Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index

Am J Clin Nutr. 2001 Jun;73(6):1086-93. doi: 10.1093/ajcn/73.6.1086.

Abstract

Background: Several different sets of reference body mass index (BMI) values are available to define overweight in children.

Objective: The objective of this study was to compare the prevalence of overweight in US children calculated with 3 sets of reference BMI values: the revised growth charts of the Centers for Disease Control and Prevention (CDC-US growth charts), international standards proposed by Cole et al, and values developed by Must et al.

Design: Data for children and adolescents came from cross-sectional nationally representative US surveys: cycles II and III of the National Health Examination Survey (1963-1965 and 1966-1970) and the first, second, and third National Health and Nutrition Examination Surveys: NHANES I (1971-1974), II (1976-1980), and III (1988-1994). The reference values of Cole et al equivalent to a BMI of 25 were compared with the 85th percentiles from the other 2 methods; the values equivalent to a BMI of 30 were compared with the 95th percentiles.

Results: The 3 methods gave similar but not identical results. The reference values of Cole et al gave lower estimates than did the CDC-US growth charts for young children but higher estimates for older children. The reference values of Must et al gave much higher prevalences for younger girls than did the other 2 methods.

Conclusions: Differences between methods were related to differences in data sets, smoothing methods, and theoretical approaches. All 3 methods are based on statistical criteria and incorporate arbitrary assumptions. These methods should be used cautiously, with awareness of the possible limitations.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Age Distribution
  • Body Mass Index*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Nutrition Surveys
  • Obesity / epidemiology*
  • Prevalence
  • Reference Values
  • Sex Distribution
  • United States / epidemiology