Alternative methods should be used to measure childhood obesity, according to researchers, who say Body Mass Index (BMI) can ‘misidentify and misdiagnose’ the disease.
Published in Paediatric Research, it concluded that using BMI is not as useful in measuring fat in children as waist-to-height ratio (WHtR).
Obesity affects almost one in four children and adolescents. It is associated with cardiovascular, metabolic, neurological, musculoskeletal diseases and also premature death in adulthood.
Assessing more than 7,200 children over a 15-year follow-up, it identified WHtR as an inexpensive accurate measure that discriminates fat mass from lean mass that could replace BMI measure of obesity in paediatrics.
Researchers said: ‘WHtR may be universally adopted as non-invasive and inexpensive fat mass overweight and obesity surveillance, monitoring, and prevention initiatives in routine paediatric healthcare practice, particularly, in low-resource settings where more complex fat mass measures are not readily available.’
Preferable to BMI
The study was conducted by the University of Exeter in collaboration with the University of Bristol and University of Eastern Finland.
Dr Andrew Agbaje, of the Children’s Health and Research Centre at the University of Exeter, said it may be preferable as WHtR does not vary with age.
‘This study provides novel information that would be useful in updating future childhood obesity guidelines and policy statements,’ he said.
‘But unlike BMI, the average waist circumference-to-height ratio in childhood, adolescence, and young adulthood does not vary with age and among individuals. This is why it might be preferable to BMI assessment in children and adolescent clinics as an inexpensive tool for detecting excess fat.
‘It also means parents can easily and quickly confirm whether an increase in their child’s BMI or weight is due to excess fat, by examining their child’s waist circumference-to-height ratio.’
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