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Percentage of overweight is overestimated in children of short stature.

BACKGROUND
The prevalence of overweight and obesity has increased not just in adults, but also in children. In Japan, percentage of overweight (POW) is widely used for the estimation and assessment of percent body fat (PBF) for children. We examine whether or not there is a difference between normal height and short stature children in terms of the relationship between POW and PBF.


METHODS
A total of 321 children of normal height (163 boys, 158 girls) and 106 children with short stature (78 boys, 28 girls) were assessed according to sex. POW was used to represent the degree of obesity. PBF of the total body was examined by dual energy X-ray absorptiometry (DXA).


RESULTS
According to their PBF examined by DXA, normal height subjects of both sexes were classified as obese if they had a POW of more than 20%, as per the definition. However, short stature subjects of both sexes were not classified as obese until the boys had a POW of 40%, and girls had a POW of 35%, respectively. Thus, overweight or obesity is overestimated in short stature children in both males and females with the rule "POW above 20% is recognized as obesity".


CONCLUSION
POW is commonly considered as a good surrogate measure to determine overweight and obesity in children of both sexes. However, this study has clarified that body fat accumulation is overestimated in children with short stature when using the POW measurement.