Childhood Obesity: Some Relevant Issues

The authors have been less than meticulous, while defining overweight and obese children using the CDC BMI percentiles, as the levels of 85th and 95th percentiles have been left belonging to neither of the groups [2]. On scrutiny of the referred material, it is clear that overweight and obese children mean those with BMI from 85th to less than 95th percentile (contrary to “more than 85th” as shown in the study), and those with equal to or greater than 95th percentile (not “more than 95th”) respectively. Again, while defining levels of blood pressure on the basis of SBP and DBP percentiles, the same thing has been done; the levels of 90th and 95th percentiles have been left as belonging to none of the categories. As mentioned, it has been done according to the manner as used by the National High Blood Pressure Education Program in the USA. However, these guidelines are not the same as shown in the study and define hypertension in childhood as repeated SBP and/or DBP measurements at the 95th percentile or higher and prehypertension as BP between 90th and 95th percentile [3].

The reference, cited at no. 4 is not correct in the given context and gives an entirely erroneous impression. In fact, the authors of this study totally disagree with the CDC approach and instead, propose a new definition of overweight and obesity in childhood, based on pooled international BMI data, linked to the widely used adult obesity cut-off point of 30 kg/m² [4].

In the discussion, the authors have used, for the subjects of the study, the words “Bengali obese children” more than once. The proposition that all subjects of the study were Bengali children is very difficult to accept. Kolkata is a big metropolis, with people of multiple ethnic groups, and one would believe any big hospital like Vivekanand Institute of Medical Sciences would keep its doors open to children of all communities. There is no mention either, any where in the study, that only Bengali children were included in the study.