Comparison of Slovak reference values for anthropometric parameters in children and adolescents with international growth standards: Implications for the assessment of overweight and obesity

Abstract

Aim To compare the national reference percentile values for body height, weight, and body mass index (BMI) of children and adolescents in Slovakia with international standards and to analyze growth trends in this population. Methods The study was designed as a repeated cross-sectional survey. Two nationwide anthropometric surveys (NAS) performed in 2001 and 2011 assessed body weight, height, and BMI of 38 692 children aged 7 to 18 years. Age- and sex-specifıc smoothed percentiles were generated with the lambda-mu-sigma method. Slovak standards were compared with World Health Organization (WHO) 2007 z-scores and International Obesity Task Force (IOTF) standards. Results Medians of body height corresponded to the 75th-85th percentile of the WHO 2007 standards. The secular trend of height increase was attenuated, and the final body height did not change between NAS 2001 and NAS 2011. The cut-off BMI values for obesity, set at the 97th percentile for age <14 years, were higher across age ranges than WHO 2007 standards but lower than IOTF standards. Obesity prevalence, relatively low in 2001 (<3%), doubled during the following decade (P< 0.001), with the highest values (4.8%-7.6%) observed in children aged up to 13 years. Conclusion NAS 2001 data were chosen as national growth standards, as these data were not influenced by the obesity rates increase in the period between the surveys. BMI cut-offs were lower than those in most European countries. Obesity proportions in prepubertal and pubertal boys might be overestimated when WHO 2007 cut-offs are used.