Body mass index trend as a new parameter for evaluating children's nutritional status

Area of Science:

• Pediatrics
• Public Health
• Anthropometry

Background:

• Absolute Body Mass Index (BMI) is commonly used to assess children's nutritional status.
• Existing national or international BMI references may not accurately reflect local population-specific growth patterns.

Purpose of the Study:

• To establish a Body Mass Index (BMI) trend as a novel indicator and predictor of children's nutritional status.
• To demonstrate the superiority of a local BMI trend over national/international trends for assessing nutritional status.

Main Methods:

• A longitudinal 8-year cohort study involving primary school children.
• Body Mass Index (BMI) measurements taken at three key points: school enrollment, 5th grade, and 8th grade.
• Development of gender- and age-based percentile curves using local (Osijek Percentile Curves - OPC) and national (Croatian Percentile Curves - CROPC-2008) data, categorizing BMI trends as 'healthy,' 'at risk,' or 'unhealthy.'

Main Results:

• The study identified differences in nutritional status categorization between local (OPC) and national (CROPC-2008) BMI trends.
• The 'unhealthy' BMI trend category showed nearly double the number of children when assessed using national (CROPC-2008) versus local (OPC) criteria.
• Individual case analysis revealed that the same child could be classified into different BMI trend categories based on whether local or national reference values were used.

Conclusions:

• A BMI trend, especially when derived from local reference values, serves as a more effective indicator and predictor of children's nutritional status than absolute BMI.
• Longitudinal cohort studies are preferable to cross-sectional studies for capturing personalized BMI trajectories.
• Local, generation-specific BMI reference values offer advantages over national references for accurate nutritional status assessment in children.