De Onis 2007 Bull World Health Organization

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de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J (2007) Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organization 85:660-7.

» PMID: 18026621 Open Access

de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J (2007) Bull World Health Organization

Abstract: OBJECTIVE: To construct growth curves for school-aged children and adolescents that accord with the WHO Child Growth Standards for preschool children and the body mass index (BMI) cut-offs for adults.

METHODS: Data from the 1977 National Center for Health Statistics (NCHS)/WHO growth reference (1-24 years) were merged with data from the under-fives growth standards' cross-sectional sample (18-71 months) to smooth the transition between the two samples. State-of-the-art statistical methods used to construct the WHO Child Growth Standards (0-5 years), i.e. the Box-Cox power exponential (BCPE) method with appropriate diagnostic tools for the selection of best models, were applied to this combined sample.

FINDINGS: The merged data sets resulted in a smooth transition at 5 years for height-for-age, weight-for-age and BMI-for-age. For BMI-for-age across all centiles the magnitude of the difference between the two curves at age 5 years is mostly 0.0 kg/m(2) to 0.1 kg/m(2). At 19 years, the new BMI values at +1 standard deviation (SD) are 25.4 kg/m(2) for boys and 25.0 kg/m(2) for girls. These values are equivalent to the overweight cut-off for adults (> or = 25.0 kg/m(2)). Similarly, the +2 SD value (29.7 kg/m(2) for both sexes) compares closely with the cut-off for obesity (> or = 30.0 kg/m(2)).

CONCLUSION: The new curves are closely aligned with the WHO Child Growth Standards at 5 years, and the recommended adult cut-offs for overweight and obesity at 19 years. They fill the gap in growth curves and provide an appropriate reference for the 5 to 19 years age group.


Bioblast editor: Gnaiger E


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Healthy reference population     Body mass excess         BFE         BME cutoffs         BMI         H         M         VO2max         mitObesity drugs



From BMI to BME

Work in progress by Gnaiger E 2020-01-20 linked to a preprint in preparation on BME and mitObesity.
Figure 1: Growth curves and allometry of body mass and height in girls and boys from 5 to 19 years (WHO 2006). (a) and (b): Height and body mass as a function of age. The curves are very similar up to 13 years. (c) and (d) Body mass and precision body mass index, BMI°, as a function of height. Three allometric phases are indicated by the shaded areas. The BMI does not yield an index that is independent of height. The precision BMI° is the BMI of the HRP (by definition, at zero BME).
The WHO growth reference for school-aged children and adolescents (see healthy reference population) provides the data set upon which the allometric dependence of body mass on height is defined for the healthy reference population. While straight mathematical fitting procedures can be applied to obtain the global best fit, a best fit by a conceptually defined algorithm is obtained only by breaking the continuous function into distinct phases. Application of the allometric power law reveals four phases of growth.
Figure 1 is based on the WHO Child Growth Standards [1-3]. It illustrates the limitation of the BMI as an index of overweight and obesity. The precision body mass index, BMI°, is claculated for the healthy reference population (HRP), in which neither underweight nor overweight prevails and which, therefore, should be characterized by a constant index. This is achieved by the body mass excess, BME [4], which relates the actual body mass, M, to the reference body mass, M°, at a given height, BME=(M-M°/M°). The BME is constant at 0.0 for the HRP for both sexes independent of height. In contrast, the increase of the precision BMI° from 15 to 21 kg·m-2 from 1.0 to 1.8 m/x represents a confounding factor which explains the necessity of adjusting the BMI cutoff points. Instead of a focus on adjusted BMI cutoff points [3], research should focus on evaluation of the concept of BME and the HRP.




Publications: BME and height

» Height of humans
 Reference
Bosy-Westphal 2009 Br J NutrBosy-Westphal A, Plachta-Danielzik S, Dörhöfer RP, Müller MJ (2009) Short stature and obesity: positive association in adults but inverse association in children and adolescents. Br J Nutr 102:453-61.
De Onis 2007 Bull World Health Organizationde Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J (2007) Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organization 85:660-7.
Gnaiger 2019 MiP2019
Erich Gnaiger
OXPHOS capacity in human muscle tissue and body mass excess – the MitoEAGLE mission towards an integrative database (Version 6; 2020-01-12).
Hood 2019 Nutr DiabetesHood K, Ashcraft J, Watts K, Hong S, Choi W, Heymsfield SB, Gautam RK, Thomas D (2019) Allometric scaling of weight to height and resulting body mass index thresholds in two Asian populations. Nutr Diabetes 9:2. doi: 10.1038/s41387-018-0068-3.
Indian Academy of Pediatrics Growth Charts Committee 2015 Indian PediatrIndian Academy of Pediatrics Growth Charts Committee, Khadilkar V, Yadav S, Agrawal KK, Tamboli S, Banerjee M, Cherian A, Goyal JP, Khadilkar A, Kumaravel V, Mohan V, Narayanappa D, Ray I, Yewale V (2015) Revised IAP growth charts for height, weight and body mass index for 5- to 18-year-old Indian children. Indian Pediatr 52:47-55.
Zucker 1962 Committee on Biological Handbooks, Fed Amer Soc Exp BiolZucker TF (1962) Regression of standing and sitting weights on body weight: man. In: Growth including reproduction and morphological development. Altman PL, Dittmer DS, eds: Committee on Biological Handbooks, Fed Amer Soc Exp Biol:336-7.

Publications: BME and BMI-cutoff

» BME cutoff points
 Reference
Cole 2000 BMJCole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240-3.
De Onis 2007 Bull World Health Organizationde Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J (2007) Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organization 85:660-7.
Gallagher 2000 Am J Clin NutrGallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y (2000) Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr 72:694-701.
Mialich 2014 Nutr HospMialich MS, Martinez EZ, Jordao JJ (2014) Application of body mass index adjusted for fat mass (BMIfat) obtained by bioelectrical impedance in adults. Nutr Hosp 30:417-24.
Mialich 2018 J Electr BioimpMialich MS, Silva BR, Jordao AA (2018) Cutoff points of BMI for classification of nutritional status using bioelectrical impedance analysis. J Electr Bioimp 9:24-30.
Romero-Corral 2008 Int J Obes (Lond)Romero-Corral A, Somers VK, Sierra-Johnson J, Thomas RJ, Collazo-Clavell ML, Korinek J, Allison TG, Batsis JA, Sert-Kuniyoshi FH, Lopez-Jimenez F (2008) Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes (Lond) 32:959-66.
Wollner 2017 J Public Health ResWollner M, Paulo Roberto BB, Alysson Roncally SC, Jurandir N, Edil LS (2017) Accuracy of the WHO's body mass index cut-off points to measure gender- and age-specific obesity in middle-aged adults living in the city of Rio de Janeiro, Brazil. J Public Health Res 6:904.

MitoPedia: BME and mitObesity

» Body mass excess and mitObesity | BME and mitObesity news | Summary |

TermAbbreviationDescription
BME cutoff pointsBME cutoffObesity is defined as a disease associated with an excess of body fat with respect to a healthy reference condition. Cutoff points for body mass excess, BME cutoff points, define the critical values for underweight (-0.1 and -0.2), overweight (0.2), and various degrees of obesity (0.4, 0.6, 0.8, and above). BME cutoffs are calibrated by crossover-points of BME with established BMI cutoffs.
Body fat excessBFEIn the healthy reference population (HRP), there is zero body fat excess, BFE, and the fraction of excess body fat in the HRP is expressed - by definition - relative to the reference body mass, M°, at any given height. Importantly, body fat excess, BFE, and body mass excess, BME, are linearly related, which is not the case for the body mass index, BMI.
Body massm [kg]; M [kg·x-1]The body mass, M, is the mass (kilogram [kg]) of an individual (object) [x] and is expressed in units [kg/x]. Whereas the body weight changes as a function of gravitational force (you are weightless at zero gravity; your floating weight in water is different from your weight in air), your mass is independent of gravitational force, and it is the same in air and water.
Body mass excessBMEThe body mass excess, BME, is an index of obesity and as such BME is a lifestyle metric. The BME is a measure of the extent to which your actual body mass, M [kg/x], deviates from M° [kg/x], which is the reference body mass [kg] per individual [x] without excess body fat in the healthy reference population, HRP. A balanced BME is BME° = 0.0 with a band width of -0.1 towards underweight and +0.2 towards overweight. The BME is linearly related to the body fat excess.
Body mass indexBMIThe body mass index, BMI, is the ratio of body mass to height squared (BMI=M·H-2), recommended by the WHO as a general indicator of underweight (BMI<18.5 kg·m-2), overweight (BMI>25 kg·m-2) and obesity (BMI>30 kg·m-2). Keys et al (1972; see 2014) emphasized that 'the prime criterion must be the relative independence of the index from height'. It is exactly the dependence of the BMI on height - from children to adults, women to men, Caucasians to Asians -, which requires adjustments of BMI-cutoff points. This deficiency is resolved by the body mass excess relative to the healthy reference population.
ComorbidityComorbidities are common in obesogenic lifestyle-induced early aging. These are preventable, non-communicable diseases with strong associations to obesity. In many studies, cause and effect in the sequence of onset of comorbidities remain elusive. Chronic degenerative diseases are commonly obesity-induced. The search for the link between obesity and the etiology of diverse preventable diseases lead to the hypothesis, that mitochondrial dysfunction is the common mechanism, summarized in the term 'mitObesity'.
Healthy reference populationHRPA healthy reference population, HRP, establishes the baseline for the relation between body mass and height in healthy people of zero underweight or overweight, providing a reference for evaluation of deviations towards underweight or overweight and obesity. The WHO Child Growth Standards (WHO-CGS) on height and body mass refer to healthy girls and boys from Brazil, Ghana, India, Norway, Oman and the USA. The Committee on Biological Handbooks compiled data on height and body mass of healthy males from infancy to old age (USA), published before emergence of the fast-food and soft-drink epidemic. Four allometric phases are distinguished with distinct allometric exponents. At heights above 1.26 m/x the allometric exponent is 2.9, equal in women and men, and significantly different from the exponent of 2.0 implicated in the body mass index, BMI [kg/m2].
Height of humansh [m]; H [m·x-1]The height of humans, h, is given in SI units in meters [m]. Humans are countable objects, and the symbol and unit of the number of objects is N [x]. The average height of N objects is, H = h/N [m/x], where h is the heights of all N objects measured on top of each other. Therefore, the height per human has the unit [m·x-1] (compare body mass [kg·x-1]). Without further identifyer, H is considered as the standing height of a human, measured without shoes, hair ornaments and heavy outer garments.
MitObesity drugsBioactive mitObesity compounds are drugs and nutraceuticals with more or less reproducible beneficial effects in the treatment of diverse preventable degenerative diseases implicated in comorbidities linked to obesity, characterized by common mechanisms of action targeting mitochondria.
ObesityObesity is a disease resulting from excessive accumulation of body fat. In common obesity (non-syndromic obesity) excessive body fat is due to an obesogenic lifestyle with lack of physical exercise ('couch') and caloric surplus of food consumption ('potato'), causing several comorbidities which are characterized as preventable non-communicable diseases. Persistent body fat excess associated with deficits of physical activity induces a weight-lifting effect on increasing muscle mass with decreasing mitochondrial capacity. Body fat excess, therefore, correlates with body mass excess up to a critical stage of obesogenic lifestyle-induced sarcopenia, when loss of muscle mass results in further deterioration of physical performance particularly at older age.
VO2maxVO2max; VO2max/MMaximum oxygen consumption, VO2max, is and index of cardiorespiratory fitness, measured by spiroergometry on human and animal organisms capable of controlled physical exercise performance on a treadmill or cycle ergometer. VO2max is the maximum respiration of an organism, expressed as the volume of O2 at STPD consumed per unit of time per individual object [mL.min-1.x-1]. If normalized per body mass of the individual object, M [kg.x-1], mass specific maximum oxygen consumption, VO2max/M, is expressed in units [mL.min-1.kg-1].


Labels: MiParea: Gender, Developmental biology  Pathology: Obesity 

Organism: Human 

Preparation: Intact organism 




BMI, HRP, BME, Height, BMI-cutoff