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Validity of body mass index and waist circumference to detect excess fat mass in children aged 7–14 years

European Journal of Clinical Nutrition volume 65, pages 151–159 (2011)Cite this article

Subjects

Abstract

Background/Objectives:

To evaluate the screening performance of body mass index (BMI) and waist circumference (WC) for excess adiposity. In addition, the diagnostic accuracy of cutoffs from different international and national reference systems based on BMI and WC was investigated.

Subjects/Methods:

Data from 2132 Jena children aged 7–14 years conducted in 2005/2006 were analyzed. Receiver operating characteristic (ROC) curves were constructed to assess BMI and WC, as screening measures for excess adiposity (derived from skinfolds). Sensitivity, specificity and positive predictive values (PPVs) were calculated for two BMI-based classification systems (IOTF and German reference) and sample-based WC cutoffs.

Results:

The BMI as well as the WC performed well in detecting excess fat mass, indicated by areas under the ROC curve (AUC) close to 1.0, with slightly greater AUCs for BMI than for WC in both sexes. The specificity of all reference systems was high for both sexes (95 to 98%). However, their sensitivities were low (53–67% in boys; 51–67% in girls). PPV were higher for the German reference and the sample-based WC cutoffs than for the IOTF reference, and higher in girls than in boys.

Conclusions:

The setting in which the reference system should be used is important for the selection of the reference system. The results support the use of the BMI-based references for monitoring in epidemiological studies. The sample-based cutoffs for WC should be refined for clinical use on national level.

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Acknowledgements

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. We thank all children and their parents, as well as the field staff for participating and showing commitment towards the study.

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  1. Institute of Human Genetics, University Hospital-Friedrich Schiller University Jena, Jena, Germany

    N Gläßer, K Zellner & K Kromeyer-Hauschild

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  1. N Gläßer
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Correspondence to K Kromeyer-Hauschild.

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Gläßer, N., Zellner, K. & Kromeyer-Hauschild, K. Validity of body mass index and waist circumference to detect excess fat mass in children aged 7–14 years. Eur J Clin Nutr 65, 151–159 (2011). https://doi.org/10.1038/ejcn.2010.245

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