Population-Level Obesity Surveillance: Monitoring Childhood Body Mass Index z-Score in a Safety-Net System

ObjectiveTo determine the utility of repeated patient-level body mass index (BMI) measurements among higher-risk patients seen at safety-net clinics as a community-level monitoring tool for overweight and obesity population trends.MethodsData from a network of urban, federally qualified community health centers with computerized tracking of BMI at sequential outpatient visits were analyzed. We performed a longitudinal observational study over 8 years (2005–2012) with children stratified by weight status groups on the basis of BMI. Changes in BMI z-scores were used to estimate population trends among children 2 to 11 years old, with at least 2 visits (at least 1 year apart), for whom weight and height were measured.ResultsAmong children (n = 33,542), the rate of overweight was 16% and rate of obesity was 18% at their last visit. Children were followed for an average of 3.24 ± 1.76 years to measure trends and change in weight status from earlier to later childhood. Children who were obese at first visit had increased odds (adjusted odds ratio 27.8, 95% confidence interval 25.6–30.2) of being obese by last visit. Mean change in BMI z-score per person-year of observation was 0.10 ± 0.38, with a differing rate of change based on weight status category at last visit (not overweight = 0.06 ± 0.39; overweight = 0.17 ± 0.34; obese = 0.19 ± 0.36). Change in BMI z-score per person-year decreased for 40% of obese children; however, their weight status group remained unchanged.ConclusionsChildhood obesity prevalence was high, with substantial progression to overweight and obesity from first to last visit. Clinically derived BMI z-score per person-year measures can effectively show population trends not observed using standard weight status categories.     

Patterns of Childhood Body Mass Index Percentile Gains as Predictors of Adolescent Body Mass Index,Waist Circumference,and Blood Pressure

ObjectiveTo examine whether patterns of body mass index (BMI) percentile gains across childhood predict BMI percentile, overweight and obesity, waist circumference, and elevated or prehypertensive blood pressure at age 15.MethodsTrained technicians in the Study of Early Child Care and Youth Development assessed children's weight and height from birth to 15 years and waist circumference and blood pressure at age 15 (n = 1132). Children's BMI percentile trajectories from age 2 to age 13 along with 28 demographic and social covariates were used to predict BMI percentile, waist circumference, overweight, obesity, and elevated or prehypertensive blood pressure. Linear and logistic regressions were used to predict BMI percentile, overweight, obesity, waist circumference, and elevated or prehypertensive blood pressure.ResultsChildren were classified into one"?>1 of 4four"?> BMI percentile trajectories: “low stable” (28.4%), “low-to-high” (11.8%), “median stable” (29.0%), and “high rising” (30.7%). Children in trajectory classes characterized by persistent above average BMI percentile or by periods of rapid BMI percentile gains were more likely than their peers to experience poor weight and elevated or prehypertensive outcomes in adolescence. Trajectory class membership explained substantially more variance in adolescent health outcomes than demographic covariates alone. Estimated maternal BMI was a key independent predictor of adolescent outcomes.ConclusionsDifferent patterns of BMI percentile gains, namely those with rapid gains or persistently above average BMI percentile, from ages 2 to 13 predicted weight, waist circumference, and elevated or prehypertensive blood pressure at age 15, above and beyond demographic and social characteristics.     

A study of growth parameters and prevalence of overweight and obesity in school children from delhi

OBJECTIVE: (1) To assess the height, weight and body mass index (BMI) of school children from Delhi and generate percentile charts as appropriate for age, gender and socio-economic status. (2) To determine the prevalence of overweight and obesity in school children from low and upper socioeconomic status (LSES and USES respectively). DESIGN: Cross sectional evaluation of anthropometric parameters in Delhi school children (5-18 years) from different geographical zones. SETTING: Government schools (non-fee paying) and Private Schools (fee paying) in Delhi. SUBJECTS: 21485 children, 8840 (3566 boys, 5274 girls) from government schools and 12645 (6197 boys, 6448 girls) from private schools. Methods: Subjects underwent assessment of height and weight and calculation of BMI. Children were classified as normal, overweight and obese as per IOTF guidelines. Height, weight and BMI percentile charts specific for the socioeconomic status were generated using the LMS method. Prevalence of overweight and obesity was assessed and compared between the two socio-economic groups. RESULTS: A significant difference was noted in height, weight and BMI between LSES and USES. The prevalence of overweight and obesity in USES children was 16.75 % and 5.59 % in boys and 19.01 % and 5.03 % in girls respectively. CONCLUSIONS: There is a significant disparity in anthropometric parameters between children from USES and LSES, with a high prevalence of overweight and obesity in USES children.     

Influence of gender, BMI and Hispanic ethnicity on physical activity in children.

OBJECTIVE: The purpose of this study was to examine the association between overweight status and physical activity (PA) among gender and ethnic (Hispanic vs. non-Hispanic) sub-groups in elementary school-age children. METHODS: PA was assessed over five days using the Actigraph accelerometer in 169 fourth grade students (mean age 9.4 years; 50% female; 63% Hispanic; and 43% overweight, defined as body mass index, BMI > or = 85th percentile for age and gender) from four elementary schools in Los Angeles County, California. RESULTS: In the total sample, boys and normal weight students had higher levels of total PA (counts per minute, cpm; p<0.05). Boys spent less time in sedentary PA (p=0.02) and more time in combined moderate to vigorous PA (MVPA, p=0.01). There was a significant gender, ethnicity, and overweight interaction for total PA and MVPA (both p<0.01). MVPA and counts per minute were significantly lower in overweight non-Hispanic girls and Hispanic boys (p<0.05) and marginally lower in overweight non-Hispanic boys (p=0.10) when compared with non-overweight students, while overweight Hispanic girls were more physically active than Hispanic non-overweight girls, though the difference was non-significant (p>0.05). CONCLUSIONS: Data from the present study does not consistently support the prevailing hypothesis that overweight subjects engage in less PA. Results show overweight students engage in less PA than non-overweight students, with the exception that non-overweight Hispanic girls do not engage in more PA than their overweight peers. These results suggest the need for further investigation into the role that ethnicity and overweight status plays in PA levels, particularly among ethnic and gender sub-groups.     

Effect of physical activity intervention on body composition in young children: influence of body mass index status and gender

AIM: To fight overweight and obesity in childhood, this study proposes an additional physical activity (PA) in young children aged 6-10 years. The objective was to evaluate the effect of school-based PA on the body composition according to body mass index (BMI) categories (nonobese vs. obese) and gender. METHODS: This 6-month study examined the effect of this intervention on body composition in 425 children in 14 primary schools (2 weekly PA sessions of 1 h each) compared to 5 control schools. Adiposity indices were evaluated or calculated: BMI, BMI z-score, waist circumference, sum of skinfolds and fat-free mass. RESULTS: No difference in the prevalence of obesity and anthropometric characteristics was found between the intervention and control groups at baseline. In girls, PA intervention had significant effect on all anthropometric variables (p < 0.05 to p < 0.001), except on BMI. In contrast, in boys only BMI z-score (p < 0.001) and fat-free mass (p < 0.001) were affected. CONCLUSIONS: Six months of preventive PA intervention offer an effective means to improve body composition in obese children. The pattern of response related to PA was similar between girls and boys. In contrast, the pattern was different according to BMI category, with a higher response in obese than nonobese children.     

Prediction of obesity from infancy to adolescence

Aim: To examine the development of childhood obesity and to determine the earliest age when estimating body mass using only weight and height data is associated with a corresponding estimate at the age of 15. Methods: Subjects included are all children born in 1991 in Östergötland County, Sweden. Weight and height data collected during regular check‐ups at well‐child centres and school health care assessments up to 15 years of age were assembled from health records. Correlations between childhood estimates of body mass and the body mass index (BMI) at 15 years of age were computed pairwise. Correlations with r > 0.5 were defined as reliably strong. Results: Complete data were available for 3579 children (62%). Fewer girls (2.6%; C.I. 1.9–3.3) than boys (4.6%; C.I. 3.7–5.5) were obese at 15 years of age. Correlations with BMI at 15 years of age were strong (significantly higher than 0.5) from 5 years of age. Only 23% of girls and 8% of boys found to be obese at 5 years of age were of normal weight at the age of 15. Conclusion: From 5 years of age, point estimates of body mass using only weight and height data are strongly associated with BMI at the age of 15. More data sources are needed to predict weight trajectories in younger children.     

Birthweight, breast-feeding, parental weight and prevalence of obesity in schoolchildren aged 10–12 years, in Greece; the Physical Activity, Nutrition and Allergies in Children Examined in Athens (PANACEA) study

Background: The purpose of the present study was to determine the prevalence of overweight and obesity in a sample of Greek children aged 10–12 years, and to evaluate these rates in relation to parental weight and birthweight.
Methods: During the 2005–2006 school period, 700 schoolchildren (323 boys, 377 girls) were randomly recruited from 18 schools, in Athens. Height and weight were measured and body mass index (BMI) was calculated. Cut-off points for BMI defining obesity and overweight for gender and age were calculated in accordance with international standards.
Results: Overall, 8.6% of boys and 9.0% of girls were obese, and 33.9% of boys and 22.1% of girls were overweight. Having an obese parent increased the odds of having an overweight or obese child (P < 0.01). Compared to non-breast-fed, boys who were breast-fed for >3 months had 70% lower likelihood of being overweight or obese (P < 0.01) and breast-fed girls had 80% lower odds (P < 0.01). Excessive birthweight (>3500 g) increased by 2.5-fold the likelihood of being overweight or obese only in girls (P < 0.05).
Conclusions: Parental weight, lack of breast-feeding and excess birthweight (in girls) were significant predictors of overweight or obesity in Greek children aged 10–12 years.     

Prevalence of acanthosis nigricans in relation to anthropometric measures: Community‐based cross‐sectional study in Korean pre‐adolescent school children

Background: This cross‐sectional study was performed to assess the prevalence of acanthosis nigricans (AN) across various anthropometric measures and to identify the cut‐offs for anthropometric indices of adiposity for development of AN in Asian preadolescent school children. Methods: Body mass index (BMI), percentage weight for height (PWH), percentage body fat (PBF), and AN of the neck were evaluated in children in the fifth grade of all elementary schools in one metropolitan, Korean city (2117 boys and 1916 girls, mean age 10.9 ± 0.6 years, mean BMI 18.6 ± 3.3 kg/m²). Results: The prevalence of AN was 8.4% in boys and 5.1% in girls, and was proportional to the BMI, PWH, and PBF. The prevalence of AN rose steeply in the 80th and 90th percentiles of the BMI, PWH, and PBF in boys and girls, respectively. According to receiver operating characteristic analysis, AN was observed in boys with BMI >22.2 kg/m², and in girls with BMI >21.2 kg/m², which are below the current criteria for childhood obesity (local BMI 95th percentile and International Obesity Task Force BMI 30 kg/m²). Conclusions: AN has a good correlation with level of adiposity, and was already present in overweight children that were not considered obese by definition.     

Prevalence of overweight and obesity in children and adolescents in a county in Sweden

Overweight among young people in Sweden is increasing. The aim of the present study was to investigate the frequency of overweight and obesity based on body mass index (BMI) values among children and adolescents. Overweight was defined as a BMI value > or = 91st percentile and obesity as a BMI value > 98th percentile on an international reference BMI curve. The study population included boys and girls from four age groups: 9, 12, 15 and 18 y. The data consisted of self-reported measures of height and weight that were obtained from questionnaires used in a cross-sectional study in December 1997. A validation study was performed using a part of the study population. A total of 7011 (81.7%) participants completed the questionnaire. The correlation between self-reported estimations and objective measures of height and weight was high in the oldest age groups (0.88-0.98), but lower in the 9-y-old age groups (0.37-0.72). These self-reported estimations in the 9-y-olds were excluded from further analysis. It was found that 12.3%, 11.6% and 11.4% of the boys in the 12-, 15- and 18-y-old age groups and 6.8%, 5.5% and 4.8% of the girls in the same age groups were overweight and 7.9%, 8.9% and 7.3% of the boys and 5.1%, 4.2% and 3.9% of the girls were obese. Conclusion: The prevalence of overweight and obesity was found to be high in the study population and is a serious public health problem. The prevalence of obesity was significantly higher (p < 0.05) in 15-y-old boys living in rural areas than in city and town dwellers of the same age.     

C-reactive protein and body mass index in children: findings from the Third National Health and Nutrition Examination Survey, 1988-1994

OBJECTIVES: To examine the relationship between C-reactive protein (CRP) concentration and body mass index (BMI) in children. STUDY DESIGN: With the use of data from 5305 children aged 6 to 18 years in the Third National Health and Nutrition Examination Survey (1988 to 1994), a cross-sectional health survey, we examined whether CRP concentrations were elevated among overweight children. RESULTS: Among children whose BMI was below the age- and sex-specific 15th percentile, 6.6% of boys and 10.7% of girls had an elevated CRP concentration (>2.1 mg/L) compared with 24.2% of boys and 31.9% of girls whose BMI was > or =95th percentile. After adjustment was done for age, sex, race or ethnicity, poverty income ratio, high-density lipoprotein cholesterol concentration, white blood cell count, and history of chronic bronchitis, the adjusted odds of having an elevated CRP concentration were 2.20 (95% CI 1.30, 3.75) for children with a BMI of 85th to <95th percentile and 4.92 (95% CI 3.39, 7.15) for children with a BMI of > or =95th percentile compared with children who had a BMI of 15th to <85th percentile. The associations did not differ significantly by age, sex, or race or ethnicity. CONCLUSIONS: In a large representative sample of US children, CRP concentration was significantly elevated among children with a BMI > or=85th percentile, thus confirming previous findings of this association in children and extending previous research in adults to children. Excess body weight may be associated with a state of chronic low-grade inflammation in children.     

Do Parents Accurately Perceive Their Child's Weight Status?

IntroductionFew studies have evaluated the accuracy of parental perceptions of their child's weight status.MethodsA cross-sectional sample of children aged 5 to 12 years and their parents (n = 576 parent-child pairs) was enrolled from four schools. Child height and weight were measured. The parents classified their child on Likert scales ranging from “extremely overweight” to “extremely underweight.” Parental perceptions were compared with their child's weight status according to body mass index (BMI) age-gender percentiles. Fisher-Halton-Freeman tests, χ², and logistic regression were used to compare demographic factors between parents who inaccurately estimated and those who accurately estimated child weight status.ResultsMisclassification occurred 25% of the time (95% confidence interval: 21.4–28.5). All parents of children with a BMI greater than or equal to the 95th percentile classified their child in a category other than “extremely overweight,” and 75% of children with a BMI from the 85th to less than the 95th percentile were misclassified as “about right” or “underweight.” Boys were more likely to be misclassified than were girls (29% vs 21%, P = .03).ConclusionsThe majority of parents of obese and overweight children underestimate their child's weight status. Parents of boys are more likely to perceive their child's weight incorrectly.     

Overweight and dietary habits among adolescent: schoolchildren study in the department of Hauts-de-Seine]

Several epidemiologic studies show in a concordant way that the prevalence of the overweight and that of obesity increase in France. Obesity is an important risk factor in public health. The main aim of the National Program of Nutrition and Health is to stop the increasing prevalence of childhood obesity. In this framework, we conducted a prevalence study among 1507 schoolchildren (boys: 51,6%; girls: 48,4%) aged from 11 to 17 years old. A self-questionnaire was used to collect information concerning the weight, height and diet. The findings show that 17,6% of collegians are either over weighted or obese, 7,7% of the girls and 10,0% of the boys are in overweight; 5,5% of the girls and 11,7% of the boys are obese, according to the French charts of body mass index (BMI). This study shows a decreasing frequency of the overweight with the age in both males and females: 28,9% at the 11 years old and 13,2% at the 17 years old. Preventive actions are needed at early stages to try to stop and, if possible, to reverse the present increase of overweight. In this context, the itinerant forum of health promotion carried out in the Hauts-de-Seine department with school doctors can play a determining part.     

Obesity and bullying: different effects for boys and girls.

AIMS: To investigate whether weight category (underweight, average weight, overweight, and obese) at age 7.5 predicts bullying involvement at 8.5 years. Models were tested separately for boys and girls to investigate gender differences in association patterns. METHODS: Prospective cohort study in southwest England. Height and weight were measured in children at age 7.5 (n = 8210). BMI (kg/m2) was used to define underweight, average weight, overweight, and obese children, according to British age and gender specific growth reference data. Overt (n = 7083) and relational (n = 6932) bullying behaviour was assessed in children at age 8.5. RESULTS: After adjustment for parental social class, compared to average weight boys, obese boys were 1.66 (95% CI 1.04 to 2.66) times more likely to be overt bullies and 1.54 (1.12 to 2.13) times more likely to be overt victims. Obese girls were 1.53 (1.09 to 2.15) times more likely to be overt victims compared to average weight girls. CONCLUSIONS: Obesity is predictive of bullying involvement for both boys and girls. Preadolescent obese boys and girls are more likely to be victims of bullying because they deviate from appearance ideals. Other obese boys are likely to be bullies, presumably because of their physical dominance in the peer group.     

Stature and weight status of children in an urban kindergarten population

To assess the prevalence of growth problems among school entrants in an urban population who were not preselected on poverty or other nutritional risk criteria, we analyzed height and weight measurements for 5170 4- and 5-year-old children (91.9% black, 5.5% white, and 2.6% Hispanic) who enrolled in District of Columbia public school kindergartens in the Fall of 1985. Compared to the National Center for Health Statistics reference, the white girls and boys were of average height, Hispanic girls were of average height, and Hispanic boys were shorter than average. The black girls and boys were taller than average. In light of published evidence for black-white differences in the timing and duration of growth, we tentatively attributed this tall stature to advanced skeletal maturation of the black children relative to the predominantly white United States population growth standards. Underweight was virtually absent in this population. Excess overweight was noted in all sex-racial/ethnic subgroups, particularly among Hispanic children. However, the extent to which overweight (high weight-for-height percentile) represents obesity in kindergarten-aged children and in different racial/ethnic groups needs clarification before the implications of the finding of excess overweight can be fully understood. Overall, the growth of these children was on a par with the National Center for Health Statistics growth reference population.     

中国0～18岁儿童、青少年体块指数的生长曲线

目的 研究制定0～18岁中国儿童的体块指数(BMI)生长参照值及生长曲线.方法 根据"2005年中国九市7岁以下儿童体格发育调查"及"2005年中国学生体质与健康调研"所获得的资料,采用九省市93 702名0～19岁(差1天未满19岁)城区健康儿童青少年的身高(3岁以下测量身长)、体重测量数据,计算BMI值并应用LMS方法对数据进行拟合修匀,通过L、M、S三个参数计算产生所需要的百分位和标准差单位(Z分值)数值并绘制相应的曲线图.采用与中国成人BMI界值点接轨的方法探讨中国儿童超重肥胖的筛查界值点.结果 制定出0～18岁儿童的BMI百分位数及标准差单位生长参照值及曲线图,并计算出了筛查2～18岁儿童超重肥胖的参考界值点.本参照曲线与世界卫生组织(WHO)BMI曲线及美国疾病预防控制中心2000年(CDC2000)曲线进行比较,三者之间存在明显的差异,尤其是在青春期、第97百分位(P97)上.总体上中国男童BMI在p97处于三者之间,而女童最低.与日本比较,在P97也有明显差异.结论 使用BMI生长曲线图有利于儿童青少年的生长与营养监测,早期识别童的超重和肥胖,建议在临床工作及预防保健服务领域推广使用.     

Analysis of factors that influence body mass index from ages 3 to 6 years: A study based on the Toyama cohort study

BACKGROUND: The aim of the present study was to elucidate both environmental and behavioral factors that influence body mass index (BMI, kg/m2) among Japanese children from ages 3-6. METHODS: In 1992 (at age 3) and 1995 (at age 6), 8170 6-year-old children (4176 boys and 3994 girls) were surveyed using a questionnaire on both body build (height and weight) and lifestyle. The correlation between BMI for 3-year-olds and for 6-year-olds were analyzed. From the temporal changes of body build between age 3 and 6 years, we categorized children into four groups: group 1, normal at both age 3 years and 6 years (normal/normal); group 2, overweight at age 3 years and normal at age 6 years (overweight/normal); group 3, normal at age 3 years and overweight at age 6 years (normal/overweight); and group 4, overweight at both age 3 years and 6 years (overweight/overweight). The authors compared the four groups with each other according to sex, concerning frequencies of children who matched the categories of environmental and behavioral factors. Each factor was tested using the chi2 test. Overweight children were defined as those whose BMI value was age-sex specific in the 90th percentile or more. RESULTS: A significant correlation was found between body builds for children aged 3 and 6 years in both genders (boys, r = 0.559, P < 0.01; girls, r = 0.584, P < 0.01). Significant factors associated with overweight children were diet (eating rice, green tea, eggs, meat, but less breads and juice), rapid eating, short sleep duration, early bedtime, long periods of television viewing, avoidance of physical activity, and frequent bowel movement. DISCUSSION: Temporal changes in BMI from age 3 years to 6 years are significantly associated with both environmental and behavioral factors at age 6 years. The results of this study may be useful for health promotion programs designed to prevent obesity during the early stages of childhood.     

Overweight/obesity and factors associated with body mass index during adolescence: the VYRONAS study

Aim: To describe overweight and obese adolescents and to determine any correlations between an adolescent's body mass index (BMI) with personal (age, gender), lifestyle (sedentary/sport activities, smoking status) and parental (smoking status, BMI, number of cars) characteristics.
Methods: Cross-sectional data on weight, height and various characteristics from 2008 Greek adolescents (12- to 17-year olds, 50.85% boys), measured in 2005–2007, were used.
Results: Almost 1 in 5 (19.2%) boys and 1 in 7 (13.2%) girls 12–17 years of age were overweight while 4.4% of the boys and 1.7% of the girls were obese. The adolescents' age, mother's smoking status, father's and mother's BMI predicted boys' and girls' BMI (b = 0.551, 0.203, 0.110, 0.495 for boys, b = 0.233, 0.187, 0.180, 0.531 for girls, respectively, p ≤ 0.05). Univariate analysis revealed that television watching/using personal computer/playing video games and playtime were not correlated with BMI, while an inverse association of exercising for ≥ 5 h/week and BMI was found in both boys and girls (b =−1.098, −0.528, p = 0.005, 0.004 respectively).
Conclusion: The results of our study underline the high prevalence of obesity during adolescence in Greece. Age and parental unhealthy behaviour (increased BMI and maternal smoking status) were positive predictors of increased BMI of adolescents in both genders.     

不同营养状况下儿童青少年骨龄发育提前或落后的风险分析

目的 分析不同营养状况下儿童青少年的骨龄发育特点,探讨超重、肥胖及消瘦与骨龄发育提前或落后的相关性。方法 运用CHN法对2012年1月至2019年2月期间在首都儿科研究所附属儿童医院就诊的4~18岁7 062例（男3 310例,女3 752例）儿童的左手腕部骨龄进行评价,利用“儿童生长发育与营养评估系统”计算体质指数Z值（BMIZ）,BMIZ＜-2为消瘦组,BMIZ＞+1和BMIZ＞+2分别为超重组和肥胖组,比较不同性别和营养状况下骨龄年龄差（BAD）的差异,并对超重、肥胖儿童骨龄提前的发生风险进行分析。结果 消瘦和正常儿童平均骨龄与年龄相符,超重、肥胖儿童骨龄提前,且女童提前幅度大于男童,超重男、女童分别提前1.10岁和1.36岁（P=0.000）;肥胖男、女童分别提前1.60岁和1.78岁（P=0.000）。与正常体重相比,超重男、女童骨龄提前的风险分别增加2.358倍（95% CI：2.759~4.086）和2.483倍（95% CI：2.928~4.144）;肥胖男、女童骨龄提前的风险分别增加5.820倍（95% CI：5.066~9.181）和7.537倍（95% CI：6.319~11.534）;消瘦男、女童骨龄落后的风险分别增加1.540倍（95% CI：1.481~4.355）和3.790倍（95% CI：2.245~10.221）（P均＜0.05）。结论 超重肥胖增加骨龄提前的风险,超重男、女童骨龄提前风险接近,肥胖女童骨龄提前风险大于男童。消瘦增加骨龄落后的风险。     

Validity of BMI based on self-reported weight and height in adolescents

Aim:  To assess in a subset of a nationally representative sample of Portuguese adolescents, the validity of Body Mass Index (BMI) based on self-reported weight and height.
Methods:  This study included 462 students in grades 6, 8 and 10 (mean age 14.0 ± 1.9 years) from 12 public schools randomly selected from the list of schools which took part in the 2006 Health Behaviour in School Aged Children Portuguese survey, corresponding to approximately 10% of the sample. Self-reported weight and height were recorded and then measured.
Results:  Prevalence of normal weight, overweight and obesity based on self-report compared with that of measured values was not significantly different for boys and girls, and among age groups. BMI based on measured weight and height was underestimated compared with BMI based on self-reported data, both among girls and boys. Larger limits of agreement were found for boys, indicating a higher variability of self-reported BMI in estimating measured BMI, specifically below the age of 14 years.
Conclusion:  These data suggest that BMI based on self-reported weight and height is not accurate for BMI prediction at an individual level. However, self-reported BMI may be used as a simple and valid tool for BMI estimates of overweight and obesity in epidemiological studies.     

Maternal prepregnancy body mass index in relation to Hispanic preschooler overweight/obesity

The aim of the current study was to examine the role of maternal prepregnancy body mass index (BMI) on overweight/obesity among US Hispanic children ages 2 and 4 years old. We used US nationally representative data from preschoolers enrolled in the Early Childhood Longitudinal Study-Birth Cohort study. The findings revealed that a significantly higher percent (41.6%) of Hispanic mothers were overweight/obese prior to pregnancy compared to white mothers (34.8%). At 2 years of age, 38.3% of the children born to Hispanic mothers were overweight/obese compared to 29.4% of children born to white mothers. By the age of 4, overweight/obesity increased significantly for both racial/ethnic groups with preschoolers whose mothers were Hispanic being more likely to be overweight/obese (44.6%) compared to children whose mothers were white (34.2%). Further, preschoolers born to overweight/obese Hispanic mothers were more than twice as likely [odds ratio = 2.74 (95% confidence interval (CI) 1.60, 4.69)] to be overweight/obese than those born to Hispanic mothers of normal prepregnancy BMI. Preschoolers born to overweight/obese white mothers were approximately 1.4 (95% CI 1.05, 1.93) times more likely to be overweight/obese in comparison to those born to mothers with a normal prepregnancy BMI. Maternal prepregnancy weight is potentially a modifiable risk factor for preschooler overweight/obesity. Study findings support the design of early and targeted interventions to reduce this risk to the long-term health of Hispanic maternal and child dyads.