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.
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.


METHODS
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.
Flegal
K M
KM
National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA. kmf2@cdc.gov
Ogden
C L
CL
Wei
R
R
Kuczmarski
R L
RL
Johnson
C L
CL
D000293:Adolescent; D017677:Age Distribution; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012016:Reference Values; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology