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[Problems in defining obesity in prepubescent children: consequences for assessing the requirements for medical
S Danielzik1, C Bartel, H Raspe
1Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Germany. sdanielzik@nutrfoodsc.uni-kiel.de
Insights
Childhood obesity definitions vary, impacting medical rehabilitation needs. A uniform definition is crucial for early intervention and effective obesity prevention strategies in children.
Area of Science:
- Pediatric Endocrinology
- Public Health Nutrition
- Childhood Obesity Research
Context:
- Rising global childhood obesity rates present significant public health challenges.
- Lack of a standardized definition for childhood obesity complicates identification and intervention.
- Medical rehabilitation needs for obese children are difficult to ascertain due to definitional inconsistencies.
Purpose:
- To assess the prevalence of overweight and obesity in 5-7 year-old German children using various definitions.
- To highlight the discrepancies in prevalence estimates based on different diagnostic criteria.
- To underscore the need for a unified definition to guide medical rehabilitation and preventive measures.
Summary:
- The Kiel Obesity Prevention Study (KOPS) analyzed 1,643 children aged 5-7 years.
- Prevalence of overweight ranged from 9% to 21% based on German and international Body Mass Index (BMI) and skinfold thickness standards.
- Only 3.3-3.5% of children were classified as obese, indicating a potential underestimation with newer BMI criteria.
Impact:
- A consensus on childhood obesity definition is urgently needed for consistent medical care.
- Current rehabilitation services target only severely obese children, potentially missing those needing earlier intervention.
- Enhanced early preventive measures are essential to combat the growing childhood obesity epidemic.
Introduction:
Prevalence of obesity has been on the increase in recent years. In contrast to obesity in adulthood, childhood obesity is still not uniformly defined. This results in problems to determine the need for medical rehabilitation.
Methods:
The Kiel Obesity Prevention Study (KOPS) is a cross-sectional study assessing the nutritional status of 5-7 year-old German children. Three different definitions of overweight and obesity (German reference data for triceps skinfold thickness [90(th) percentile] and BMI [90(th)/97(th) percentile] as well as an international standard for BMI [extrapolated to levels of adults]) were applied to 1,643 children of KOPS enrolled between 1996 and 2000 (19 % of all first-graders in Kiel in this period).
Results:
The prevalence of overweight varies from 9 to 21 % depending on the applied definition. With the definitions of overweight and obesity based on newer BMI percentiles a part of overweight children are not classified as such. The present state of art is that there is only a need for obese children for medical rehabilitation: these are 3.3 and 3.5 % of 5-7 year-old children in Kiel, respectively.
Conclusions:
Experts should work out an agreement concerning a uniform definition of childhood obesity. Currently, medical rehabilitation services are offered only to extremely obese children. There is a need for more and earlier preventive measures.