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Updated: Dec 30, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Is child weight status correctly reported to parents? Cross-sectional analysis of National Child Measurement
Nicola Firman1, Kambiz Boomla1, Mohammed T Hudda2
1Centre for Primary Care & Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK.
Insights
Ethnic-specific adjustments to Body Mass Index (BMI) calculations are crucial for accurately assessing child weight status in diverse populations. Implementing these changes in the National Child Measurement Programme (NCMP) ensures equitable health information for all children.
Area of Science:
- Pediatric health
- Public health surveillance
- Anthropometry
Background:
- Body Mass Index (BMI) accuracy varies across ethnic groups in children.
- BMI underestimates body fat in South Asian children and overestimates it in Black children.
- Current UK National Child Measurement Programme (NCMP) may misclassify weight status in minority ethnic groups.
Purpose of the Study:
- To evaluate the impact of ethnic-specific BMI adjustments on weight status categorization in UK children.
- To assess how ethnic-specific adjustments would alter parental information regarding child weight.
- To determine the effect on obesity prevalence estimates within the NCMP.
Main Methods:
- Utilized cross-sectional data from 38,270 children (ages 4-5 and 10-11) in inner-London.
- Analyzed data from the English National Child Measurement Programme (NCMP) for 2015-2017.
- Estimated changes in weight status information and obesity prevalence with ethnic-specific BMI adjustments.
Main Results:
- 19.7% of South Asian children would be reclassified into a heavier weight category.
- 19.1% of Black children would be reclassified into a lighter weight category.
- Ethnic-specific adjustments increased overall obesity prevalence in both age groups studied.
Conclusions:
- Ethnic-specific BMI adjustments are necessary for equitable weight status categorization in the NCMP.
- Accurate weight status information empowers parents and supports targeted health interventions.
- Implementing ethnic-specific adjustments improves the reliability of public health surveillance data.
Background:
BMI underestimates and overestimates body fat in children from South Asian and Black ethnic groups, respectively.
Methods:
We used cross-sectional NCMP data (2015-17) for 38 270 children in three inner-London local authorities: City & Hackney, Newham and Tower Hamlets (41% South Asian, 18.8% Black): 20 439 4-5 year-olds (48.9% girls) and 17 831 10-11 year-olds (49.1% girls). We estimated the proportion of parents who would have received different information about their child's weight status, and the area-level prevalence of obesity-defined as ≥98th centile-had ethnic-specific BMI adjustments been employed in the English National Child Measurement Programme (NCMP).
Results:
Had ethnic-specific adjustment been employed, 19.7% (3112/15 830) of parents of children from South Asian backgrounds would have been informed that their child was in a heavier weight category, and 19.1% (1381/7217) of parents of children from Black backgrounds would have been informed that their child was in a lighter weight category. Ethnic-specific adjustment increased obesity prevalence from 7.9% (95% CI: 7.6, 8.3) to 9.1% (8.7, 9.5) amongst 4-5 year-olds and from 17.5% (16.9, 18.1) to 18.8% (18.2, 19.4) amongst 10-11 year-olds.
Conclusions:
Ethnic-specific adjustment in the NCMP would ensure equitable categorization of weight status, provide correct information to parents and support local service provision for families.
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