IOTF thresholds for overweight and obesity and their relation to metabolic risk in children (EarlyBird 20).

The International Obesity TaskForce has published paediatric cutoffs from the age of 2 years for overweight and obesity, based on adult thresholds. We question their rationale. The adult cutoffs were based on known health risk; the children's were not. Data from the EarlyBird Study show that BMI category for overweight and obesity in young children are poor markers of insulin resistance and, by implication, of metabolic risk and diabetes. Moreover, BMI is known to track poorly from early childhood to adulthood. We know even less about the tracking of insulin resistance and other indices of metabolic risk from the earliest years. Until we understand more about which children acquire such risk factors, any such thresholds for overweight and obesity should be used with caution in the very young, as they may unnecessarily stigmatise the heavier child.