Comparison of different internationally accepted reference standards to measure childhood adiposity rates in Latvia

Childhood adiposity is increasingly affecting developed and developing countries alike. Body Mass Index (BMI) is a good first approximation of body weight, but interpretation in specific patient populations may be inconsistent. The aim of this study was to compare adiposity rates using three internationally accepted weight reference standards - World Health Organisation (WHO), International Obesity Task Force (IOTF), and US Centers for Disease Control (CDC), plus a local national scale (LV), evaluating 465, 6-to-9-year old school children in Latvia. After obtaining height and weight, BMI was calculated, and the four scales were individually applied by gender and age. Highly significant differences between LV and CDC, LV and IOTF, LV and WHO were found in all age groups (P < 0.01), and between WHO and IOTF reference standards (P < 0.01) in 7- and 8-year olds. We conclude that reference standards should be used with great caution. Reference standards for local ethnic populations are needed to avoid disagreements between scales, as this can lead to incorrect choice of therapy; reliance on any single reference standard may not consider a patient's unique set of circumstances that have resulted in excess weight and information that is vital for a good clinical outcome.