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An application of bootstrap resampling method to obtain confidence interval for percentile fatness cutoff points in childhood and adolescence overweight diagnoses

Abstract

OBJECTIVE:

To present a resampling approach to obtain confidence intervals (CIs) and the empirical distributions for the studentized regression residuals percentiles when used as cutoff points for overweight and obesity diagnosis in children and adolescents.

METHOD:

A tutorial for the nonparametric bootstrap with bias accelerating correction is presented. A classical method, the Binomial interpretation, is used as comparing criterion.

SUBJECTS:

A case study comprising 418 randomly selected subjects from a private secondary school (age: 10–17 y, boys: 52%).

MEASUREMENTS:

Body fat percentage (by), age (y) and Tanner criteria.

RESULTS:

The empirical distributions presented skewness suggesting that the CIs should not be symmetric. CIs obtained by the proposed approach were more realistic than the classical ones.

CONCLUSIONS:

We propose a simple and efficient way to obtain the interval estimates and the distribution properties of cutoff points for overweight and obese classification using a sample-based method that allows the comparison of cutoffs among many subpopulations.

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References

  1. Martorell R, Khan LK, Hughes ML, Grummer-Strawn LM . Obesity in Latin American women and children. J Nutr 1998; 128: 1464–1473.

    Article  CAS  Google Scholar 

  2. Wang Y, Monteiro C, Popkin BM . Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia. Am J Clin Nutr 2002; 75: 971–977.

    Article  CAS  Google Scholar 

  3. Pietrobelli A, Faith MS, Allison DB, Gallagher D, Chiumello G, Heymsfield SB . Body mass index as a measure of adiposity among children and adolescents: a validation study. J Pediatr 1998; 132: 204–210.

    Article  CAS  Google Scholar 

  4. Malina RM, Katzmarzyk PT . Validity of the body mass index as an indicator of the risk and presence of overweight in adolescents. Am J Clin Nutr 1999; 70: 131S–136S.

    Article  CAS  Google Scholar 

  5. Ellis KJ, Abrams SA, Wong WW . Monitoring childhood obesity: assessment of the weight/height index. Am J Epidemiol 1999; 150: 939–946.

    Article  CAS  Google Scholar 

  6. Sauerbrei W . The use of resampling methods to simplify regression model in medical statistics. Appl Stat 1999; 48/3: 313–329.

    Google Scholar 

  7. Efron B . The bootstrap and modern statistics. J Am Stat Assoc 2000; 95: 1293–1296.

    Article  Google Scholar 

  8. Conover WJ . Practical nonparametric statistics. John Wiley and Sons: New York; 1980.

    Google Scholar 

  9. Quennouille MH . Approximate tests of correlation in time series. J R Statist Soc B 1949; 11: 68–84.

    Google Scholar 

  10. Quennouille MH . Notes on bias in estimation. Biometrika 1956; 43: 353–360.

    Article  Google Scholar 

  11. Tukey JW . Bias and confidence in not-quite large samples (Abstract). Ann Math Statist 1958; 29: 614.

    Article  Google Scholar 

  12. Efron B . Bootstrap methods: another look at the Jackknife. Ann Statist 1979; 7: 1–26.

    Article  Google Scholar 

  13. Carpenter J, Bithell J . Bootstrap confidence intervals: when, which, what? A practical guide for medical statisticians. Stat Med 2000; 19: 1141–1164.

    Article  CAS  Google Scholar 

  14. Efron B . Better bootstrap confidence intervals. J Am Stat Assoc 1987; 82: 171–200.

    Article  Google Scholar 

  15. Tanner JM . Growth at adolescence, 2nd edn. Blackwell: Oxford; 1962.

    Google Scholar 

  16. Morrison JA, Khoury PR, Chumlea WC . Body composition measures from underwater weighing and dual energy X-ray absorptiometry in black and white girls: a comparative study. Am J Hum Biol 1994; 6: 481–490.

    Article  Google Scholar 

  17. Doornik JA . Ox: an object-oriented matrix programming language, 2nd edn. Timberlake Consultants: London; 1998.

    Google Scholar 

  18. Stata Corporation. Stata Statistical Software: release 7.0. 2001.Texas, College Station.

  19. Carpenter JR, Royston P . BC a bootstrap confidence intervals. Stata J 2001; 1: 1–14.

    Article  Google Scholar 

  20. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 2000; 320: 1–6.

    Article  Google Scholar 

Download references

Acknowledgements

We thank the reviewers for the improving comments that improved this paper. This work was financially supported by FAPESP (02/07860-0) and CNPq.

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Correspondence to F A B Colugnati.

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Colugnati, F., Louzada-Neto, F. & de Aguiar Carrazedo Taddei, J. An application of bootstrap resampling method to obtain confidence interval for percentile fatness cutoff points in childhood and adolescence overweight diagnoses. Int J Obes 29, 340–347 (2005). https://doi.org/10.1038/sj.ijo.0802866

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