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Title: Age, sex and ethnic differences in the prevalence of underweight and overweight, defined by using the CDC and IOTF cut points in Asian culture

Author
item TUAN, NGUYEN - Children'S Nutrition Research Center (CNRC)
item NICKLAS, THERESA - Children'S Nutrition Research Center (CNRC)

Submitted to: European Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/7/2009
Publication Date: 8/19/2009
Citation: Tuan, N., Nicklas, T.A. 2009. Age, sex and ethnic differences in the prevalence of underweight and overweight, defined by using the CDC and IOTF cut points in Asian culture. European Journal of Clinical Nutrition. 63: 1305-1312.

Interpretive Summary: This study showed age, sex, and ethnic differences in the prevalence of underweight and overweight, defined by using the Centers for Disease Control and Prevention (CDC), and International Obesity TaskForce (IOTF) cut points, in selective low- and lower-middle-income countries. The findings suggest that each country should carefully evaluate any external cut points before using it in their populations. Although country-specific cut points show advantages in tracking nutrition status in a given country, effort should be made to create universally accepted cut points for underweight and overweight in children to facilitate between-country comparisons.

Technical Abstract: No nationally representative data from middle- and low-income countries have been analyzed to compare the prevalence of underweight and overweight, defined by using the Centers for Disease Control and Prevention (CDC), and the International Obesity TaskForce (IOTF) body mass index cut points. To examine the consistency in the prevalence of underweight and overweight, defined by using the CDC and IOTF cut points in Chinese, Indonesian, and Vietnamese children. We used data from 1,600 Chinese, 11,756 Indonesian and 53,826 Vietnamese children aged 2–18 years, who participated in three recent, representative surveys in China, Indonesia, and Vietnam. A smaller difference between prevalence and a higher k-statistic indicated a higher consistency level. The prevalence of underweight was higher with the IOTF than the CDC cut points; absolute differences in the Chinese, Indonesian, and Vietnamese were 6, 10 and 13% (boys), and 10, 13 and 19% (girls), respectively. The prevalence of overweight was more consistent (absolute differences were <2%, except for the 2–5.9-year-old Chinese and Indonesian children (from 2 to <5%)). Values of k-statistic (from 0.55 to 0.88) varied by age, sex, and ethnicity. The consistency was gradually improving from the Vietnamese to Indonesians and to Chinese boys and girls, from girls to boys, from the younger to older boys and from the older to younger girls. The age, sex, and ethnic differences in the prevalence of underweight and overweight suggest a systematic evaluation of the cut points.