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Impact of using national v. international definitions of underweight, overweight and obesity: an example from Kuwait

  • Mira El-Ghaziri (a1), Shurooq Boodai (a1), David Young (a2) and John J Reilly (a1)
Abstract
AbstractObjective

To compare the classification of overweight, obesity and underweight using international v. national approaches in Kuwaiti adolescents.

Design

Assessment of underweight, overweight and obesity using a national approach (based on Kuwaiti reference data for BMI-for-age) was compared with assessments obtained using three international approaches: the Cole et al. and International Obesity Task Force (IOTF) definitions of thinness and of overweight and obesity (Cole-IOTF); WHO 2007; and US Centers for Disease Control and Prevention (CDC) 2000 reference data and definitions. The degree of agreement between the different methods was assessed using the weighted κ statistic (κw).

Setting

Two randomly selected public intermediate schools in Kuwait City.

Subjects

A total of 499 10–14-year-old Kuwaiti adolescents.

Results

Prevalence of overweight and obesity using Kuwaiti reference data (36·7 %; 95 % CI 32·4, 41·1) was significantly lower than that obtained using international approaches – Cole-IOTF (44·7 %; 95 % CI 40·3, 49·2), CDC 2000 (44·9 %; 95 % CI 40·5, 49·4) and WHO 2007 (50·5 %; 95 % CI 46·0, 55·0) (P < 0·01). All three international approaches showed almost perfect agreement: IOTF v. WHO (κw = 0·82; 95 % CI 0·79, 0·85) and IOTF v. CDC (κw = 0·90; 95 % CI 0·87, 0·92). However, Kuwaiti reference data showed the lowest agreement with the three international approaches, the poorest being with WHO 2007 (κw = 0·54; 95 % CI 0·49, 0·59).

Conclusions

Caution should be exercised when using recently collected national reference data and definitions while assessing underweight, overweight and obesity for clinical and public health applications.

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Copyright
Corresponding author
*Corresponding author: Email John.Reilly@Glasgow.ac.uk, john.j.reilly@strath.ac.uk
Address for correspondence: Physical Activity for Health Research Group, School of Psychological Sciences and Health, University of Strathclyde, Jordanhill Campus, 76 Southbrae Drive, Glasgow G13 1PP, Scotland, UK.
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Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
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