Having two different reference charts with different

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Having two different reference charts with different indications for use, has the potentialto cause confusion.Some authors have found the Cole charts to be inferior to both the CDC and locallyderived reference charts in terms of sensitivity for identifying obesity, but comparablewhen identifying overweight (Fu et al 2003; Reilly et al 2000; Reilly 2002).Theyrecommend using population-specific BMI cut-offs for screening, epidemiological andclinical purposes, and international cut-offs for international comparisons only.Giventhat New Zealand has no population-specific reference data or cut-offs, using theinternational charts by Cole et al seems the best available option, while recognisingtheir limitations in application to certain ethnic groups and the reduced sensitivity ofidentifying obesity.The sensitivity for identifying overweight using the Cole charts ishigh (over 90%) while retaining acceptable specificity.As a population indicator, BMI does not need to be a precise measure (high sensitivityand specificity) at an individual level.However, population BMI collection will allowtrends to be followed, both in terms of mean BMI and its distribution and the prevalenceof overweight and obesity for the population and within subgroups such as ethnicgroups or communities.It would be a useful tool to detect differences between groupsconcurrently or over time.By identifying trends in the whole population or subgroups ofthe population, targeted interventions and forecasting for future service needs will bepossible.The usefulness of collecting population BMI will be further discussed inSection 5.22An Analysis of the Usefulness and Feasibility of aPopulation Indicator of Childhood Obesity
2Timing of BMI CollectionWhen assessing the best age to collect BMI at a population level the following issuesneed to be considered:accessibility to a health professionalprevalence of obesity in the age groupability to measure changeminimisation of potential harmpredictability of obesity in adulthoodthe presence of modifiable lifestyle factorspotential responsiveness of children or young people and their families to lifestyleand other interventions.Of the above factors, the most relevant to deciding the best age for collecting BMI forthe purpose of population monitoring are the first four: accessibility, prevalence ofobesity, the consequent increased ability to measure change, and minimising potentialharm.The final three factors are more relevant to screening, which is not the purposeof this proposal.They would be highly relevant issues if we were screening to identifysignificantly obese children for intervention (see Appendix 2).To analyse the optimal age to collect BMI, the age brackets of five to six years, sevento nine years, 10 to 11 years and adolescents (12 years and over) have been used.

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Term
Summer
Professor
NoProfessor
Tags
The American, The Land, Childhood obesity, Indicator of Childhood Obesity

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