In Reply We agree with Drs Stefan and Schulze that there are limitations of BMI as a surrogate of adiposity in our study of the prevalence of obesity among children aged 2 through 4 years enrolled in WIC.1
The association between height and excess weight (relative to the sex-, age-, and height-specific median weight of a reference population) among children has been known for more than 75 years.2 However, we believe that the reported correlation of r = 0.47 may overstate the magnitude of the association between BMI and height. Based on our analyses of other data,3 this may be the unadjusted correlation between height and BMI over a wide range of ages or among children between the ages of 8 and 10 years. One method to control for this association is to transform BMI and height into z scores that account for sex and age differences.
Freedman DS, Pan L, Blanck HM. Trends in Obesity Among Low-Income Young Children—Reply. JAMA. 2019;322(17):1714–1715. doi:10.1001/jama.2019.14247
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