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Abstract
Background: This study compares prevalence estimates of underweight and excess weight among two groups of children from the Caribbean islands of St. Kitts and Trinidad, according to two Body Mass Index reference cut-points. The cut-points are based on growth references generated by the World Health Organization (WHO) and the International Obesity Task Force (IOTF).
Methods: Heights and weights were obtained from both cohorts of children from St. Kitts (n=189) and Trinidad (n=463) during the baseline assessment of the 'Improving the nutrition and health of CARICOM populations through sustainable agricultural technologies that increase food availability and diversity of food choices' (2011). Prevalence of underweight, overweight and obesity was estimated using the WHO (2007) and IOTF growth cut-offs.
Results: Irrespective of classification method the prevalence of overweight and obesity were high: St. Kitts-12.3% and 8.0% (WHO); 7.0% and 3.7% (IOTF), Trinidad-14.4% and 12.7% (WHO) and 12.3% and 10.3% (IOTF), respectively. Underweight estimates also varied: St. Kitts-2.1% (WHO); 25.7% (IOTF), Trinidad-5.0% (WHO) and 13.6% (IOTF), respectively.
Conclusion: There is a lack of consistency between the two main international growth references in accessing weight status in children and adolescents. The IOTF growth reference produces higher estimates of underweight compared to the WHO and lower rates of overweight and obesity, which were all statistically significant. However there is virtually no stunting in the populations, with underweight children appearing to be as tall as children in other weight categories. Therefore the question of dual burden of underweight and excess weight in the groups from St. Kitts and Trinidad remains unclear. Therefore when interpreting the prevalence estimates of underweight, overweight and obesity for children it is paramount to consider the weight classification used.





