Designing and evaluating clinical cutpoints for childhood obesity

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2008-01-01
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Laurson, Kelly
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Joey C. Eisenmann
Gregory J. Welk
Rick L. Sharp
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Kinesiology
The Department of Kinesiology seeks to provide an ample knowledge of physical activity and active living to students both within and outside of the program; by providing knowledge of the role of movement and physical activity throughout the lifespan, it seeks to improve the lives of all members of the community. Its options for students enrolled in the department include: Athletic Training; Community and Public Health; Exercise Sciences; Pre-Health Professions; and Physical Education Teacher Licensure. The Department of Physical Education was founded in 1974 from the merger of the Department of Physical Education for Men and the Department of Physical Education for Women. In 1981 its name changed to the Department of Physical Education and Leisure Studies. In 1993 its name changed to the Department of Health and Human Performance. In 2007 its name changed to the Department of Kinesiology. Dates of Existence: 1974-present. Historical Names: Department of Physical Education (1974-1981), Department of Physical Education and Leisure Studies (1981-1993), Department of Health and Human Performance (1993-2007). Related Units: College of Human Sciences (parent college), College of Education (parent college, 1974 - 2005), Department of Physical Education for Women (predecessor) Department of Physical Education for Men
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Abstract

This dissertation consists of a series of papers which focused on creating age-, sex-, and ethnicity-specific body fat centiles and the concordance of those centiles with other commonly used childhood obesity indices. Anthropometric and body composition data of 5 to 18 year olds were taken from a large, multi-ethnic, nationally-representative sample participating in one of three cycles of the National Health and Nutrition Examination Surveys. Percent body fat (%BF) was calculated using tricep and subscapular skinfold measurements within the commonly used Slaughter equations. %BF growth curves were created for white, black, and Mexican-American children and adolescents. Values were provided so that future researchers can identify children based on these reference data. In addition, the concordance of single-value body fat cutpoints, Body Mass Index (BMI) centiles, Waist Circumference (WC) centiles and %BF centiles was examined. It was found that BMI and WC centiles demonstrated a reasonable level of agreement with the single-value %BF cutpoints of 25% and 30% in boys and girls, respectively. However, current Centers for Disease Control BMI cutpoints for obesity have low sensitivity and high specificity when compared to these values. Further, BMI and WC centiles agreed more consistently with single-value %BF cutpoints in boys than girls. Using receiver operator characteristic (ROC) curves, it was indicated that %BF centiles corresponded consistently with currently used BMI cutpoints for overweight and obesity. Furthermore, the values of sensitivity, specificity, and area under the ROC indicated no large discrepancies between the sexes or among ethnic groups. The optimal %BF values identified at younger ages were well below the single-value %BF cutoffs of 25% and 30% fat. The LMS-derived %BF centiles can be used to improve agreement between %BF measures and current BMI classification systems. Single-value, or static, %BF thresholds are not sensitive to growth and maturation and should not be used across the pediatric age range.

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Tue Jan 01 00:00:00 UTC 2008