TOPLINE: 

BMI screening confirmed excess adiposity in > 98% of youth with obesity, while also identifying excess adiposity in up to 32.5% of youth without obesity. Researchers found that anthropometric measures alone were as effective as DEXA in confirming excess adiposity.

METHODOLOGY:

• Analysis included 183 participants aged 8-17 years from the Cameron County Hispanic Cohort (CCHC), a randomly ascertained, population-based cohort in southern Texas, recruited between 2014 and 2023.
• Researchers confirmed excess adiposity among participants with obesity using waist-height ratio (WHtR), severe obesity criteria, or fat mass index (FMI) measured via DEXA.
• Investigators compared CCHC participants with age- and sex-matched National Health and Nutrition Examination Survey (NHANES) Mexican American, non-Hispanic Black, and non-Hispanic White participants from 2013-2018.
• Data collection followed Strengthening the Reporting of Observational Studies in Epidemiology guidelines, with participants categorized by BMI ≥ 95th percentile per CDC/National Center for Health Statistics 2000 age- and sex-specific reference curves.

TAKEAWAY:

• Among CCHC participants with obesity by BMI criteria, 98.5% had confirmed excess adiposity, with similar high confirmation rates in NHANES Mexican American (98.2%), non-Hispanic White (97.1%), and non-Hispanic Black (86.0%) participants.
• Prevalence of elevated WHtR was highest in CCHC participants (56.3%), followed by NHANES Mexican American (45.4%), non-Hispanic White (31.7%), and non-Hispanic Black (30.6%) participants.
• Elevated FMI prevalence showed similar patterns, with CCHC participants highest at 32.2%, followed by NHANES Mexican American (21.9%), and both non-Hispanic White and Black participants at 12.6%.
• According to the authors, anthropometric measures alone effectively identified the same individuals with excess adiposity as DEXA measurements, suggesting their utility as practical, low-cost markers. 

IN PRACTICE:

"Screening for pediatric obesity using BMI alone effectively identified excess adiposity in almost all youth with obesity and underdiagnosed adiposity in youth without obesity. Notably, nearly one-third of CCHC youth without obesity by BMI had excess adiposity. These youth would be missed in traditional screening by BMI alone, highlighting the importance of incorporating body composition measures into routine clinical care and surveillance," wrote the authors of the study.

SOURCE:

The study was led by Alexandra B. Palmer, PhD, Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill. It was published online on September 8 in JAMA Pediatrics.

LIMITATIONS: 

According to the authors, the study could not address pubertal status due to small sample sizes, though findings were similar across age groups. 

DISCLOSURES:

The study was funded in part by a Center for Clinical and Translational Sciences and a National Institutes of Health Clinical and Translational Award. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.