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838 Am J Clin Nutr 2004;79:838 – 43. Printed in USA. © 2004 American Society for Clinical Nutrition
DETECTION OF OVERWEIGHT IN SWISS CHILDREN 839
in 250 children in this age group in Switzerland (21). Sixty were used to study sex differences. The 85th and 95th percentiles
communities and schools across Switzerland were identified by of %BF-for-age were calculated separately for boys and girls by
stratified random selection. Three or 4 classrooms were then quantile regression (24). A square root transformation of %BF
randomly selected from each school, and all students from the resulted in a near linear age dependency of the percentiles. Over-
selected classrooms were invited to participate. The average weight and obesity were defined as values above the 85th and
sample size at each school was 45 students, and the number 95th percentiles, respectively, for %BF-for-age. BMI was cal-
varied according to the size of the classrooms. Ethical approval culated as weight (in kg) divided by height2 (in m). The BMI
for the study was obtained from the Swiss Federal Institute of values of the children were compared with the IOTF reference
Technology, Zürich, Switzerland. Written informed consent was data (10) and with reference data from the CDC (11). Children
obtained from the school physician, the teachers, and the parents with a BMI at or above the age-specific cutoffs were defined as
of the children. overweight or obese. For the calculation of the prevalence of
For the measurements, the subjects removed their shoes, emp- overweight and obesity, the sample was divided into 3 age groups
tied their pockets, and wore light indoor clothing. Height and (6 – 8, 9 –10, and 11–12 y). Prevalence data were expressed as
weight were measured by using standard anthropometric tech- percentages and were compared by using chi-square tests.
niques (1). Body weight was measured to the nearest 0.1 kg by Because BMI does not follow a Gaussian distribution, a
using a Tanita digital scale (HD-313; Tanita, Tokyo) calibrated shifted logarithmic transformation, log (x Ҁ 11), was done to
TABLE 1
Descriptive characteristics of the national sample of 6 –12-y-old Swiss
children1
The 85th and 95th percentiles for %BF by age from the
TABLE 2
The prevalence of overweight and obesity in a national sample of 6 –12-y-old Swiss children by age and sex according to BMI criteria from the
International Obesity Task Force (IOTF) and the US Centers for Disease Control and Prevention (CDC)1
6–8 y
Boys (n ҃ 450) 16.4 앐 1.7 4.00 앐 0.93 21.8 앐 1.9 8.00 앐 1.28
Girls (n ҃ 446) 19.7 앐 1.9 4.26 앐 0.96 20.0 앐 1.9 6.73 앐 1.19
9–10 y
Boys (n ҃ 381) 19.2 앐 2.0 4.46 앐 1.06 21.8 앐 2.1 8.40 앐 1.42
Girls (n ҃ 398) 19.6 앐 2.0 3.27 앐 0.89 18.8 앐 2.0 4.77 앐 1.07
11–12 y
Boys (n ҃ 365) 14.0 앐 1.8 3.01 앐 0.89 16.2 앐 2.1 6.08 앐 1.39
Girls (n ҃ 391) 17.9 앐 1.9 3.58 앐 0.94 18.4 앐 2.0 6.14 앐 1.21
All
Boys (n ҃ 1196) 16.6 앐 1.1 3.85 앐 0.56 20.3 앐 1.2 7.63 앐 0.79
Girls (n ҃ 1235) 19.1 앐 1.1 3.72 앐 0.54 19.1 앐 1.1 5.91 앐 0.67
1
All values are percentage 앐 SE. There were no significant differences between the sexes (chi-square test).
DETECTION OF OVERWEIGHT IN SWISS CHILDREN 841
TABLE 3
Regression of log (BMI Ҁ 11) on percentage of body fat for boys and for
girls in a national sample of 6 –12-y-old Swiss children1
Boys Girls
2
Intercept 1.148 (0.013) 1.136 (0.013)
Slope 0.039 (0.001) 0.036 (0.001)3
Residual SE 0.196 0.204
R2 0.74 0.74
P 쏝 0.0001 쏝 0.0001
1
n ҃ 2431.
2
Regression coefficient; SE in parentheses (all such values).
3
Significantly different from the boys, P 쏝 0.001 (analysis of covari-
ance).
TABLE 4
Areas under the receiver operating characteristic curves of BMI SD scores
for prediction of overweight and obesity in boys and girls on the basis of
the 85th and 95th percentiles of percentage of body fat (%BF),
respectively, in a national sample of 6 –12-y-old Swiss children1
Overweight Obesity
TABLE 5
Sensitivity and specificity of the age- and sex-specific BMI reference values for overweight and obesity from the International Obesity Task Force (IOTF)
and the US Centers for Disease Control and Prevention (CDC) in a national sample of 6 –12-y-old Swiss children1
Overweight Obesity
6–8 y % % % %
IOTF 83.6 94.1 91.7 91.5 68.0 99.1 68.4 98.6
CDC 93.4 89.5 91.7 91.2 100 96.3 84.2 96.7
9–10 y
IOTF 78.6 94.2 76.4 92.9 61.2 99.4 30.0 98.1
CDC 81.4 91.6 75.0 93.6 91.3 96.9 54.0 97.6
11–12 y
IOTF 72.9 95.0 84.9 92.6 60.7 100 47.6 98.9
CDC 79.2 94.0 84.9 92.6 76.5 97.7 59.1 97.6
weight, but the IOTF reference value for obesity generated an sory board affiliations, in the companies or organizations sponsoring this
앒50% lower prevalence estimate than did the CDC reference research.
value.
The CDC and IOTF BMI criteria were generated by using
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