title: High adiposity and high body mass index-for-age in US children and adolescents overall and by race-ethnic group.
abstract: BACKGROUND
  Body mass index (BMI)-for-age has been recommended as a screening test for excess adiposity in children and adolescents.
  
  
  OBJECTIVE
  We quantified the performance of standard categories of BMI-for-age relative to the population prevalence of high adiposity in children and adolescents overall and by race-ethnic group in a nationally representative US population sample by using definitions of high adiposity that are consistent with expert committee recommendations.
  
  
  METHODS
  Percentage body fat in 8821 children and adolescents aged 8-19 y was measured by using dual-energy X-ray absorptiometry in 1999-2004 as part of a health examination survey.
  
  
  RESULTS
  With the use of several different cutoffs for percentage fat to define high adiposity, most children with high BMI-for-age (> or = 95th percentile of the growth charts) had high adiposity, and few children with normal BMI-for-age (<85th percentile) had high adiposity. The prevalence of high adiposity in intermediate BMI categories varied from 45% to 15% depending on the cutoff. The prevalence of a high BMI was significantly higher in non-Hispanic black girls than in non-Hispanic white girls, but the prevalence of high adiposity was not significantly different.
  
  
  CONCLUSIONS
  Current BMI cutoffs can identify a high prevalence of high adiposity in children with high BMI-for-age and a low prevalence of high adiposity in children with normal BMI-for-age. By these adiposity measures, less than one-half of children with intermediate BMIs-for-age (85th to <95th percentile) have high adiposity. Differences in high BMI ranges between race-ethnic groups do not necessarily indicate differences in high adiposity.
authors.affiliation: Centers for Disease Control Prevention, Hyattsville, MD 20782, USA. kmf2@cdc.gov
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Flegal
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Ogden
authors.forename: Jack A
authors.initials: JA
authors.lastname: Yanovski
authors.forename: David S
authors.initials: DS
authors.lastname: Freedman
authors.forename: John A
authors.initials: JA
authors.lastname: Shepherd
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
authors.forename: Lori G
authors.initials: LG
authors.lastname: Borrud
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity / Q000208:ethnology; D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D015995:Prevalence; D012016:Reference Values; D014481:United States / Q000453:epidemiology; D055815:Young Adult