MULT: An allometric body mass index (ABMI) reference to assess nutritional status of multi-ethnic children and adolescents

ObjectivesTo develop an allometric body mass index (ABMI) reference that adjusts the weight in relation to height, taking into account the changes during development (MULT ABMI reference), and to compare it with international BMI references. MethodsThe MULT ABMI reference was constructed through the LMS method, calculated with 65 644 ABMI observations of 17 447 subjects aged 5-22 years, from the United Kingdom, Ethiopia, India, Peru, Vietnam, Portugal, and Brazil. The M, S, and L curves of the MULT ABMI reference were compared with the curves of the MULT, World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF), and Dutch Growth Study (DUTCH). ResultsThe greater differences in the M curve between MULT ABMI and WHO, CDC, IOTF, DUTCH, and MULT BMI references were around puberty (138 to 150 months for boys; 114 to 132 for girls). MULT ABMI presented S values similar to IOTF and DUTCH BMI references for boys 60 to 114 months and then became higher, approaching the MULT BMI S values from 198 to 240 months. For girls the MULT ABMI S values were close to the IOTF, CDC, and DUTCH from 60 to 110 months, and then became higher, approaching the MULT BMI S values until 240 months. ConclusionMULT ABMI presented an advantage in comparison to the existing BMI references because it takes into account the growth changes during puberty and is a new option to assess the nutritional status of multi-ethnic populations.