RECOMMENDED BODY-MASS INDEX CUTOFF VALUES FOR OVERWEIGHT SCREENING PROGRAMS IN AUSTRALIAN CHILDREN AND ADOLESCENTS - COMPARISONS WITH NORTH-AMERICAN VALUES

Objective: Guidelines for screening children and adolescents for overw eight have recently been published by a North American Expert Committe e. As Australian clinicians might uncritically adopt these recommendat ions, we explore the consequences of applying North American body mass index (BMI) cutoff values to an Australian population. Methodology: T he Australian BMI cutoffs were calculated using the methods recommende d from height and weight data for 8492 schoolchildren aged 7-15 years old. Results: Smoothed Australian BMI cutoffs were similar to those de rived from the first United States National Health and Nutrition Exami nation Survey (NHANES-I) values for whites. However, the NHANES-I cuto ffs would result in systematic misclassification. Among 7 year olds, t he NHANES-I 85th percentile cutoff would wrongly classify 4.6% of norm al males and 9.1% of normal females as 'at risk of overweight'. At age 14 years, the NHANES-I 95th percentile cutoff would misclassify 3.5% of children as 'overweight' instead of 'at risk of overweight'. Conclu sion: Australian screening programmes should use BMI cutoffs appropria tely derived from local measurements, and these are given for Australi an children.