Defining health-related obesity in prepubertal children

Objective: The purpose of this study was to develop percentage of fat and w aist circumference cut-points in prepubertal children with the intention of defining obesity associated with cardiovascular disease (CVD) risk. Research Methods and Procedures: A cross-sectional analysis of 87 prepubert al children aged it to 11 years was used. Percentage of body fat was determ ined by DXA, Waist circumference was measured to the nearest millimeter. Re ceiver Operating Characteristic analyses of percentage of fat and waist cir cumference were used to develop cut-points for individuals with adverse lev els of CVD risk factors. Results: The risk factors selected for analyses (i.e., fasting insulin, hig h-density lipoprotein cholesterol, low-density lipoprotein cholesterol, tri glycerides, and total cholesterol/high-density lipoprotein cholesterol) wer e significantly related to percentage of body fat and waist circumference. Likelihood ratios were used to identify percentage of fat and waist circumf erence cut-points associated with adverse cardiovascular risk profiles. Two cut-points, an upper cut-point of 33% body fat and a lower cut-point of 20 % body fat, were derived. Waist circumference cut-points indicative of adve rse and normal risk-factor profiles were 71 cm and 61 cm, respectively. Discussion: The data indicate that children with greater than or equal to 3 3% body, fat and children with a waist circumference greater than or equal to 71 cm were more likely to possess an adverse CVD risk-factor profile tha n a normal risk-factor profile. The likelihood of children with <20% body f at or a waist circumference <61 cm possessing an adverse CVD risk-factor pr ofile as opposed to a normal risk-factor profile was small. The cutpoints d escribe an adequate health-related definition of childhood obesity.