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Quarter of obese children missed by BMI tests could be at risk of diabetes and heart disease, scientists warn

As many as a quarter of obese children tested using the body mass index could be missed putting them at risk of developing diabetes and heart disease, scientists have warned.

While the BMI correctly identifies obese children it does not measure a child's percentage body fat.

The test, which uses a person's height and weight to determine whether they are obese, does not measure waist size.

The larger a person's waist measurement, the more likely they are to suffer obesity-related diseases, including type 2 diabetes and heart disease.

It is that failure of the test that has led scientists at the US's Mayo Clinic to warn relying on BMI alone could mean large numbers of children at risk of obesity-related disease could be missed under the radar.

Dr Francisco Lopez-Jimenez, senior study author from the Mayo Clinic, in Rochester, said: 'If we are using BMI to find out which children are obese, it works if the BMI is high, but what about the children who have a normal BMI but do have excess fat? 

'Those parents may get a false sense of reassurance that they do not need to focus on a better weight for their children.'  

In the study, published in Paediatric Obesity, the researchers used 37 eligible studies that evaluated 53,521 patients, aged between four and 18.

It is the first systematic review to assess the diagnostic performance of BMI to identify excess body fat as compared with other techniques considered as standard to measure obesity.

They include skin-fold thickness measurement and dual-energy X-ray absorptiometry - where X-ray beams can be used to measure body composition and fat content.

Dr Asma Javed, the study's first author, said: 'It is known that childhood obesity can lead to an increased risk of type 2 diabetes and cardiovascular disease.

'Our research raises the concern that we very well may be missing a large group of children who potentially could be at risk for these diseases as they get older.

'We hope our results shine a light on this issue for physicians, parents, public health officials and policymakers.'

While the BMI correctly identifies obese children it does not measure a child's percentage body fat.The test, which uses a person's height and weight to determine whether they are obese, does not measure waist size. The larger a person's waist measurement, the more likely they are to suffer obesity-related diseases
 
The findings of this study mirror results found in past research examining adults, carried out by Dr Lopez-Jimenez.

Over several years he and a team of researchers discovered what they call normal weight obesity.

It describes a situation where adults have a normal BMI but a large percentage of body fat.

Normal weight obesity shares some of the same risks as obesity, including pre-diabetes, metabolic syndrome and cardiovascular death.  

He said: 'The lesson is that we need additional research in children to determine the potential impact of having high fat in the setting of normal BMI to recognise this issue and perhaps justify the use of body composition techniques to detect obesity at an early stage.'

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