Measuring obesity among school-aged youth in India: a comparison of three growth references.
OBJECTIVE
To compare three growth references that can be used to assess the weight status of school-aged youth living in India, with a particular focus on identifying overweight and obese youth.


METHODS
Cross-sectional study. Kappa scores were used to measure agreement between growth references. Regression models were used to test for differences in weight status by grade level, gender, and school type, using each growth reference.


METHODS
Private (n=4) and Government schools (n=4) in Delhi, India.


METHODS
Students (n=1818) in eighth and tenth grade attending the schools.


METHODS
Weight status was derived using age- and gender-specific cut-points provided by: (a) a national growth reference specific to India; (b) an international reference recommended by the International Obesity Task Force (IOTF); and (c) a new international reference recommended by the World Health Organization (WHO).


RESULTS
The IOTF reference consistently classified participants in a lower weight status category, compared with the national reference (k=0.57) and the WHO reference (k=0.69). The agreement between the WHO and the national references was higher (k=0.84).


CONCLUSIONS
To date, all published studies of childhood obesity in India have used the IOTF reference, the national reference, or an old WHO reference to measure weight status among school-going youth. The new WHO reference may be a better choice. Compared to the IOTF reference, it does not appear to underestimate obesity and can still be used to compare trends, globally.
Michael and Susan Dell Center for Advancement of Healthy Living, School of Public Health, University of Texas, Austin and Houston, Texas, USA. Melissa.H.Stigler@uth.tmc.edu
M H
MH
Stigler
M
M
Arora
P
P
Dhavan
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V
Tripathy
R
R
Shrivastav
K S
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Reddy
C L
CL
Perry
D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D012016:Reference Values; D012574:Schools / Q000706:statistics & numerical data; D012737:Sex Factors