Chen W, Lin C C, Peng C T, Li C I, Wu H C, Chiang J, Wu J Y, Huang P C
Department of Pediatrics, China Medical College and Hospital, Taichung, Taipei, Taiwan.
Obes Rev. 2002 Aug;3(3):225-32. doi: 10.1046/j.1467-789x.2002.00064.x.
Current body mass index (BMI) norms for children and adolescents are developed from a reference population that includes obese and slim subjects. The validity of these norms is influenced by the observed secular increase in body weight and BMI. We hypothesized that the performance of children in health-related physical fitness tests would be negatively related to increased BMIs, and therefore fitness tests might be used as criteria for developing a more appropriate set of BMI norms. We evaluated the existing data from a nation-wide fitness survey for students in Taiwan (444 652 boys and 433 555 girls) to examine the relationship between BMI and fitness tests. The fitness tests used included: an 800/1600-m run/walk; a standing long jump; bent-leg curl-ups; and a sit-and-reach test. The BMI percentiles developed from the subgroup whose test scores were better than the 'poor' quartile in all four tests were compared with those of the whole population and linked to the adult criteria for overweight and obesity. The BMIs were significantly related to the results of fitness testing. A total of 43% of students had scores better than the poorest quartile in all of their tests. The upper BMI percentile curves of this fitter subgroup were lower than those of the total population. The 85th and 95th BMI percentile values of the fitter 18-year-old-students (23.7 and 25.5 kg m(-2) for boys; 22.6 and 24.6 kg m(-2) for girls) linked well with the adult cut-off points of 23 and 25 kg m(-2), which have been recommended as the Asian criteria for adult overweight and obesity. Hence, the BMI norms for children and adolescents could be created from selected subgroups that have better physical fitness. We expect that the new norms based on this approach will be used not only to assess the current status of obesity or overweight, but also to encourage activity and exercise.
当前儿童和青少年的身体质量指数（BMI）标准是根据一个包括肥胖和苗条个体的参考人群制定的。这些标准的有效性受到观察到的体重和BMI长期增长的影响。我们假设，儿童在健康相关体能测试中的表现与BMI的增加呈负相关，因此体能测试可作为制定一套更合适的BMI标准的依据。我们评估了台湾一项全国性学生体能调查的现有数据（444652名男生和433555名女生），以研究BMI与体能测试之间的关系。所使用的体能测试包括：800/1600米跑/走；立定跳远；屈膝仰卧起坐；以及坐位体前屈测试。将在所有四项测试中成绩优于“差”四分位数的亚组得出的BMI百分位数与总体人群的百分位数进行比较，并与成人超重和肥胖标准相关联。BMI与体能测试结果显著相关。共有43%的学生在所有测试中的成绩优于最差的四分位数。这个更健康亚组的BMI百分位数上限曲线低于总体人群。18岁更健康学生的BMI第85和第95百分位数（男生为23.7和25.5 kg/m²；女生为22.6和24.6 kg/m²）与成人临界值23和25 kg/m²很好地关联，这两个临界值已被推荐作为亚洲成人超重和肥胖的标准。因此，可以从体能状况更好的选定亚组中制定儿童和青少年的BMI标准。我们期望基于这种方法的新标准不仅用于评估当前肥胖或超重状况，还用于鼓励活动和锻炼。
