Overweight and obesity among Saudi children: Monitoring of the trend is what matters most.

We thank Dr. Al-Mendalawi for his interest in our paper published recently in SJG[1] and for his valuable comment.

In his letter to the editor[2] the author states that the prevalence of overweight (13.4%) and obesity (18.2%) obtained from our large school-based cohort study among Saudi children and adolescents in Riyadh were overestimated because we used the World Health Organization (WHO) body mass index (BMI) percentile standards instead of the recently published Saudi percentile standards.[3] One of the major objectives of our study was to determine the trend in childhood obesity in Riyadh city over the past 2 decades because monitoring of trends of childhood obesity is crucial for developing and evaluating success of interventions for prevention of obesity in any country. To achieve this objective, we had to compare our results with previous local studies that published data comparable to our study in terms of geography, sample age (6–16 years), and use of similar references and cut offs to define obesity. Since no previous local studies used the Saudi percentile standards for BMI, we chose to use the WHO BMI percentile standards because they have been recommended and widely used in several studies around the world. The use of WHO BMI percentile standards also offered us the advantage of comparison of our results with others regionally and internationally. The 2 main sets of growth charts commonly used worldwide, the WHO and Center for Disease Control (CDC) standards, differ in that the CDC charts represent a growth reference based on the general United States population[4] and the WHO growth standards, on the other hand, represent growth of children in several populations around the world.[5] Therefore, growth estimates were higher with the CDC growth charts than WHO growth standards,[6] which are thought to be more close to the actual growth estimates in different populations than the CDC growth standards.

We do concur with Dr. Al-Mendalawi that the use of national BMI percentile standards could better estimate the actual prevalence of overweight and obesity among Saudi children; however, whether the WHO BMI percentile standards overestimate the overweight and obesity rates among Saudi children necessitates and prompt us to use the Saudi BMI percentiles to estimate BMI prevalence rates in our study cohort and compare them to the prevalence rates already obtained by using the WHO percentile standards.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.