Assessing overweight and obesity in American Samoan adolescents

A small number of informed Samoans question the relevance of applying standards developed primarily from Caucasian populations when screening Polynesian children for obesity. They attribute higher body mass index values in Polynesian populations, in part, to anatomical factors other than higher body fat percentage.

We attempted to allay these suspicions by assessing a sample of 380 American Samoan schoolchildren aged 11 to 18 for overweight and obesity using both the International Obesity Task Force and the Centers for Disease Control age- and sex-specific body mass index cutoffs and recently proposed age- and sex-specific waist circumference cutoffs for children and adolescents. We tested cholesterol and glucose levels for risk factors associated with obesity, and hemoglobin levels for iron deficiency. We also compared body mass index values from our sample with those from a similar sample taken in American Samoa in 1978 and 1982.

Both body mass index cutoffs equally distinguished overweight or obese individuals, constituted by 62% of the males and 70% of the females, from individuals with normal weight. Waist circumference cutoffs assigned percentages of 56% and 61%, respectively. Applying BMI cutoffs to data collected a quarter century ago indicated that 23.0% of males and 43.5% of females were either overweight or obese. We failed to obtain evidence for elevated levels of cholesterol and glucose in overweight and obese individuals among 49 preprandial students. Six males and ten females had subnormal levels of hemoglobin but displayed no physical symptoms suggesting iron deficiency.

The prevalence of overweight and obesity among contemporary American Samoan adolescents make them an especially vulnerable faction of the global obesity epidemic.