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. 2010 Apr;91(4):1020-6.
doi: 10.3945/ajcn.2009.28589. Epub 2010 Feb 17.

High adiposity and high body mass index-for-age in US children and adolescents overall and by race-ethnic group

Katherine M Flegal  1 , Cynthia L Ogden, Jack A Yanovski, David S Freedman, John A Shepherd, Barry I Graubard, Lori G Borrud
Affiliations

High adiposity and high body mass index-for-age in US children and adolescents overall and by race-ethnic group

Katherine M Flegal et al. Am J Clin Nutr. 2010 Apr.

Abstract

Background: Body mass index (BMI)-for-age has been recommended as a screening test for excess adiposity in children and adolescents.

Objective: We quantified the performance of standard categories of BMI-for-age relative to the population prevalence of high adiposity in children and adolescents overall and by race-ethnic group in a nationally representative US population sample by using definitions of high adiposity that are consistent with expert committee recommendations.

Design: Percentage body fat in 8821 children and adolescents aged 8-19 y was measured by using dual-energy X-ray absorptiometry in 1999-2004 as part of a health examination survey.

Results: With the use of several different cutoffs for percentage fat to define high adiposity, most children with high BMI-for-age (> or = 95th percentile of the growth charts) had high adiposity, and few children with normal BMI-for-age (<85th percentile) had high adiposity. The prevalence of high adiposity in intermediate BMI categories varied from 45% to 15% depending on the cutoff. The prevalence of a high BMI was significantly higher in non-Hispanic black girls than in non-Hispanic white girls, but the prevalence of high adiposity was not significantly different.

Conclusions: Current BMI cutoffs can identify a high prevalence of high adiposity in children with high BMI-for-age and a low prevalence of high adiposity in children with normal BMI-for-age. By these adiposity measures, less than one-half of children with intermediate BMIs-for-age (85th to <95th percentile) have high adiposity. Differences in high BMI ranges between race-ethnic groups do not necessarily indicate differences in high adiposity.

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Figures

FIGURE 1
FIGURE 1
Overall prevalence (%) of high adiposity within BMI categories by different percentile cutoffs for high adiposity.
FIGURE 2
FIGURE 2
Prevalence (%) of high BMI-for-age and high adiposity (≥80th percentile) by race-ethnic group in boys and girls. *Mexican Americans were significantly different from non-Hispanic whites and non-Hispanic blacks by 2-sample t test: P < 0.0001. **Non-Hispanic blacks were significantly different from non-Hispanic whites and Mexican Americans by 2-sample t test: P < 0.0001.
FIGURE 3
FIGURE 3
Prevalence (%) of high adiposity (≥80th percentile) by race-ethnic group and BMI category in boys and girls.
See this image and copyright information in PMC

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