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      Measurement and Definitions of Obesity In Childhood and Adolescence: A field guide for the uninitiated

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      Nutrition Journal
      BioMed Central

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          Abstract

          This paper aims to guide readers embarking on the complex literature in respect of childhood and adolescent obesity. It opens with a discussion of definitions of 'obesity' based on overall fat levels and the significance of fat distribution. This is followed by simple descriptions of the various techniques used to measure fat, including density-based, scanning, bioelectrical impedance and anthropometric methods. The paper then turns to 'overweight' and the measurement of weight in relation to height, particularly via body mass index (BMI). While it is a relatively simple measure and a valuable tool, BMI has several disadvantages, which are described. These include a lack of consensus on which values should be used to define 'overweight' or 'obese', with the result that the literature contains a confusing multiplicity of child and adolescent obesity rates.

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          Physical Status: The Use and Interpretation of Anthropometry

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            Beyond body mass index.

            Body mass index (BMI) is the cornerstone of the current classification system for obesity and its advantages are widely exploited across disciplines ranging from international surveillance to individual patient assessment. However, like all anthropometric measurements, it is only a surrogate measure of body fatness. Obesity is defined as an excess accumulation of body fat, and it is the amount of this excess fat that correlates with ill-health. We propose therefore that much greater attention should be paid to the development of databases and standards based on the direct measurement of body fat in populations, rather than on surrogate measures. In support of this argument we illustrate a wide range of conditions in which surrogate anthropometric measures (especially BMI) provide misleading information about body fat content. These include: infancy and childhood; ageing; racial differences; athletes; military and civil forces personnel; weight loss with and without exercise; physical training; and special clinical circumstances. We argue that BMI continues to serve well for many purposes, but that the time is now right to initiate a gradual evolution beyond BMI towards standards based on actual measurements of body fat mass.
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              Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents.

              Recent studies have shown considerable variation in body fatness among children and adolescents defined as obese by a percentile rank for skinfold thickness. We examined the relationship between percent body fat and risk for elevated blood pressure, serum total cholesterol, and serum lipoprotein ratios in a biracial sample of 3320 children and adolescents aged 5 to 18 years. Equations developed specifically for children using the sum of subscapular (S) and triceps (T) skinfolds were used to estimate percent fat. The S/T ratio provided an index of trunkal fat patterning. Significant overrepresentation (greater than 20%) of the uppermost quintile (UQ) for cardiovascular disease (CVD) risk factors was evident at or above 25% fat in males (32.2% to 37.3% in UQ) and at or above 30% fat in females (26.6% to 45.4% in UQ), even after adjusting for age, race, fasting status, and trunkal fat patterning. These data support the concept of body fatness standards in White and Black children and adolescents as significant predictors of CVD risk factors. Potential applications of these obesity standards include epidemiologic surveys, pediatric health screenings, and youth fitness tests.
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                Author and article information

                Journal
                Nutr J
                Nutrition Journal
                BioMed Central
                1475-2891
                2007
                26 October 2007
                : 6
                : 32
                Affiliations
                [1 ]MRC Social and Public Health Sciences Unit, 4, Lilybank Gardens, Glasgow, G12 8RZ, UK
                Article
                1475-2891-6-32
                10.1186/1475-2891-6-32
                2164947
                17963490
                07395dde-e13c-4f04-961a-545f8c22399c
                Copyright © 2007 Sweeting; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 March 2007
                : 26 October 2007
                Categories
                Review

                Nutrition & Dietetics
                Nutrition & Dietetics

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