Establishing a standard definition for child overweight and obesity worldwide: international survey

doi:10.1136/bmj.320.7244.1240

BMJ 2000;320:1240 ( 6 May )

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Establishing a standard definition for child overweight and obesity worldwide: international survey

Tim J Cole, professor of medical statistics, ^a Mary C Bellizzi, health policy officer, ^b Katherine M Flegal, senior research scientist, ^c William H Dietz, director. ^d

^a Department of Epidemiology and Public Health, Institute of Child Health, London WC1N 1EH, ^b International Obesity Task Force Secretariat, London NW1 2NS, ^c National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville MD 20782, USA, ^d Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta GA 30341-3724, USA

Correspondence to: T J Cole tim.cole{at}ich.ucl.ac.uk

Objective: To develop an internationally acceptable definitionof child overweight and obesity, specifying the measurement, thereference population, and the age and sex specific cut offpoints.
Design: International survey of six large nationallyrepresentative cross sectional growthstudies.
Setting: Brazil, Great Britain, Hong Kong, the Netherlands,Singapore, and the UnitedStates.
Subjects: 97 876 males and 94 851 females from birthto 25 years ofage.
Main outcome measure: Body mass index (weight/height²).
Results: For each of the surveys, centile curves weredrawn that at age 18 years passed through the widely used cutoff points of 25 and 30 kg/m² for adult overweight and obesity. The resulting curves were averagedto provide age and sex specific cut off points from 2-18years.
Conclusions: The proposed cut off points, which are lessarbitrary and more internationally based than current alternatives,should help to provide internationally comparable prevalence ratesof overweight and obesity inchildren.

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Re: Reanalysis suggests that the new definition for child obesity has questionable validity in puber: Sanjay Kinra
bmj.com, 4 Jun 2000 [Full text]
BMI centile charts: J Vignerova
bmj.com, 7 Oct 2000 [Full text]
Establishing a standard definition for child overweight and obesity worldwide: Sophie S F Leung
bmj.com, 20 Aug 2001 [Full text]
Underweight in children � how show we define fine it?: Charles Agyemang, PhD
bmj.com, 1 Feb 2007 [Full text]