Original article
Overweight and Obesity Prevalence Among School-Aged Nunavik Inuit Children According to Three Body Mass Index Classification Systems

https://doi.org/10.1016/j.jadohealth.2015.03.022Get rights and content

Abstract

Purpose

Little is known about the suitability of three commonly used body mass index (BMI) classification system for Indigenous children. This study aims to estimate overweight and obesity prevalence among school-aged Nunavik Inuit children according to International Obesity Task Force (IOTF), Centers for Disease Control and Prevention (CDC), and World Health Organization (WHO) BMI classification systems, to measure agreement between those classification systems, and to investigate whether BMI status as defined by these classification systems is associated with levels of metabolic and inflammatory biomarkers.

Methods

Data were collected on 290 school-aged children (aged 8–14 years; 50.7% girls) from the Nunavik Child Development Study with data collected in 2005–2010. Anthropometric parameters were measured and blood sampled. Participants were classified as normal weight, overweight, and obese according to BMI classification systems. Weighted kappa (κw) statistics assessed agreement between different BMI classification systems, and multivariate analysis of variance ascertained their relationship with metabolic and inflammatory biomarkers.

Results

The combined prevalence rate of overweight/obesity was 26.9% (with 6.6% obesity) with IOTF, 24.1% (11.0%) with CDC, and 40.4% (12.8%) with WHO classification systems. Agreement was the highest between IOTF and CDC (κw = .87) classifications, and substantial for IOTF and WHO (κw = .69) and for CDC and WHO (κw = .73). Insulin and high-sensitivity C-reactive protein plasma levels were significantly higher from normal weight to obesity, regardless of classification system. Among obese subjects, higher insulin level was observed with IOTF.

Conclusions

Compared with other systems, IOTF classification appears to be more specific to identify overweight and obesity in Inuit children.

Section snippets

Study population and setting

The data in the present study were sourced from the Nunavik Child Development Study (NCDS, September 2005–February 2010). The NCDS design has been described elsewhere [14]. Briefly, participants were school-aged Inuit children living in Nunavik, a region north of the 55th parallel in Arctic Quebec (Canada). The NCDS is an 11-year follow-up of school-aged children recruited before birth when their mothers participated in one of the two following cohort studies: the 1993–1998 Cord Blood

Results

Participants' characteristics are presented by sex in Table 1. They were aged between 8 and 14 years, 51% were girls, and average BMI was 19.5 kg/m2. All characteristic variables were similar between boys and girls.

Prevalence estimations of weight status categories (overweight and obesity) for each BMI classification criterion are provided for overall participants (Figure 1A) and by gender (Figure 1B). Regardless of BMI classification system, overweight prevalences appeared to be higher in boys

Discussion

Three prior selections should be considered when classifying children's weight status: an anthropometric indicator, a reference population for comparison, and cutoff points that best identify individuals and populations at risk of overweight- and obesity-related morbidity and mortality [18]. To our knowledge, this is the first comparison-based approach attempting to assess three sets of commonly used BMI reference criteria among Nunavik Inuit school-aged children. The results showed that BMI

Acknowledgments

The authors are grateful to the Nunavik population, particularly the parents and children who participated in this study. G.M. obtained funding and was investigator of the Nunavik Child Development Study; T.C.M.M., P.A., A.S-J, S.M., C.R., G.M., and M.L. created the concept for the current analysis and provided statistical expertise. T.C.M.M., P.A., G.M., and M.L. analyzed the data. T.C.M.M. wrote the first draft of the article. All authors contributed to the interpretation of the results and

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    Conflicts of Interest: The authors have no conflicts of interest to report.

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