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Children at High Risk for Overweight: A Classification and Regression Trees Analysis Approach
Article first published online: 6 SEP 2012
2005 North American Association for the Study of Obesity (NAASO)
Volume 13, Issue 7, pages 1270–1274, July 2005
How to Cite
Toschke, A. M., Beyerlein, A. and Von Kries, R. (2005), Children at High Risk for Overweight: A Classification and Regression Trees Analysis Approach. Obesity Research, 13: 1270–1274. doi: 10.1038/oby.2005.151
- Issue published online: 6 SEP 2012
- Article first published online: 6 SEP 2012
- Received for review November 16, 2004; Accepted in final form May 02, 2005
- prevention and control;
- energy metabolism;
- feeding behavior
Objective: Early identification of children at high risk for childhood overweight is a major challenge in fighting the obesity epidemic. We tried to identify the most powerful set of combined predictors for childhood overweight at school entry.
Research Methods and Procedures: A classification and regression trees analysis on risk factors for childhood overweight in 4289 children 5 to 6 years of age participating in the obligatory school entry health examination 2001/2002 in Bavaria, Germany, was performed. Parental questionnaires asked for children's weight at birth and 2 years, breastfeeding history, maternal smoking in pregnancy, parental education, parental overweight/obesity, nationality, and number of older siblings. Overweight was defined according to sex- and age-specific BMI cut-points proposed by the International Obesity Task Force.
Results: Prevalence of overweight was 11% among the entire study population. Although high early weight gain >10, 000 grams was found in about one-half of the overweight children, its positive predictive value reached only 25%, indicating that one of four children with a high early weight gain is overweight at school entry. The best reliable set of predictors included high early weight gain and obese parents and accounted for a likelihood ratio of 3.6, with a corresponding positive predictive value of 40%, and was found in 4% of all children.
Discussion: A combination of predictors available at 2 years of age could improve predictability of overweight at school entry. However, corresponding low positive predictive values indicate a precision of the prediction that might be insufficient for targeting intervention programs for identified high-risk children.