Monitoring childhood obesity:: Assessment of the weight/height2 index

The body mass index (BMI), defined as weight/height(2), is often used to monitor childhood obesity. BMI values for 979 children (438 White, 283 Black, and 258 Hispanic) aged 3-18 years living in the Houston, Texas, metropolitan area from 1994 to 1998 were compared with percentage of fat (%Fat) measurements obtained by using dual-energy x-ray absorptiometry, The associations between %Fat and BMI were statistically significant (r(2) = 0.34-0.70, p < 0.0005) and were gender and ethnic dependent (p < 0.0005), indicating that BMI can provide a general description of the adiposity characteristics of a healthy pediatric population. However, BMI was a poor predictor for the individual child, with a standard error for %Fat of 4.7-7.3% of body weight. It is advantageous to identify accurately, as early as possible, those children who truly have excess adiposity, but this assessment should not be done at the risk of falsely mislabeling a significant number of healthy children as overweight or obese.