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

• Published in: European journal of clinical nutrition Vol. 65; no. 2; pp. 151 - 159
• Main Authors: Glasser, N, Zellner, K, Kromeyer-Hauschild, K
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-02-2011; Nature Publishing Group
• Subjects: 692/699/1702/393; 692/700/139/1735; 692/700/1720; Adipose tissue; Adipose Tissue - metabolism; Adipose Tissue - pathology; Adiposity; Adolescent; Anthropometry - methods; Biological and medical sciences; Body Composition - physiology; Body fat; Body Mass Index; Body size; Child; Children; Children & youth; Classification systems; Clinical Nutrition; Cross-Sectional Studies; Epidemiology; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Girls; Health aspects; Humans; Internal Medicine; Male; Mass Screening; Measurement techniques; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Obesity; Obesity - classification; Obesity - diagnosis; original-article; Overweight - classification; Overweight - diagnosis; Predictive Value of Tests; Public Health; Reference systems; Reference Values; ROC Curve; Screening; Sensitivity; Sensitivity and Specificity; Sex Factors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Waist Circumference; Germany; excess adiposity; waist circumference; children; body mass index; ROC analysis; Human; Adipose tissue; Anthropometry; Metabolic diseases; Corporal biometry; Fat mass; Body mass index; Waist circumference; Validity; Adiposity; Waist hip ratio; Child
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2010.245

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.