Kain J, Uauy R, Vio F, Albala C
Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.
Eur J Clin Nutr. 2002 Mar;56(3):200-4. doi: 10.1038/sj.ejcn.1601301.
To compare trends in prevalence of overweight and obesity among Chilean children using three different criteria.
Descriptive cross-sectional school-based study to analyse these trends in 6-y-old boys and girls who entered first grade in 1987, 1990, 1993, 1996 and 2000. Gender-specific prevalence of overweight and obesity were determined with three criteria: weight for height (W-H) Z-scores compared to NCHS 1977; present reference used by the Ministry of Health; and body mass index (BMI) compared to the revised US CDC Growth Charts with cut-off values of P85-95 and P-95 and IOTF reference with cut-offs extrapolated from an adult BMI of 25 and 30.
The prevalence of overweight determined by W-H (WHO) increased from 15% in 1987 to 20% in 2000 for boys and from 17.2 to 21.8% for girls. With BMI-CDC, the increase was from 13.2 to 19.2% for boys and 12 to 18.5% for girls. With BMI-IOTF, rates were very similar. Prevalence of obesity using W-H (WHO) increased from 6.5% in 1987 to 17% in 2000 for boys and from 7.8 to 18.6% for girls. Using BMI-CDC, the increase was from 5.1 to 14.7% for boys and from 4 to 15.8% for girls; using BMI-IOTF prevalence estimates were much lower.
Obesity prevalence in children has increased over time, and trends are similar independent of criteria. The reference used to define prevalence is important since it provides different estimates. Policy makers should be aware that a spurious drop in prevalence may appear if the IOTF reference is compared to the other criteria.
采用三种不同标准比较智利儿童超重和肥胖患病率的趋势。
开展基于学校的描述性横断面研究，分析1987年、1990年、1993年、1996年和2000年进入一年级的6岁男童和女童的这些趋势。采用三种标准确定超重和肥胖的性别特异性患病率：身高别体重（W-H）Z评分与1977年美国国家卫生统计中心（NCHS）数据比较；卫生部目前使用的参考标准；以及体重指数（BMI）与修订后的美国疾病控制与预防中心（CDC）生长图表比较，其临界值为P85-95和P-95，以及国际肥胖工作组（IOTF）参考标准，其临界值根据成人BMI为25和30外推得出。
根据W-H（世界卫生组织）标准确定的超重患病率，男孩从1987年的15%增至2000年的20%，女孩从17.2%增至21.8%。根据BMI-CDC标准，男孩从13.2%增至19.2%，女孩从12%增至18.5%。根据BMI-IOTF标准，患病率非常相似。根据W-H（世界卫生组织）标准确定的肥胖患病率，男孩从1987年的6.5%增至2000年的17%，女孩从7.8%增至18.6%。使用BMI-CDC标准，男孩从5.1%增至14.7%，女孩从4%增至15.8%；使用BMI-IOTF标准，患病率估计值低得多。
儿童肥胖患病率随时间增加，且趋势与标准无关。用于定义患病率的参考标准很重要，因为它提供了不同的估计值。政策制定者应意识到，如果将IOTF参考标准与其他标准进行比较，患病率可能会出现虚假下降。
