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Weighing in on international growth standards: testing the case in Australian preschool children
C L Pattinson1,2, S L Staton1,2, S S Smith3
1Institute for Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Queensland, Australia.
Insights
Estimating childhood obesity requires careful selection of growth standards. Different methods like WHO, CDC, and IOTF yield significantly different prevalence rates in preschool children.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Childhood overweight and obesity are significant public health issues requiring accurate prevalence data.
- Existing international growth standards (CDC, WHO, IOTF) use varied methodologies for assessment.
- Systematic review of Australian studies (2006-2017) highlights varied adoption of these standards.
Purpose of the Study:
- To examine the adoption of international growth standards in Australian population studies.
- To demonstrate the impact of different growth standards on overweight/obesity prevalence estimates in preschool children.
- To recommend judicious selection of growth standards for accurate public health assessments.
Main Methods:
- Systematic review of 20 Australian population studies (2006-2017) on childhood overweight/obesity prevalence.
- Application of WHO, CDC, and IOTF growth standards to a sample of 1,926 Australian children (aged 3-5 years).
Main Results:
- Most Australian studies (16/20) utilized International Obesity Task Force (IOTF) standards.
- Prevalence estimates varied significantly across standards when applied to the same population: WHO (9.3%), IOTF (21.7%), CDC (33.1%).
Conclusions:
- The choice of growth standard critically impacts childhood overweight/obesity prevalence estimates.
- Standardized methodologies and data accessibility are crucial for reliable comparisons.
- Careful selection of growth standards is recommended for public health and clinical interventions in preschool children.
Abstract:
Overweight and obesity in preschool-aged children are major health concerns. Accurate and reliable estimates of prevalence are necessary to direct public health and clinical interventions. There are currently three international growth standards used to determine prevalence of overweight and obesity, each using different methodologies: Center for Disease Control (CDC), World Health Organization (WHO) and International Obesity Task Force (IOTF). Adoption and use of each method were examined through a systematic review of Australian population studies (2006-2017). For this period, systematically identified population studies (N = 20) reported prevalence of overweight and obesity ranging between 15 and 38% with most (n = 16) applying the IOTF standards. To demonstrate the differences in prevalence estimates yielded by the IOTF in comparison to the WHO and CDC standards, methods were applied to a sample of N = 1,926 Australian children, aged 3-5 years. As expected, the three standards yielded significantly different estimates when applied to this single population. Prevalence of overweight/obesity was WHO - 9.3%, IOTF - 21.7% and CDC - 33.1%. Judicious selection of growth standards, taking account of their underpinning methodologies and provisions of access to study data sets to allow prevalence comparisons, is recommended.
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