Original Article | Open

This is an unedited manuscript that has been accepted for publication. Nature Research are providing this early version of the manuscript as a service to our customers. The manuscript will undergo copyediting, typesetting and a proof review before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers apply.

Patterns of childhood body mass index (BMI), overweight and obesity in South Asian and black participants in the English National child measurement programme: Effect of applying BMI adjustments standardizing for ethnic differences in BMI-body fatness associations

Published online:



The National Child Measurement Programme (NCMP) records weight and height and assesses overweight-obesity patterns in English children using body mass index (BMI), which tends to underestimate body fatness in South Asian children and overestimate body fatness in Black children of presumed African ethnicity. Using BMI adjustments to ensure that adjusted BMI was similarly related to body fatness in South Asian, Black and White children, we reassessed population overweight and obesity patterns in these ethnic groups in NCMP.


Analyses were based on 2012–2013 NCMP data in 582 899 children aged 4–5 years and 485 362 children aged 10–11 years. Standard centile-based approaches defined weight status in each age-group before and after applying BMI adjustments for English South Asian and Black children derived from previous studies using the deuterium dilution method.


Among White children, overweight-obesity prevalences (boys, girls) were 23 and 21% respectively in 4–5 year-olds and 33 and 30% respectively in 10–11 year-olds. Before adjustment, South Asian children had lower overweight-obesity prevalences at 4–5 years (19%, 19%) and slightly higher prevalences at 10–11 years (42%, 34%), while Black children had higher overweight-obesity prevalences both at 4–5 years (31%, 29%) and 10–11 years (42%, 45%). Following adjustment, overweight-obesity prevalences were markedly higher in South Asian children both at 4–5 years (39%, 35%) and at 10–11 years (52%, 44%), while Black children had lower prevalences at 4–5 years (11%, 12%); at 10–11 years, prevalences were slightly lower in boys (32%) but higher in girls (35%).


BMI adjustments revealed extremely high overweight-obesity prevalences among South Asian children in England, which were not apparent in unadjusted data. In contrast, after adjustment, Black children had lower overweight-obesity prevalences except among older girls.


British Heart Foundation, NIHR CLAHRC (South London), NIHR CLAHRC (North Thames).

Author information


  1. Population Health Research Institute, St George’s, University of London, London, UK

    • M T Hudda
    • , C M Nightingale
    • , A S Donin
    • , C G Owen
    • , A R Rudnicka
    • , D G Cook
    •  & P H Whincup
  2. Childhood Nutrition Research Centre, Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK

    • J C K Wells
  3. ECOHOST—The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK

    • H Rutter


  1. Search for M T Hudda in:

  2. Search for C M Nightingale in:

  3. Search for A S Donin in:

  4. Search for C G Owen in:

  5. Search for A R Rudnicka in:

  6. Search for J C K Wells in:

  7. Search for H Rutter in:

  8. Search for D G Cook in:

  9. Search for P H Whincup in:

Corresponding author

Correspondence to M T Hudda.

Creative Commons BY-NC-SAThis work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/