ARS | Publication request: BMI UNDERESTIMATES OBESITY AND RELATED DISEASE RISK IN 8-13 YEAR OLD AMERICAN INDIAN CHILDREN

Submitted to: Pediatric Research
Publication Type: Abstract Only
Publication Acceptance Date: February 2, 2004
Publication Date: May 1, 2004
Citation: Weber, J.L., Going, S.B., Simpson, P.M., Lohman, T.G., Flick, E., Eklund, J., Gladstone, J. 2004. BMI underestimates obesity and related disease risk in 8-13 year old American Indian children [abstract]. Pediatric Research. 55(4):592A.

Technical Abstract: Background: Some studies suggest that BMI may overestimate the prevalence of obesity in American Indian (AI) children because they may have a higher proportion of fat-free mass than the national reference standards. Others suggest that body fat quantity and distribution may differ among ethnic groups, and that estimates of body fat based on national BMI reference data may underestimate obesity in AI populations. Objective: To evaluate the use of BMI to assess obesity in high-risk minority population. Design/Methods: We measured height, weight, 4 skinfolds (SFs) and bioelectric impedance (BIA) in 289 8-13 year old AI children in SW Arizona. We calculated BMI, and also percent fat using an equation previously validated in AI children, and compared those values to established cut-points for overweight, obesity and disease risk. Comparisons were also made to data from the Continuing Survey of Food Intakes of Individuals (CSFII; 1994-1998) for the same age/sex groups. Results: Mean BMIs ranged from 23.4 for 8-10 year of males to 27.6 for 11-13 year old females, all of which were significantly different (p<.001) from the same age/sex groups in CSFII. Percent body fat ranged from 39.9-46.6% across groups. Using BMI, 82 children were classified as normal weight (<85th percentile), 70 were overweight (85th -94th percentile), and 137 were obese (>95th percentile); however, when using the criteria of 25% fat (boys) or 30% fat (girls) to estimate obesity and increased risk for obesity-related diseases, all but 7 children were classified as obese. Conclusions: We conclude that the prevalence of obesity in AI children in SW Arizona is very high, and is underestimated by measures of BMI alone. National Heart, Lung and Blood Institute