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Variation in childhood and adolescent obesity prevalence defined by international and country-specific criteria in England and the United States

European Journal of Clinical Nutrition volume 65, pages 143–150 (2011)Cite this article

Subjects

Abstract

Objective:

To compare childhood obesity prevalence in England and the United States using different criteria.

Subjects/Methods:

Participants included 2- to 17-year olds in the Health Survey for England (HSE, n=33 563) and the US National Health and Nutrition Examination Survey (NHANES, n=14 540) 1999 through 2006. Mean body mass index (BMI) and prevalence of obesity were compared using the UK 1990, US 2000 Centers for Disease Control and International Obesity Task Force (IOTF) criteria.

Results:

English children at ages 2–5 years had a higher mean BMI than US children (mean difference (English minus US)=0.41 kg/m2, 95% confidence intervals (CI) 0.31–0.52). At age ⩾8 years, mean BMI was lower in England (for ages 8–11 years, mean difference=−1.00 kg/m2, 95% CI −1.26 to −0.75; for ages 12–17 years, mean difference=−1.37 kg/m2, 95% CI −1.59 to −1.14). The IOTF criteria produced the lowest estimates of obesity prevalence. The 2000 Centre for Disease Control and Prevention (CDC) criteria produced the highest estimates in younger children and the UK 1990 criteria produced the highest in adolescents. Children aged 2–5 years in England had higher prevalence of obesity than those in the United States when using the 2000 CDC and UK 1990 criteria. US adolescents had the highest prevalence of obesity by age group using each of the three criteria.

Conclusion:

The 2000 CDC and UK 1990 criteria give a higher prevalence of obesity in England than in the United States at ages 2–5 years; however, at age ⩾8 years, the reverse is true. Estimates of childhood obesity prevalence rely on the criteria used, which has implications for surveillance and clinical practice.

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Acknowledgements

No funding was received for the design and conduct of the study; for collection, management, analysis and interpretation of the data; and for preparation, review or approval of the manuscript. No specific funding was received for the work. IAL is funded by NIHR, the UK National Institute for Health Research, as part of PenCLAHRC, the Peninsula Collaboration for Leadership in Applied Health Research and Care. RRK is supported by the South West Public Health Training Scheme. DAL is funded by the Higher Education Funding Council for England. DAL has grants from the UK Medical Research Council, the Wellcome Trust and the British Heart Foundation, although this work was not directly funded by any of these. RJ is funded from a Career Development Fellowship supported by the National Institute for Health Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

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Author notes

  1. I A Lang and R R Kipping: Joint first authors.

Authors and Affiliations

  1. PenCLAHRC, Peninsula Medical School, University of Exeter, Exeter, UK

    I A Lang

  2. Public Health Directorate, NHS Devon, Exeter, UK

    I A Lang

  3. School of Social and Community Medicine, University of Bristol, Bristol, UK

    R R Kipping & D A Lawlor

  4. Centre for Exercise, Nutrition & Health, School for Policy Studies, University of Bristol, Bristol, UK

    R Jago

  5. MRC Centre for Causal Analysis in Translational Epidemiology, University of Bristol, Bristol, UK

    D A Lawlor

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  1. I A Lang
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  2. R R Kipping
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  3. R Jago
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  4. D A Lawlor
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Corresponding author

Correspondence to R R Kipping.

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Supplementary Information accompanies the paper on European Journal of Clinical Nutrition website

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Lang, I., Kipping, R., Jago, R. et al. Variation in childhood and adolescent obesity prevalence defined by international and country-specific criteria in England and the United States. Eur J Clin Nutr 65, 143–150 (2011). https://doi.org/10.1038/ejcn.2010.260

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