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Child Weight Status Calculation YH National Obesity Forum 18-Feb-2010

Objectives. Market to you a calculator for determining child weight statusIdentify issues / barriers and answer questionsKeep you engagedVaguely keep to time. Weight Status. Strong association between weight status and health / diseaseSignificant (public) health issueCategorisation:Underweight / thinNormal weightOverweightObeseMorbidly obese.

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Child Weight Status Calculation YH National Obesity Forum 18-Feb-2010

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    1. Child Weight Status Calculation Y&H National Obesity Forum 18-Feb-2010 Dr Rory O’Conor Consultant in Public Health Wakefield District PCT Yorkshire & Humber PHO

    2. Objectives Market to you a calculator for determining child weight status Identify issues / barriers and answer questions Keep you engaged Vaguely keep to time

    3. Weight Status Strong association between weight status and health / disease Significant (public) health issue Categorisation: Underweight / thin Normal weight Overweight Obese Morbidly obese

    4. Measurement of weight status Visual judgement “looks fat”, “looks thin” Quantification Body Mass Index (height/weight squared) Waist circumference Skinfold thickness Other measures

    5. Body Mass Index Has stood test of time Research body of evidence Adults: Underweight BMI < 18.5 m/kg2 Overweight BMI > 25 m/kg2 Obese BMI > 30 m/kg2 Morbidly Obese BMI > 40 m/kg2 Simple numbers, relatively simple formula

    6. Example Mother and daughter Mother age 25 yrs, height 5’4” = 1.63m 46 kg = 6st 5lb Daughter age 10 yrs, height 4’11” = 1.2m 25 kg = 3st 8lb What is the weight status of the mother and her daughter? Ps: after next slide you decide Underweight, normal, overweight/obese

    7. Example Mother and daughter Mother age 25 yrs, height 5’4” = 1.63m 46 kg = 6st 5lb BMI = 46/(1.63*1.63) = 17.3 Daughter age 10 yrs, height 4’11” = 1.2m 25 kg = 3st 8lb BMI = 25/(1.2*1.2) = 17.4 What is the weight status of the mother and her daughter?

    8. BMI in children Children grow ! Describe / show child height/weight charts Ideal BMI keeps changing What to do? Visual estimation (v poor guide) Comparison of centile lines for weight and height Child BMI chart algorithms

    9. Example Mother and daughter Mother age 25 yrs, height 5’4” = 1.63m 46 kg = 6st 5lb BMI = 46/(1.63*1.63) = 17.3 Daughter age 10 yrs, height 4’11” = 1.2m 25 kg = 3st 8lb BMI = 25/(1.2*1.2) = 17.4 What is the weight status of the mother and her daughter?

    11. Algorithms for child BMI Charts from Child Growth Foundation Expensive / copyright / not electronic Tim Cole / IOTF – LMS addin for Excel Requires analytical skills Unsuitable for health visitors, teachers, parents and children Unsuitable for incorporating into programs Rory O’Conor derived formula Complicated formula Derived from LMS data using regression techniques Usable direct in Excel or clinical systems US CDC Teen and Child BMI Calculator Another online calculator using LMS method and CDC2000 data

    12. Example Mother and daughter Mother age 25 yrs, height 5’4” = 1.63m 46 kg = 6st 5lb BMI = 46/(1.63*1.63) = 17.3 Daughter age 10 yrs, height 4’11” = 1.2m 25 kg = 3st 8lb BMI = 25/(1.2*1.2) = 17.4 What is the weight status of the mother and her daughter?

    13. Instances of Rory’s formula Original spreadsheet Demo JAVA program Demo Download and applet Available for download from www.btinternet.com/~rory.oconor/obesity/

    14. Requires JAVA – call IT support

    15. Usability Formula is complex (but accurate) and can be hidden Excel spreadsheet & JAVA program usable By all, even children and parents Greater access and feedback about “correct” weight status, greater opportunity for change Formula copes with change as child ages and grows Benefit – access to accurate child weight status

    16. Future potential Use of formulae / programs on other websites Incorporation of formula into clinical systems General Practice Child Health Education Incorporation into other products iPoD apps Scales WII boards etc Internationalisation and improvement of JAVA program Addition of centile and z score values

    17. Conclusion Formula for adult equivalent BMI provides an accurate and usable measurement of child weight status The formula is already available in a spreadsheet and JAVA calculator The formula can potentially be used in clinical systems and user equipment such as scales

    18. Request Use it Research interest Write article in journal about use Marketing Get into GP/Child health systems Get into scales Website Use it

    19. Contact details Website www.btinternet.com/~rory.oconor/obesity/ Email roc501@york.ac.uk Rory.oconor@wdpct.nhs.uk

    20. Technical Annex See website for further details Formula calculates “adult equivalent BMI” which is the BMI that a child maintaining the same centile would have at age 18 years Formula has 18 terms, non-linear regression Formula derived using 3474 data points for ages 2 to 18 years and adult BMI between 17 to 40 R squared 0.995, max error BMI +/- 2.6 Recommendation: Independent quality assurance

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