Prevalence of Thinness,Overweight, Obesity,and Central Obesity in Finnish School-Aged Children: A Comparison of National and International Reference Values |
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| Authors: | Catharina Sarkkola Jannina Viljakainen Rejane Augusta de Oliveira Figueiredo Antti Saari Sohvi Lommi Elina Engberg Heli Viljakainen |
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| Institution: | aFolkhälsan Research Center, Helsinki, Finland;bFaculty of Medicine, University of Helsinki, Helsinki, Finland;cKuopio University Hospital, Kuopio, Finland;dUniversity of Eastern Finland, Kuopio, Finland;eDepartment of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland;fDepartment of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland |
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| Abstract: | IntroductionThe global epidemic of obesity concerns children, and monitoring the prevalence is of highest priority. Body mass index (BMI) with age- and sex-specific cutoff values determines weight status in children, although multiple reference systems exist. Our aim was to compare the prevalence for thinness, normal weight, overweight, and obesity in Finnish school-aged children according to national and international reference values, as well as to determine which cutoff values for overweight agree with the criteria for central obesity.MethodsThis study includes 10,646 children aged 9–12 years from the Finnish Health in Teens cohort. Height, weight, and waist circumference were measured in 2011–2014. BMI (weight kg]/height m]2) and the waist-to-height ratio (WHtR; waist cm]/height cm]) were calculated. The WHtR cutoff of >0.5 indicated central obesity. We compared the sex-specific prevalence of thinness, overweight, and obesity using the International Obesity Task Force (IOTF), World Health Organization (WHO) and Finnish (FIN) BMI-for-age reference values, as well as these three against central obesity based on the WHtR.ResultsThe prevalence of thinness, overweight, and obesity were 11.0%, 12.7%, and 2.6%, respectively, using IOTF; 2.6%, 15.9%, and 5.2% using WHO; and 5.1%, 11.4%, and 2.2% using FIN. Overweight and obesity were more common in boys than girls using WHO and FIN, while thinness was more common in girls using IOTF and FIN. IOTF versus WHO exhibited moderate agreement (κ = 0.59), which improved for IOTF versus FIN (κ = 0.74). Of those classified as overweight by WHO, 37% and 47% were regarded as normal weight according to IOTF and FIN, respectively. The prevalence of central obesity was 8.7%, and it was more common in boys than girls. WHO provided the highest sensitivity: 95% of individuals with central obesity were classified with overweight or obesity. Using FIN provided the highest specificity (93%).ConclusionOur findings show that WHO overestimates the prevalence of overweight and obesity, while IOTF overrates thinness. Thus, comparing prevalence rates between studies requires caution. The novelty of this study is the comparison of the cutoff values for overweight with central obesity. The choice of reference system affects the generalizability of the research results. |
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| Keywords: | Children Body mass index Reference values Overweight Central obesity |
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