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"The validity of selected cutoff points to identify adolescents
with the highest percentage of body fat has been investigated. In general,
common cutoff points for BMI and relative weight have low sensitivities
but high specificities. For example, BMIs >
85th percentile has a sensitivity of 29% and 23% for identifying
adolescent males and females, respectively, who are above the 90th
percentile for percentage body fat; corresponding specificities are 99%
and 100%. In screening for adolescent overweight, specificity may be more
important than sensitivity. Maximizing specificity minimizes the
proportion of adolescents who will be incorrectly considered overweight by
the screen."1
Recently it has been shown that cardiovascular risk factors are
associated with the established BMI-for-age cutoffs. Freedman et al.,
(1999) found that approximately 60% of 5- to 10 year-old children with
BMI-for-age values >
the 95th percentile had at least one biochemical or clinical risk factor
for cardiovascular disease such as hypertension, elevated insulin levels,
and hyperlipidemia. Twenty percent of children had two or more risk
factors.
1 Himes and Dietz, Guidelines for overweight
in adolescent preventive services: Recommendations from an expert
committee. Am J Clin Nutr 1994;59:307–316.
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