International BMI-for-age references underestimate thinness and overestimate overweight and obesity in Bolivian adolescents.

BACKGROUND: Since no growth standards for adolescents exist and a single reference applicable everywhere is still in debate, it is recognized that the best reference should be derived from the growth pattern of the healthy population that will use it. In 2007 a study developed references for body mass index for 12th to 18th y Bolivian school adolescent (BAP. OBJECTIVES: To compare nutritional status outcomes applying BMI references from the BAP, the Center for Disease Control and Prevention CDC 2000, the International Task Force (IOTF), and the 2007 WHO, to determine appropriateness of use in Bolivian adolescents. SUBJECTS/METHODS: References were applied in 3306 adolescents, 45.0% male, 55% female, 12th to 18th y selected from a nationally representative sample. RESULTS: Main findings reveal that the CDC and the 2007 WHO underestimate underweight (p<0.001) and the three international references overestimate overweight (p<0.001) with variation between ages and gender. CONCLUSIONS: Bolivian health providers are advised to replace CDC, OITF and 2007 WHO references for the use of BAP in Bolivia which reflects its healthy adolescent population growth pattern. International references may lead to incorrect conclusions when applied on Bolivian adolescents. They could deflect efforts from population which need prompt intervention and mislead treatments and budget to unnecessary ones. We recommend validation of international references where appropriate until a standard is released.

Anthropometry of height, weight, arm, wrist, abdominal circumference and body mass index, for Bolivian adolescents 12 to 18 years: Bolivian adolescent percentile values from the MESA study.

Anthropometry is important as clinical tool for individual follow-up as well as for planning and health policy-making at population level. Recent references of Bolivian Adolescents are not available. The aim of this cross sectional study was to provide age and sex specific centile values and charts of Body Mass Index, height, weight, arm, wrist and abdominal circumference from Bolivian Adolescents. Data from the MEtabolic Syndrome in Adolescents (MESA) study was used. Thirty-two Bolivian clusters from urban and rural areas were selected randomly considering population proportions, 3445 school going adolescents, 12 to 18 y, 45% males; 55% females underwent anthropometric evaluation by trained personnel using standardized protocols for all interviews and examinations. Weight, height, wrist, arm and abdominal circumference data were collected. Body Mass Index was calculated. Smoothed age- and gender specific 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th and 97th Bolivian adolescent percentiles(BAP) and Charts(BAC) where derived using LMS regression. Percentile-based reference data for the antropometrics of for Bolivian Adolescents are presented for the first time.

Prevalence of overweight in Bolivia: data on women and adolescents.

Secondary analysis of Bolivian Demographic and Health Surveys 1994, 1998 and 2003 revealed a steady raising trend in levels of overweight and obesity among women in childbearing age (20-45 years), reaching 30% and 15% respectively in 2003. Adolescents' cross-sectional data suggest that overweight and obesity are mainly found in urban areas. Applying the Bolivian body mass index-for-age reference, obesity reached 5% in adolescents, while overweight affects 14% of adolescents. This overview highlights the importance of including the prevention of weight gain among the public health nutrition policies in Bolivia.