Validity of childhood adiposity classification in predicting adolescent overweight and obesity.
OBJECTIVE
Identification of children at risk for adolescent overweight can assist in targeting interventions. Uncertainty remains regarding the validity of current body mass index (BMI) reference values in predicting future risk on a population basis. This study aimed to assess the validity of current childhood adiposity classifications in predicting adolescent overweight and obesity among Israeli youth.


METHODS
Historical cohort study.


METHODS
School-based childhood health studies and adolescent physical examinations.


METHODS
A total of 3 163 subjects surveyed first at age 8-15 and again at age 17-19.


METHODS
Age, sex, height, weight and BMI.


METHODS
Sensitivity, specificity, positive and negative predictive values, and relative risk of childhood adiposity classification.


RESULTS
Childhood overweight and obesity showed low sensitivity and high specificity for predicting adolescent overweight and obesity. Positive predictive values were low and varied by age and sex, but negative predictive values were consistently high in both sexes and all ages (range 0.85-0.99). After adjusting for age and sex, both childhood overweight and obesity substantially increased the risk of adolescent overweight (relative risk [RR] 7.03 and 7.20, respectively) and adolescent obesity (RR 24.34 and 28.41, respectively).


CONCLUSIONS
Childhood overweight and obesity are strong risk factors for adolescent overweight and obesity among Israeli youth. Normal weight children were at very low risk for adolescent overweight. These findings suggest that population-based health promotion aimed at maintaining normal weight among children should be given preference over risk-guided approaches targeting weight reduction among obese children.
Huerta
Michael
M
Ben-Gurion University of the Negev - Barzilai Medical Center Campus, Research Institute, Ashkelon, Israel. mhuerta@barzi.health.gov.il
Zarka
Salman
S
Bibi
Haim
H
Haviv
Jacob
J
Scharf
Shimon
S
Gdalevich
Michael
M
D000273:Adipose Tissue / Q000378:metabolism*; D000293:Adolescent; D000886:Anthropometry / Q000379:methods; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012572:School Health Services; D011795:Surveys and Questionnaires