Obesity in children and adolescents

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Growth Disorders, Second Edition, 2007, pp. 538 - 562
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© 2007 Edward Arnold (Publishers) Ltd. All rights reserved. Body mass index (BMI; weight/height2), is a simple, costeffective measure of body fatness in both adulthood and childhood.1 Among adults, a person with a BMI of 25.0029.99 kg m2 is considered overweight, while those with a BMI 30.00 kg m2 are classified as obese, cut-points that relate to the point at which health risks rise steeply, at least in adult European populations.2 Among children there is insufficient evidence to provide an absolute definition of health-related overweight. BMI also varies dramatically with age and sex during childhood and adolescence, rising in the first year, falling during pre-school years before then rising once more into adolescence, the point at which BMI starts to increase again, between 4 and 7 years of age, being termed Until recently, no standard definitions of overweight and obesity existed for children and adolescents. In the late 1990s, the International Obesity TaskForce (IOTF) recommended that BMI, based on centile curves that at age 18 pass through the adult cut-points of 25 kg m2 and 30 kg m2, be used to define overweight and obesity among children and adolescents.3 Subsequently, in 2000, Cole and his colleagues developed a table of age-and sex-specific cut-points based upon a compilation of nationally representative cross-sectional growth studies from a number of countries4 (see Table 37.1). These cut-points are used in epidemiological research to classify overweight and obesity and allow international comparison of trends in overweight and obesity. The IOTF definition is not designed for clinical use.
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