BACKGROUND: Estimates of the prevalence of overweight and obesity in young people are typically based on body mass index (BMI). However, BMI may not indicate the level of central adiposity. Waist circumference has therefore been recommended to identify young people at risk of morbidity associated with central adiposity. OBJECTIVE: To investigate (a) change in total and central adiposity between 7 - 8 and 12 - 13 y (b) agreement between classifying young people as overweight or obese based on total adiposity and central adiposity, and (c) risk factors associated with the development of total and central adiposity. DESIGN: Anthropometric measurements were taken on 342 children in 1996/97 and 5 y later. Risk factors examined included birth weight, physical activity, TV viewing, pubertal status, parental adiposity, diet and socio-economic status. RESULTS: Between 7 - 8 and 12 - 13 y indices of central adiposity increased more than total adiposity; waist circumference z-score increased by (mean +/- s.d.) 0.74 +/- 0.92 and BMI z-score increased by 0.18 +/- 0.67. At 12 - 13 y there was moderate agreement between the two measures of adiposity (weighted kappa = 0.64). However, waist circumference identified a greater number of young people as overweight or obese compared to BMI (41.2 vs 29.3%, P < 0.001). Adiposity status at 7 - 8 y, maternal obesity, and pubertal stage were the strongest predictors of BMI status at 12 - 13 y. Risk factors associated with increased central adiposity were similar. CONCLUSIONS: Overweight and obesity, as measured by waist circumference, is a bigger problem than is currently assessed by BMI. Targeting known risk factors for total adiposity may be an appropriate strategy for preventing increased central adiposity.
International Journal of Obesity Vol. 29, no. 11, p. 1353-1360