¹Department of Endocrinology and Metabolism, Peninsula Medical School, Plymouth, UK

Correspondence: Dr LD Voss, EarlyBird Research Centre, Child Health, Level 12, Derriford Hospital, Plymouth PL6 8DH, UK. E-mail: l.voss@phnt.swest.nhs.uk

Received 13 April 2005; Revised 30 August 2005; Accepted 14 October 2005; Published online 29 November 2005.

Abstract

The International Obesity TaskForce has published paediatric cutoffs from the age of 2 years for overweight and obesity, based on adult thresholds. We question their rationale. The adult cutoffs were based on known health risk; the children's were not. Data from the EarlyBird Study show that BMI category for overweight and obesity in young children are poor markers of insulin resistance and, by implication, of metabolic risk and diabetes. Moreover, BMI is known to track poorly from early childhood to adulthood. We know even less about the tracking of insulin resistance and other indices of metabolic risk from the earliest years. Until we understand more about which children acquire such risk factors, any such thresholds for overweight and obesity should be used with caution in the very young, as they may unnecessarily stigmatise the heavier child.