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Establishing a standard definition for child overweight and obesity worldwide: international survey

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7244.1240 (Published 06 May 2000) Cite this as: BMJ 2000;320:1240
  1. Tim J Cole, professor of medical statistics (tim.cole{at}ich.ucl.ac.uk)a,
  2. Mary C Bellizzi, health policy officerb,
  3. Katherine M Flegal, senior research scientistc,
  4. William H Dietz, directord
  1. a Department of Epidemiology and Public Health, Institute of Child Health, London WC1N 1EH
  2. b nternational Obesity Task Force Secretariat, London NW1 2NS
  3. c National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville MD 20782, USA
  4. d Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta GA 30341-3724, USA
  1. Correspondence to: T J Cole
  • Accepted 21 January 2000

Abstract

Objective: To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points.

Design: International survey of six large nationally representative cross sectional growth studies.

Setting: Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States

Subjects: 97 876 males and 94 851 females from birth to 25 years of age

Main outcome measure: Body mass index (weight/height2).

Results: For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m2 for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2-18 years.

Conclusions: The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.

Footnotes

  • Funding This work was supported by the Childhood Obesity Working Group of the International Obesity Task Force. TJC is supported by a Medical Research Council programme grant

  • Competing interests None declared

  • Accepted 21 January 2000
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