Prevalence of overweight and underweight in schoolchildren in Constantine, Algeria: comparison of four reference cut-off points for body mass index.

BACKGROUND

Algeria is experiencing a nutritional transition and increasing overweight in children.

AIMS

This study aimed to determine the prevalence of overweight and underweight in children aged 6-10 years in Constantine city, Algeria using four international reference cut-offs for body mass index.

METHODS

A cross-sectional study was conducted between February and May 2015 with a sample of 509 schoolchildren aged 6-10 years. Height and weight were measured according to World Health Organization (WHO) recommendations. The body mass index cut-offs of WHO, International Obesity Task Force, Centers for Disease Control and Prevention (CDC) and French national references were used to classify the sample as underweight and overweight according to age and sex. The kappa coefficient was used to assess agreement between the reference cut-offs.

RESULTS

Based on the of different reference cut-offs, the prevalence of underweight in the children varied from 1.4% to 8.8%. The prevalence of overweight varied from 22.8% to 28.3%. The WHO cut-off gave a significantly higher prevalence of overweight in boys than girls (32.6% versus 24.0%, P = 0.03). The kappa values (between 0.251 and 0.954) indicated a fair to excellent agreement between the different reference cut-offs.

CONCLUSION

The prevalence of overweight and underweight differs in the Constantine children depending on the reference cut-off used, suggesting international references should be used with care to avoid potential misclassification of children's nutritional status.