ArticleBulletin of the World Health Organization2018
Body mass index vs deuterium dilution method for establishing childhood obesity prevalence, Ghana, Kenya, Mauritius, Morocco, Namibia, Senegal, Tunisia and United Republic of Tanzania.
Article in Bulletin of the World Health Organization, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- External validation of a prediction model for estimating fat mass in children and adolescents in 19 countries: individual participant data meta-analysis.BMJ (Clinical research ed.) · 2022Pooled it
- Diagnostic Accuracy of Body Mass Index in Defining Childhood Obesity: Analysis of Cross-Sectional Data from Ghanaian Children.International journal of environmental research and public health · 2019Trial
- Report of a Meeting: An Expert Consultation on Body Composition and Adiposity for Children and Adolescents in All Their Diversity.Current developments in nutrition · 2025Article
- Obesity and dental caries in childhood: trends in prevalence and socioeconomic inequalities-a multicohort population-wide data linkage study.Archives of disease in childhood · 2024Article
- Association between Physical Activity and Health Outcomes (High Body Fatness, High Blood Pressure) in Namibian Adolescents and Adult women.International journal of environmental research and public health · 2024Article
- Relationship of body mass index to percent body fat determined by deuterium isotopic dilution and impedancemetry among Tunisian schoolchildren.African health sciences · 2023Article
- Epidemiologic transition and the double burden of disease in Ghana: What do we know at the neighborhood level?PloS one · 2023Article
- Surveillance to improve physical activity of children and adolescents.Bulletin of the World Health Organization · 2022Article
- Results from Scotland's 2021 report card on physical activity and health for children and youth: Grades, secular trends, and socio-economic inequalities.Journal of exercise science and fitness · 2022Article
- Instruments to identify risk factors associated with adverse childhood experiences for vulnerable children in primary care in low- and middle-income countries: A systematic review and narrative synthesis.PLOS global public health · 2022Article
- Article
- Cardiovascular Risk Factors in Children and Adolescents with Congenital Adrenal Hyperplasia.Advanced biomedical research · 2021Article
- Body composition-derived BMI cut-offs for overweight and obesity in ethnic Indian and Creole urban children of Mauritius.The British journal of nutrition · 2020Article
- Total energy expenditure assessed by doubly labeled water technique and estimates of physical activity in Mauritian children: analysis by gender and ethnicity.European journal of clinical nutrition · 2020Article
- Classification Accuracy of Body Mass Index for Excessive Body Fatness in Kuwaiti Adolescent Girls and Young Adult Women.Diabetes, metabolic syndrome and obesity : targets and therapy · 2020Article
- Article
- Characterizing Obesity Interventions and Treatment for Children and Youths During 1991-2018.International journal of environmental research and public health · 2019Article
- Prevalence of obesity among school-age children and adolescents in the Gulf cooperation council (GCC) states: a systematic review.BMC obesity · 2019Article
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Authors and funding
13 authors at 6 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the World Health Organization (WHO) body mass index (BMI)-for-age definition of obesity against measured body fatness in African children.
methodsIn a prospective multicentre study over 2013 to 2017, we recruited 1516 participants aged 8 to 11 years old from urban areas of eight countries (Ghana, Kenya, Mauritius, Morocco, Namibia, Senegal, Tunisia and United Republic of Tanzania). We measured height and weight and calculated BMI-for-age using WHO standards. We measured body fatness using the deuterium dilution method and defined excessive body fat percentage as > 25% in boys and > 30% in girls. We calculated the sensitivity and specificity of BMI z-score > +2.00 standard deviations (SD) and used receiver operating characteristic analysis and the Youden index to determine the optimal BMI z-score cut-off for classifying excessive fatness.
findingsThe prevalence of excessive fatness was over three times higher than BMI-for-age-defined obesity: 29.1% (95% CI: 26.8 to 31.4; 441 children) versus 8.8% (95% CI: 7.5 to 10.4; 134 children). The sensitivity of BMI z-score > +2.00 SD was low (29.7%, 95% CI: 25.5 to 34.2) and specificity was high (99.7%, 95% CI: 99.2 to 99.9). The receiver operating characteristic analysis found that a BMI z-score +0.58 SD would optimize sensitivity, and at this cut-off the area under the curve was 0.86, sensitivity 71.9% (95% CI: 67.4 to 76.0) and specificity 91.1% (95% CI: 89.2 to 92.7).
conclusionWhile BMI remains a practical tool for obesity surveillance, it underestimates excessive fatness and this should be considered when planning future African responses to the childhood obesity pandemic.
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