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      Body mass index in Saudi Arabian children and adolescents: a national reference and comparison with international standards

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          Abstract

          BACKGROUND AND OBJECTIVES:

          Because there are no reference standards for body mass index (BMI) in Saudi children, we established BMI reference percentiles for normal Saudi Arabian children and adolescents and compared them with international standards.

          SUBJECTS AND METHODS:

          Data from a stratified multistage probability sample were collected from the 13 health regions in Saudi Arabia, as part of a nationwide health profile survey of Saudi Arabian children and adolescents conducted to establish normal physical growth references. Selected households were visited by a trained team. Weight and length/height were measured and recorded following the WHO recommended procedures using the same equipment, which were subjected to both calibration and intra/interobserver variations.

          RESULTS:

          Survey of 11 874 eligible households yielded 35 275 full-term and healthy children and adolescents who were subjected to anthropometric measurements. Four BMI curves were produced, from birth to 36 months and 2 to 19 years for girls and boys. The 3 rd, 5 th, 10 th, 25 th, 50 th, 75 th, 85 th, 90 th, 95 th, and 97 th percentiles were produced and compared with the WHO and CDC BMI charts. In the higher percentiles, the Saudi children differed from Western counterparts, indicating that Saudi children have equal or higher BMIs.

          CONCLUSION:

          The BMI curves reflect statistically representative BMI values for Saudi Arabian children and adolescents.

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          Most cited references25

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          2000 CDC Growth Charts for the United States: methods and development.

          This report provides detailed information on how the 2000 Centers for Disease Control and Prevention (CDC) growth charts for the United States were developed, expanding upon the report that accompanied the initial release of the charts in 2000. The growth charts were developed with data from five national health examination surveys and limited supplemental data. Smoothed percentile curves were developed in two stages. In the first stage, selected empirical percentiles were smoothed with a variety of parametric and nonparametric procedures. In the second stage, parameters were created to obtain the final curves, additional percentiles and z-scores. The revised charts were evaluated using statistical and graphical measures. The 1977 National Center for Health Statistics (NCHS) growth charts were revised for infants (birth to 36 months) and older children (2 to 20 years). New body mass index-for-age (BMI-for-age) charts were created. Use of national data improved the transition from the infant charts to those for older children. The evaluation of the charts found no large or systematic differences between the smoothed percentiles and the empirical data. The 2000 CDC growth charts were developed with improved data and statistical procedures. Health care providers now have an instrument for growth screening that better represents the racial-ethnic diversity and combination of breast- and formula-feeding in the United States. It is recommended that these charts replace the 1977 NCHS charts when assessing the size and growth patterns of infants, children, and adolescents.
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            Smoothing reference centile curves: the LMS method and penalized likelihood.

            Refence centile curves show the distribution of a measurement as it changes according to some covariate, often age. The LMS method summarizes the changing distribution by three curves representing the median, coefficient of variation and skewness, the latter expressed as a Box-Cox power. Using penalized likelihood the three curves can be fitted as cubic splines by non-linear regression, and the extent of smoothing required can be expressed in terms of smoothing parameters or equivalent degrees of freedom. The method is illustrated with data on triceps skinfold in Gambian girls and women, and body weight in U.S.A. girls.
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              The presentation and use of height and weight data for comparing the nutritional status of groups of children under the age of 10 years.

              This paper presents recommendations for the analysis and presentation of height and weight data from surveillance or surveys involving nutrition and anthropometry in young children up to the age of 10 years. These recommendations are only for the analysis of data collected on a cross-sectional basis. The basic indices recommended are height for age and weight for height, each considered either in terms of centiles or in a cross-classification scheme using standard deviation scores. It is hoped that these methods of analysis and presentation will prove widely acceptable, so that international comparisons will be made easier.
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                Author and article information

                Journal
                Ann Saudi Med
                ASM
                Annals of Saudi Medicine
                Medknow Publications (India )
                0256-4947
                0975-4466
                Sep-Oct 2009
                : 29
                : 5
                : 342-347
                Affiliations
                [a ]From the Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
                [b ]From the Ministry of Health, Riyadh, Saudi Arabia
                [c ]From the School of Mathematics, Manchester University, United Kingdom
                Author notes
                Correspondence: Abdullah S. Al Herbish, MD · 2965 Abdulaziz Aba Husain Street-Al Morsalat, Riyadh 12461-6591, Saudi Arabia · T: +966-55-525-3313 F: +966-1-463-3582 · asalherbish@ 123456yahoo.com / vppa_office@ 123456drsulaimanalhabib.com · Accepted for publication June 2009
                Article
                ASM-29-342
                10.4103/0256-4947.55162
                3290051
                19700890
                49ca576d-2355-464b-a3ea-e05fc0274c46
                © Annals of Saudi Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Medicine
                Medicine

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