Paper Title
Diagnostic Comparison of Centres for Disease Control and Prevention and International Obesity Task Force Criteria for Obesity Classification in Nigerian and South African Children

Abstract
Globally, childhood overweight and obesity have increased substantially leading to high prevalence rates of noncommunicable diseases. Obesity does not only persist in high-income countries, but is also prevalent in middle to lower income nations. This study compared the diagnostic criteria of the Centres for Disease Control and Prevention (CDC) and International Obesity Task Force (IOTF) for obesity classification in Nigerian and South African children. Anthropometric measurements were taken using standardize protocol and used to estimate body mass index (BMI) and waist-to-hip ratio (WHR). BMI for age and country was used to classify the children according to weight categories, whilst WHR assessed fat distribution among the children and percentage of body fat (% BF) indicated adiposity. BMI, %BF, WHR and sum of skinfolds (SSK) were examined for boys and girls according to age category. The results showed that 1.1% (IOTF cut-off point) and 9.9% (CDC criteria) of Nigerian children were overweight. Corresponding data for South African children were 1.8% (IOTF) and 10.0% (CDC). Obesity estimates for Nigerian and South African children slightly varied for IOTF classification (1.1; 0.7%), but were similar when CDC classification was used (5.1%). The IOTF results showed that South African children were more underweight (74.6%) compared to Nigerian children (70.6%). In contrast, the CDC standard indicated strikingly lower incidence of underweight among the South African (4.9%) and Nigerian (4.8%) children. The lack of consistency in body weight classification using CDC and IOTF reference standards raises the question as to the right standard to use to evaluate weight abnormalities in children and adolescents. The choice of cut-off point in assessing overweight and obesity in childhood and adolescence should be based on sound judgment as this could undermine the integrity of epidemiological research data. Keywords - CDC, IOTF, Nigeria, South Africa.