Published online August 31, 2009
PEDIATRICS Vol. 124 Supplement September 2009, pp. S3-S22 (doi:10.1542/peds.2008-3586D)
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SUPPLEMENT ARTICLE


Challenges of Accurately Measuring and Using BMI and Other Indicators of Obesity in Children

John H. Himes, PhD, MPH

Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, Minnesota

BMI is an important indicator of overweight and obesity in childhood and adolescence. When measurements are taken carefully and compared with appropriate growth charts and recommended cutoffs, BMI provides an excellent indicator of overweight and obesity that is sufficient for most clinical, screening, and surveillance purposes. Accurate measurements of height and weight require that adequate attention be given to data collection and management. Choosing appropriate equipment and measurement protocols and providing regular training and standardization of data collectors are critical aspects that apply to all settings in which BMI will be measured and used. Proxy measures for directly measured BMI, such as self-reports or parental reports of height and weight, are much less preferred and should only be used with caution and cognizance of the limitations, biases, and uncertainties attending these measures. There is little evidence that other measures of body fat such as skinfolds, waist circumference, or bioelectrical impedance are sufficiently practicable or provide appreciable added information to be used in the identification of children and adolescents who are overweight or obese. Consequently, for most clinical, school, or community settings these measures are not recommended for routine practice. These alternative measures of fatness remain important for research and perhaps in some specialized screening situations that include a specific focus on risk factors for cardiovascular or diabetic disease.

Key Words: body mass index • overweight • obesity • child obesity • measurement

Abbreviations: CDC—Centers for Disease Control and Prevention • IOTF—International Obesity Taskforce • WHO—World Health Organization • CI—confidence interval • BIA—bioelectrical impedance analysis

Accepted Apr 29, 2009.


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 PediatricsHome page
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