Sensitivity and specificity of different classification criteria for excess weight in schoolchildren from João Pessoa, Paraíba, Brazil
Keywords:
Evaluate nutritional status, Skinfold thickness, Body mass index, Anthropometric measures, Sensitivity and specificity, OverweightAbstract
Objective
The objective of this study was to describe the proportion of excess weight using different body mass index classification criteria and assess the sensitivity, specificity, and agreement among the criteria.
Methods
The population included 1,570 students, aged 7-12 years, of the city of João Pessoa (PB), in 2005. Excess weight was classified according to the World Health Organization, International Obesity Task Force criteria and other criteria. The percentage of body fat was estimated from skinfold thickness measurements and used as reference criteria (≥.25% in males and ≥.30% in females).
Results
The proportion of excess weight differed among the different classification systems. It was lower according to the World Health Organization criteria than to Brazilian authors’ criteria (p<0.05). Body mass index classification criteria presented high sensitivity (83-97%), except for the classification proposed by the World Health Organization (65% in males and 48% in females). The specificity was high for all the analyzed criteria (85-98%). The Kappa index showed good agreement among the criteria, with a small increase for the International Obesity Task Force criteria (Kappa=0.72) and smaller agreement for the World Health Organization criteria (Kappa=0.63).
Conclusion
The analyzed criteria were sensitive for the detection of excess weight, but the World Health Organization criteria were less sensitive. There was high specificity and agreement among the criteria; however, the values obtained for the different genders and ages varied less when the International Obesity Task Force criteria were used. Thus, the results suggest that the International Obesity Task Force criteria are more appropriate for the determination of excess weight in similar populations.
References
World Health Organization. Physical status: the use and interpretation of anthropometry. Geneva: WHO;1995. Report of a WHO Expert Committee.
World Health Organization. Growth reference data for 5-19 years. 2007 [cited 2009 Abr 16]. Available from: <http://www.who.int/growthref/en/>.
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000; 6;320(7244):1240-3. doi: 10.1136/bmj.320.7244.1240.
Must A, Dallal GE, Dietz WH. Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thikness. Am J Clin Nutr. 1991; 53(4):839-46.
Conde WL, Monteiro CA. Valores críticos do índice de massa corporal para classificação do estado nutricional de crianças e adolescentes brasileiros. J Pediatr. 2006; 82(4):266-72. doi: 10.2223/jped.1502.
Neovius M, Linné Y, Barkeling B, Rossner S. Sensitivity and specificity of classification systems for fatness in Adolescents. Am J Clin Nutr. 2004; 80(3):597-603.
Zimmermann MB, Gubeli C, Puntener C, Molinari L. Detection of overweight and obesity in a national sample of 6-12y old Swiss children: accuracy and validity of reference values for body mass index from the US Centers for Disease Control and
Prevention and the International Obesity Task Force. Am J Clin Nutr. 2004; 79(5):838-43.
Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran IM, Dietz HW. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. Am J Clin Nutr. 2002; 75(6):978-85.
Watts K, Naylor LH, Davis EA, Jones TW, Beeson B, Bettenay F, et al. Do Skinfolds accurately assess changes in body fat in obese children and adolescents? Med Sci Sports Exerc. 2006; 38(3): 439-44.
Semiz S, Ozgoren E, Sabir N. Comparison of ultrasonographic and anthropometric methods to assess body fat in childhood obesity. Int J Obes. 2007; 31(1):53-8. doi: 10.1038/sj.ijo.0803414.
Freedman DS, Thornton JC, Mei Z, Wang J, Dietz WH, Pierson RN, et al. Height and adiposity among children. Obes Res. 2004; 12(5):846-53.
Chiara V, Sichieri R, Martins PD. Sensibilidade e especificidade de classificação de sobrepeso em adolescentes, Rio de Janeiro. Rev Saúde Pública. 2003; 37(2):226-31. doi: 10,1590/S0034-89102003000200010.
Vitolo MR, Campagnolo PDB, Barros ME, Gama CM, Lopez FA. Avaliação de duas classificações para excesso de peso em adolescentes brasileiros. Rev Saúde Pública. 2007; 41(4):653-6. doi: 10.1590/S0034-89102007000400021.
Vieira ACR, Alvarez MM, Marins VMR, Sichieri R, Veiga GV. Desempenho de pontos de corte do índice de massa corporal de diferentes referências na predição de gordura corporal em adolescentes. Cad Saúde Pública. 2006; 22(8):1681-1690. doi: 10.1590/S0102-311X2006000800016.
Veiga GV, Dias PC, Anjos LA. A comparison of distribution curves of body mass from Brazil and the United States for assessing overweight and obesity in Brazilian adolescents. Rev Panam Salud Publica. 2001; 10(2):79-85. doi: 10.1590/S102049892001000800002.
Sardinha LB, Going SB, Teixeira PJ, Lohman TG. Receiver operating characteristic analysis skinfold thickness and arm girth for obesity screening in children and adolescents. Am J Clin Nutr. 1999; 70(6):1090-5.
Maynard LM, Wisemandle W, Roche AF, Chumlea WC, Guo SS, Siervogel RM. Childhood body composition in relation to body mass index. Pediatrics. 2001; 107(2):344-50.
Widhalm K, Schonegger K, Huemer C, Auterith A. Does the BMI reflect body fat in obese children and adolescents? A study using the TOBEC method. Int J Obes. 2001, 25(2):279-85.
Demerath EW, Schubert CM, Maynard LM, Sun SS, Chumlea WC, Pickoff A, et al. Do changes in body mass index percentile reflect changes in body composition in children? Data from the fels longitudinal study. Pediatrics. 2006; 117(3):487-95. doi: 10.1542/peds.2005-0572.
Anjos LA, Veiga GV, Castro IRR. Distribuição dos valores do índice de massa corporal da população brasileira até 25 anos de idade. Rev Panam Salud Publica. 1998; 3(3):164-73. doi: 10.1590/S1020-49891998000300004.
Luiz RR, Magnanini MMF. A lógica da determinação do tamanho da amostra em investigações epidemiológicas. Cad Saúde Coletiva. 2000; 8(2):9-28.
Hallal PC, Bertoldi AD, Gonçalves H, Victora CG. Prevalência de sedentarismo e fatores associados em adolescentes de 10-12 anos de idade. Cad Saúde Pública. 2006; 22(6):1277-87. doi: 10.1590/S0102-311X2006000600017.
Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Champaign (Illinois): Human Kinetics Books; 1988.
Pederson D, Gore C. Erros de medição em antropometria. In: Kevin N, Tim O. Antropométrica. Porto Alegre: Artmed; 2005.
Boileau RA, Lohman TG, Slaughter MH. Exercise and body composition in children and youth. Scand J Sports Sci. 1985; 7(1):17-27.
Williams DP, Going SB, Lohman TG, Harsha DW, Srinivasan SR, Webber LS, et al. Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein rations in children and adolescents. Am J Public Health. 1992; 82(3):358-63.
Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth referente for school-aged children and adolescents. Bull World Health Org. 2007; 85(9): 660-7.
Farias Júnior JC, Konrad LM, Rabacow FM, Graup S, Araújo VC. Sensibilidade e especificidade de critérios de classificação do índice de massa corporal em adolescentes. Rev Saúde Pública. 2009; 43(1):53-9. doi: 10.1590/S0034-89102009000100007.
Fernandes RA, Rosa CSC, Silva CB, Bueno DR, Oliveira AR, Freitas Júnior IF. Desempenho de diferentes valores críticos de índice de massa corporal na identificação de excesso de gordura corporal e obesidade abdominal em adolescentes. Rev Assoc Med Bras. 2007; 53(6):515-9. doi: 10.1590/S0104-42302007000600019.
Ramirez Erik, Grijalva-Haro MI, Ponce JA, Valencia ME. Prevalencia de sobrepeso y obesidad en el noroeste de México por tres referencias de índice de masa corporal: diferencias en la clasificación. ALAN. 2006; 56(3):251-6. doi: 10.1590/S0004-0622200
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Kelly Samara da SILVA, Adair da Silva LOPES, Francisco Martins da SILVA
This work is licensed under a Creative Commons Attribution 4.0 International License.