The estimate of agreement between the three different classification systems for determining students nutritional status

Abstract

The aim of this paper is to determine the agreement in assessing the nutritional status of adolescents using the classification systems of the US Centers for Disease Control and Prevention (CDC), the International Obesity Task Force (IOTF) and the World Health Organization (WHO). Non-experimental observation was performed on a sample of 213 first grade high school students from Banja Luka, Republika Srpska, Bosnia and Herzegovina, with an average age of 15.67 years, of which 89 (41.8%) were male and 124 female (58.2%). Each of the subjects was categorized according to a unique scale, as underweight, normal weight, overweight or obese, using IOTF, CDC and WHO reference values. The Cohen kappa coefficient (k) was used to estimate the agreement of the three classification systems in determining nutritional status. The prevalence of underweight was found to be highest according to IOTF standards in both sexes, while the prevalence of overweight was highest according to WHO references. The differences between analyzed three systems are not large for the obese category, especially in girls. In boys, CDC references show a slightly higher percentage of obese compared to the other two systems. The agreement between the classification systems ranges from 0.83 to 0.86 on the total sample of respondents based on all nutritional status categories, which can be considered a reliable parameter for further monitoring, comparison and prescribing of measures.