% (169/400 individuals were obese according to their BMI). The sensitivity of BMI to identify the excessively fat individuals was moderate (66%) but specificity was high (96%). The positive predictive value of BMI was 96% and the negative predictive value was 64%. Conclusion: BMI-based measures substantially underestimate the prevalence of excessive fatness in Kuwaiti adolescent females. Obesity is even more prevalent, and requires more urgent attention, than is apparent from BMI-based measures used in most research and national surveys. BMI may also be too crude for use as an exposure or outcome variable in many epidemiological studies of Arab adolescent girls and adult women.

show abstract

Prevalence of Obesity Is Higher Than Published Estimates Suggest

Reilly

2024

JAMA Pediatr

View full text Add to dashboard Cite

To the Editor Zhang et al 1 report valuable estimates of the national, regional, and global prevalence of obesity in children and adolescents. It may not be clear that their prevalence estimates are conservative, and more conservative in some populations than others.Systematic reviews 2,3 have shown repeatedly that body mass index (BMI) for age in children and adolescents is highly specific for obesity (almost all those with high BMI for age will also have high body fatness), but has only lowmoderate sensitivity: a high percentage of children with apparently healthy BMI for age also have high body fatness. This low-moderate sensitivity produces underestimates of the prevalence of obesity. Moreover, sensitivity varies between populations and is even lower among some populations than others-in Asian and African children and adolescents relative to European children and adolescents, for example. 4,5 In our study of children across Africa, the sensitivity of the BMI for age for high body fatness was only 30%. 5 Between-population differences in the ability of BMI for age to define obesity complicate international comparisons of the prevalence of obesity.While the BMI for age provides a useful simple proxy definition of obesity, and is here to stay, low-moderate sensitivity is a major limitation, particularly for comparisons of obesity prevalence between populations. This limitation was not referred to by Zhang et al 1 in the Limitations section of their article. Future estimates of obesity prevalence should acknowledge this limitation of BMI for age and its important practical implications.

show abstract

Body mass index vs deuterium dilution method for establishing childhood obesity prevalence, Ghana, Kenya, Mauritius, Morocco, Namibia, Senegal, Tunisia and United Republic of Tanzania

Cited by 25 publications

References 20 publications

Diagnostic Accuracy of Body Mass Index in Defining Childhood Obesity: Analysis of Cross-Sectional Data from Ghanaian Children

Diagnostic Accuracy of Body Mass Index in Defining Childhood Obesity: Analysis of Cross-Sectional Data from Ghanaian Children

<p>Classification Accuracy of Body Mass Index for Excessive Body Fatness in Kuwaiti Adolescent Girls and Young Adult Women</p>

Prevalence of Obesity Is Higher Than Published Estimates Suggest

Contact Info

Product

Resources

About