Diagnostic Accuracy of Body Mass Index in Defining Childhood Obesity: Analysis of Cross-Sectional Data from Ghanaian Children

Theodosia Adom, André Pascal Kengne, Anniza De Villiers, Rose Boatin and Thandi Puoane
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Theodosia Adom: School of Public Health, Faculty of Community and Health Sciences, University of Western Cape, Cape Town 7535, South Africa
André Pascal Kengne: Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
Anniza De Villiers: Division of Research Capacity Development, South African Medical Research Council, Cape Town 7505, South Africa
Rose Boatin: Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra LG80, Ghana
Thandi Puoane: School of Public Health, Faculty of Community and Health Sciences, University of Western Cape, Cape Town 7535, South Africa

IJERPH, 2019, vol. 17, issue 1, 1-11

Abstract: Background: Screening methods for childhood obesity are based largely on the published body mass index (BMI) criteria. Nonetheless, their accuracy in African children is largely unknown. The diagnostic accuracies of the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the International Obesity Taskforce (IOTF) BMI-based criteria in defining obesity using deuterium dilution as a criterion method in a sample of Ghanaian children are presented. Methods: Data on anthropometric indices and percent body fat were collected from 183 children aged 8–11 years. The sensitivity, specificity, and predictive values were calculated. The overall performance of the BMI criteria was evaluated using the receiver operating characteristics area under the curve (AUC). Results: Overall sensitivity of WHO, CDC, and IOTF were 59.4% (40.6–76.3), 53.1% (34.7–70.9), and 46.9% (29.1–65.3) respectively. The overall specificity was high, ranging from 98.7% by WHO to 100.0% by IOTF. The AUC were 0.936 (0.865–1.000), 0.924 (0.852–0.995), and 0.945 (0.879–1.000) by the WHO, CDC, and IOTF criteria respectively for the overall sample. Prevalence of obesity by the WHO, CDC, IOTF, and deuterium oxide-derived percent body fat were 11.5%, 10.4%, 8.2%, and 17.5% respectively, with significant positive correlations between the BMI z-scores and percent body fat. Conclusions: The BMI-based criteria were largely specific but with moderate sensitivity in detecting excess body fat in Ghanaian children. To improve diagnostic accuracy, direct measurement of body fat and other health risk factors should be considered in addition to BMI.

Keywords: body mass index; obesity; deuterium oxide; percent body fat; sensitivity; specificity; accuracy; school children (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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