Weight-for-length ratio or body mass index - which one is the best predictor of future overweight and obesity?

Abstract

Anthropometric references play a central role in identifying children at risk of overweight and obesity. However, there is still no consensus on whether body mass index (BMI) or weight/length ratio (W/L ratio) serves as the superior predictor of obesity in early childhood. This study aims to determine which of these two measurements is the more reliable predictor of future obesity. Retrospective and observational cohort study, that included children followed in consultation from a level II hospital, currently aged between 5 and 15 years. Inclusion criteria required children who had anthropometric records at 0, 2, and 5 years old, as well as at least one record at 6, 12, or 18 months. A correlation analysis was conducted between the BMI z-score (z-BMI) and the W/L ratio z-score (z-W/L). Logistic regression was employed to assess the association between z-BMI and z-W/L up to 2 years with the presence of overweight/obesity at 5/6 years. The prevalence of overweight and obesity by 5/6 years old was 12% and 13%, respectively. There was a strong correlation between z-BMI and z-W/L (r = 0.908 - 0.997, p