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  • Original Article
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BMI-based obesity cutoffs and excess adiposity in a Caribbean adolescent population of African origin

European Journal of Clinical Nutrition volume 63, pages 253–258 (2009)Cite this article

Abstract

Objective:

To evaluate the diagnostic utility of recommended body mass index (BMI)-based classification systems in detecting excess body fat (BF) in an Afro-Caribbean adolescent population.

Subjects:

All adolescents aged 12–18 years were invited to participate in the study. A total of 3749 persons participated fully in the study.

Result:

Males (12.2%) (95% confidence interval (CI): 10.7, 13.9) and females (43.6%) (95% CI: 41.5, 45.7) had excess adiposity. Specificities were high for all cutoff values (range 90.1–99.7%). Sensitivities ranged from 25.7 to 86.4% and from 15.6 to 54.4% for Centre for Disease Control (CDC) and International Obesity Task Force (IOTF) cutoff values, respectively. The mean areas under the receiver-operating characteristic curves ranged from 62.7 to 88.2% in males and 57.7 to 75.1% in females, while positive likelihood ratios ranged from 8.7 to 90.9 for the recommended BMI cutoff values.

Conclusions:

Overall, the CDC cutoffs had a higher sensitivity than the IOTF cutoffs in screening for excess fat. Specificities were high for cutoff values in both systems and would produce fewer false negatives.

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References

  • Ariza AJ, Chen EH, Binns HJ, Christoffel KK (2004). Risk factors for overweight in five- to six-year-old Hispanic-American children: a pilot study. J Urban Health 81, 150–161.

    Article  PubMed  PubMed Central  Google Scholar 

  • Benefice E, Caius N, Garnier D (2004). Cross-cultural comparison of growth, maturation and adiposity indices of two contrasting adolescent populations in rural Senegal (West Africa) and Martinique (Caribbean). Public Health Nutr 7, 479–485.

    Article  PubMed  Google Scholar 

  • Bini V, Celi F, Berioli MG, Bacosi ML, Stella P, Giglio P et al. (2000). Body mass index in children and adolescents according to age and pubertal stage. Eur J Clin Nutr 54, 214–218.

    Article  CAS  PubMed  Google Scholar 

  • Biro FM, Huang B, Crawford PB, Lucky AW, Striegel-Moore R, Barton BA et al. (2006). Pubertal correlates in black and white girls. J Pediatr 148, 234–240.

    Article  PubMed  Google Scholar 

  • Burke DM, Litt IF, Gross RT (1980). Adolescents' self-assessment of sexual maturation. Pediatrics 66, 918–920.

    Google Scholar 

  • Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000). Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 1240–1243.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Field AE, Laird N, Steinberg E, Fallon E, Semega-Janneh M, Yanovski JA (2003). Which metric of relative weight best captures body fatness in children? Obes Res 11, 1345–1352.

    Article  PubMed  Google Scholar 

  • Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL (2001). Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index. Am J Clin Nutr 73, 1086–1093.

    Article  CAS  PubMed  Google Scholar 

  • Fletcher RH, Fletcher SW, Wagner EH (1996). Clinical Epidemiology. The Essentials, 3rd edn. Williams and Wilkins: Baltimore, MD.

    Google Scholar 

  • Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS (2005a). Racial differences in the tracking of childhood BMI to adulthood. Obes Res 13, 928–935.

    Article  PubMed  Google Scholar 

  • Freedman DS, Wang J, Maynard LM, Thornton JC, Mei Z, Pierson RN et al. (2005b). Relation of BMI to fat and fat-free mass among children and adolescents. Int J Obes (London) 29, 1–8.

    Article  CAS  Google Scholar 

  • Frisard MI, Greenway FL, Delany JP (2005). Comparison of methods to assess body composition changes during a period of weight loss. Obes Res 13, 845–854.

    Article  PubMed  Google Scholar 

  • Fu WP, Lee HC, Ng CJ, Tay YK, Kau CY, Seow CJ et al. (2003). Screening for childhood obesity: international vs population specific definitions. Which is more appropriate? Int J Obes Relat Metab Disord 27, 1121–1126.

    Article  CAS  PubMed  Google Scholar 

  • Gaskin PS, Walker SP (2003). Obesity in a cohort of black Jamaican children as estimated by BMI and other indices of adiposity. Eur J Clin Nutr 57, 420–426.

    Article  CAS  PubMed  Google Scholar 

  • Goldfield GS, Cloutier P, Mallory R, Prud'homme D, Parker T, Doucet E (2006). Validity of foot-to-foot bioelectrical impedance analysis in overweight and obese children and parents. J Sports Med Phys Fitness 46, 447–453.

    CAS  PubMed  Google Scholar 

  • Gordis L (2004). Epidemiology, 3rd edn. W B Saunders Co: Phildelphia, PA.

    Google Scholar 

  • Greil H (2006). Patterns of sexual dimorphism from birth to senescence. Coll Antropol 30, 637–641.

    PubMed  Google Scholar 

  • Hanley JA, McNeil BJ (1982). The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143, 29–36.

    Article  CAS  PubMed  Google Scholar 

  • Hosking J, Metcalf BS, Jeffery AN, Voss LD, Wilkin TJ (2006). Validation of foot-to-foot bioelectrical impedance analysis with dual-energy X-ray absorptiometry in the assessment of body composition in young children: the EarlyBird cohort. Br J Nutr 96, 1163–1168.

    Article  CAS  PubMed  Google Scholar 

  • Janssen I, Katzmarzyk PT, Srinivasan SR, Chen W, Malina RM, Bouchard C et al. (2005). Utility of childhood BMI in the prediction of adulthood disease: comparison of national and international references. Obes Res 13, 1106–1115.

    Article  PubMed  Google Scholar 

  • Jebb SA, Cole TJ, Doman D, Murgatroyd PR, Prentice AM (2000). Evaluation of the novel Tanita body-fat analyser to measure body composition by comparison with a four-compartment model. Br J Nutr 83, 115–122.

    Article  CAS  PubMed  Google Scholar 

  • Kain J, Uauy R, Vio F, Albala C (2002). Trends in overweight and obesity prevalence in Chilean children: comparison of three definitions. Eur J Clin Nutr 56, 200–204.

    Article  CAS  PubMed  Google Scholar 

  • Kim J, Shen W, Gallagher D, Jones Jr A, Wang Z, Wang J et al. (2006). Total-body skeletal muscle mass: estimation by dual-energy X-ray absorptiometry in children and adolescents. Am J Clin Nutr 84, 1014–1020.

    Article  CAS  PubMed  Google Scholar 

  • Kosti RI, Panagiotakos DB (2006). The epidemic of obesity in children and adolescents in the world. Cent Eur J Public Health 14, 151–159.

    Article  PubMed  Google Scholar 

  • Kruger R, Kruger HS, Macintyre UE (2006). The determinants of overweight and obesity among 10–15-year-old schoolchildren in the North West Province, South Africa—the THUSA BANA (Transition and Health during Urbanisation of South Africans; BANA, children) study. Public Health Nutr 9, 351–358.

    Article  CAS  PubMed  Google Scholar 

  • Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R et al. (2000). CDC growth charts: United States. Adv Data 314, 1–27.

    Google Scholar 

  • Lazzer S, Boirie Y, Meyer M, Vermore M (2003). Evaluation of two foot-to-foot bioelectrical impedance analysers to assess body composition in overweight and obese Adolescents. Br J Nutr 90, 987–992.

    Article  CAS  PubMed  Google Scholar 

  • Lohman T, Roche A, Martorell R (1988). Anthropomelric Standardization Reference Manual. Human Kinetics Book: Champaign, IL.

    Google Scholar 

  • McCarthy HD, Cole TJ, Fry T, Jebb SA, Prentice AM (2006). Body fat reference curves for children. Int J Obes (London) 30, 598–602.

    Article  CAS  Google Scholar 

  • Mei Z, Grummer-Stn LM, Pietrobelli A, Goulding A, Goran MI, Dietz WH (2002). Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. Am J Clin Nutr 75, 978–985.

    Article  CAS  PubMed  Google Scholar 

  • Neovius MG, Linne YM, Barkeling BS, Rossner SO (2004). Sensitivity and specificity of classification systems for fatness in adolescents. Am J Clin Nutr 80, 597–603.

    Article  CAS  PubMed  Google Scholar 

  • Orio Jr F, Palomba S, Cascella T, Savastano S, Lombardi G, Colao A (2007). Cardiovascular complications of obesity in adolescents. J Endocrinol Invest 30, 70–80.

    Article  PubMed  Google Scholar 

  • Reilly JJ (2002). Assessment of childhood obesity: national reference data or international approach? Obes Res 10, 838–840.

    Article  PubMed  Google Scholar 

  • Sacker A, Cable N (2006). Do adolescent leisure-time physical activities foster health and well-being in adulthood? Evidence from two British birth cohorts. Eur J Public Health 16, 332–336.

    Article  PubMed  Google Scholar 

  • Shetty P, Schmidhuber J (2006). Introductory lecture the epidemiology and determinants of obesity in developed and developing countries. Int J Vitam Nutr Res 76, 157–162.

    Article  CAS  PubMed  Google Scholar 

  • Simeon DT, Rattan RD, Panchoo K, Kungeesingh KV, Ali AC, Abdool PS (2003). Body image of adolescents in a multi-ethnic Caribbean Population. Eur J Clin Nutr 51, 157–162.

    Article  Google Scholar 

  • Slaughter NM, Lohman TG, Boileau RA, Horswill CA, Stillman RJ, Van Loan MD et al. (1988). Skinfold equations for estimation of body fatness in children and youth. Human Biol 60, 709–723.

    CAS  PubMed  Google Scholar 

  • Spencer CE, Lingard JM, Bermingham MA (2003). Comparison of a footpad analyser with a tetrapolar model for the determination of percent body fat in young men. J Sci Med Sport 6, 455–460.

    Article  CAS  PubMed  Google Scholar 

  • Taylor CB, Bryson S, Celio Doyle AA, Luce KH, Cunning D, Abascal LB et al. (2006). The adverse effect of negative comments about weight and shape from family and siblings on women at high risk for eating disorders. Pediatrics 118, 731–738.

    Article  PubMed  Google Scholar 

  • Wang Y, Wang JQ (2005). A comparison of international references for the assessment of child and adolescent overweight and obesity in different populations. Eur J Clin Nutr 56, 973–982.

    Article  Google Scholar 

  • Williams DP, Going SB, Lohman TG, Harsha DW, Srinivasan SR, Webber LS et al. (1992). Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents. Am J Public Health 82, 358–363.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zimmermann MB, Gubeli C, Puntener C, Molinari L (2004). Detection of overweight and obesity in a national sample of 6–12-y-old Swiss children: accuracy and validity of reference values for body mass index from the US Centers for Disease Control and Prevention and the International Obesity Task Force. Am J Clin Nutr 79, 838–843.

    Article  CAS  PubMed  Google Scholar 

  • Zweig MH, Campbell G (1993). Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem 39, 561–577.

    CAS  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Agricultural Economics and Extension (DAEE), University of the West Indies, St Augustine, Trinidad and Tobago

    S D Nichols

  2. Tobago Hypertension Society, Fairfield complex, Tobago, Trinidad and Tobago

    S D Nichols & F Cadogan

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  1. S D Nichols
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  2. F Cadogan
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Correspondence to S D Nichols.

Additional information

Guarantor: SD Nichols.

Contributors: SDN contributed to the study concept and design, collection and analysis of data, drafting and revision of the paper. FC initiated and directed the study and was responsible for recruitment and enrolment participant as well as drafting of the paper.

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Nichols, S., Cadogan, F. BMI-based obesity cutoffs and excess adiposity in a Caribbean adolescent population of African origin. Eur J Clin Nutr 63, 253–258 (2009). https://doi.org/10.1038/sj.ejcn.1602913

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602913

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