Defining obesity in children and adolescents: Clinical approaches

Robinson, Thomas N.

doi:10.1080/10408399309527626

Cited by 23 publications

(14 citation statements)

References 51 publications

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“…29,30 Taking this into consideration, BMI is the most appropriate measure for clinical assessment of adiposity in children and adolescents. 30,45 However, in our previous national surveys the de®nition of obesity is based on the weight ± IBW ratio. For comparison with information from these surveys, we also used the weight ± IBW ratio to de®ne overweight and obese children in this study.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and trends of obesity among school children in Taiwan—the Taipei Children Heart Study

Chu

2001

Int J Obes

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Section: Discussionmentioning

confidence: 99%

Prevalence and trends of obesity among school children in Taiwan—the Taipei Children Heart Study

Chu

2001

Int J Obes

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“…Despite the fact that many of these gaps were pointed out Ͼ10 years ago, 127 little subsequent research has addressed the most clinically relevant questions. In ad-…”

Section: E138mentioning

confidence: 99%

Screening and Interventions for Childhood Overweight: A Summary of Evidence for the US Preventive Services Task Force

et al. 2005

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ABSTRACT. Background. Childhood and adolescent overweight and obesity are related to health risks, medical conditions, and increased risk of adult obesity, with its attendant effects on morbidity and mortality rates. The prevalence of childhood overweight and obesity has more than doubled in the past 25 years.Purpose. This evidence synthesis examines the evidence for the benefits and harms of screening and early treatment of overweight among children and adolescents in clinical settings.Methods. We developed an analytic framework and 7 key questions representing the logical evidence connecting screening and weight control interventions with changes in overweight and behavioral, physiologic, and health outcomes in childhood or adulthood. We searched Results. Although BMI is a measure of relative weight rather than adiposity, it is recommended widely for use among children and adolescents to determine overweight and is the currently preferred measure. The risk of adult overweight from childhood overweight provides the best available evidence to judge the clinical validity of BMI as an overweight criterion for children and adolescents. BMI measures in childhood track to adulthood moderately or very well, with stronger tracking seen for children with >1 obese parent and children who are more overweight or older. The probability of adult obesity (BMI of >30 kg/m 2 ) is >50% among children >13 years of age whose BMI percentiles meet or exceed the 95th percentile for age and gender. BMI-based overweight categorization for individuals, particularly for racial/ethnic minorities with differences in body composition, may have limited validity because BMI measures cannot differentiate between increased weight for height attributable to relatively greater fat-free mass (muscle, bone, and fluids) and that attributable to greater fat. No trials of screening programs to identify and to treat childhood overweight have been reported. Limited research is available on effective, generalizable interventions for overweight children and adolescents that can be conducted in primary care settings or through primary care referrals.Conclusions.

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“…As a screening aid the assessment of obesity should be sensitive and speci®c, 36 while as a public health tool it should detect differences between groups concurrently or over time. In the epidemiological situation there is less need for a cut-off, since the degree of obesity can be handled satisfactorily as a continuously varying quantity.…”

Section: Measuring Excess Body Fatmentioning

confidence: 99%

Review: Measurement and long-term health risks of child and adolescent fatness

Power¹,

1997

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This paper reviews child and adolescent adiposity measures and associated long-term health risks. The ®rst section argues that anthropometric measures are practical for large scale epidemiological studies, particularly the body mass index. Limitations of this and other measures are presented. The second section summarises the evidence on the relationship between child and adolescent and adult adiposity. This is based on a search for relevant literature in the following computerised databases: Medline (1985±96), BIDS (EMBASE and Science Citation Index 1985±96). The literature search revealed that the child to adult adiposity relationship is now well-documented, although methodological differences hinder comparisons. Nonetheless, consistently elevated risks of adult obesity are evident for fatter children, although the prediction of adult obesity from child and adolescent adiposity measures is only moderate. Fewer studies could be identi®ed in relation to long-term health risks of child and adolescent adiposity. It is therefore dif®cult to specify categories of risk associated with childhood adiposity without more information from long-term studies. Further evidence is also required to con®rm the suggestion from some studies that adult disease risks are associated with a change in adiposity from normal weight in childhood to obesity in adulthood. However, on the basis of the evidence available, it is argued that population-based approaches to the prevention of obesity are likely to be more effective than approaches targeted at fat children. Population-based approaches are desirable, ®rst because of the poor prediction of adult obesity from child and adolescent measures, and second, because risks of adult mortality and morbidity may be elevated for individuals who become overweight after adolescence.Keywords: body mass index; obesity; measures; childhood; adolescence; tracking; morbidity; mortality; review IntroductionPrevention of obesity is a public health priority, 1 with much of the concern focusing on childhood and adolescence. 2 Child and adolescent adiposity is of particular interest because of possible long-term associations with adult disease, but evidence on long-term relationships is fragmentary and an overview is needed that clari®es how they might occur.There are three main sections to this review. The ®rst provides a summary of the basic methods used to assess child and adolescent adiposity. This key issue is included here because it is essential that appropriate measures are used, for example, to investigate trends over time and over the life course. The second section summarises the evidence on the relationship between child and adolescent and adult adiposity. This relationship is studied because of the concern that child and adolescent adiposity in¯uences adult disease primarily through its association with adiposity in adult life. Evidence is now available from several prospective and retrospective samples following subjects from childhood to adulthood. The speci®c questions of interest in this se...

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Defining obesity in children and adolescents: Clinical approaches

Cited by 23 publications

References 51 publications

Prevalence and trends of obesity among school children in Taiwan—the Taipei Children Heart Study

Prevalence and trends of obesity among school children in Taiwan—the Taipei Children Heart Study

Screening and Interventions for Childhood Overweight: A Summary of Evidence for the US Preventive Services Task Force

Review: Measurement and long-term health risks of child and adolescent fatness

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