The Prevalence of Childhood Obesity Depends on Which Body Composition and Anthropometric Measurement and Cutoff Were Used

ABSTRACT

Using the 2017–2018 National Health and Nutrition Examination Survey (weighted population size = 35,460,209; 8–18 years old; 52.1% males), we compared the obesity prevalence in children and adolescents between body mass index-based (BMI-based) and total percent body fat-based (BF%-based, measured by the dual-energy x-ray absorptiometry) cutoffs. The BMI-based cutoffs exhibited closer alignments (k, .88–.97) in the childhood obesity prevalence, while the absolute (sex-specific) BF% cutoffs had higher prevalence rates than the relative (age- and sex-specific) BF% cutoffs (k = .43 [95% CI, 0.38–0.49]), overly labeling Non-Hispanic white and Other race/ethnicity females with obesity. The BF%-based cutoffs had higher prevalence rates in most sex, age, and race/ethnicity groups than the BMI-based cutoffs. Furthermore, the absolute BF% cutoffs overly labeled Hispanic and Other race/ethnicity females with obesity. In summary, childhood obesity prevalence varied by sex, age, race/ethnicity across different cutoffs, with the BMI-based cutoffs showing closer alignments than the BF%-based cutoffs.

KEYWORDS:

• Childhood obesity prevalence
• body composition
• anthropometric
• cutoff
• body mass index
• total percent body fat

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authorship contribution statement

All authors are involved in the conceptualization, paper review, and editing process. Additionally, Xu developed the research methodology, conducted data curation and analysis, and wrote the original draft of the manuscript. Zhu provided supervision, guided the research progress, and ensured the overall quality of the manuscript. Gao provided supervision, oversaw project administration, developed research methodology, and ensured the overall quality of the manuscript.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/1091367X.2024.2319305