To describe (1) the prevalence of overweight and obesity and theirassociation with physical activity; (2) the effect of different cut-offpoints for body mass index (BMI) on weight status categorisation; and (3)associations of weight status with perceptions of body size, health and dietquality.

A cross-sectional study.

Secondary schools in Barbados.

A cohort of 400 schoolchildren, 11–16 years old, selected to studyphysical education practices.

Prevalence of overweight (15% boys; 17% girls) and obesity (7% boys; 12%girls) was high. Maternal obesity, as defined by the International ObesityTask Force (IOTF) BMI cut-off points, predicted weight status such thatreporting an obese mother increased the odds of being overweight by 5.25(95% confidence interval: 2.44, 11.31). Physical activity was inverselyassociated with weight status; however levels were low. Recreationalphysical activity was not associated with weight status in either category.Overweight subjects tended to misclassify themselves as normal weight andthose who misclassified perceived themselves to be of similar health statusto normal-weight subjects. The National Center for Health Statistics andIOTF BMI cut-off points produced different estimates of overweight andobesity.

Our findings suggest that inadequate physical activity and ignorance relatedto food and appropriate body size are promoting high levels of adipositywith a strong contribution from maternal obesity, which may be explained byperinatal and other intergenerational effects acting on both sexes.Prevalence studies and local proxy tools for adiposity assessment areneeded.

There are no data on optimal cut-off points to classify obesity among OmaniArabs. The existing cut-off points were obtained from studies of Europeanpopulations.

To determine gender-specific optimal cut-off points for body mass index(BMI), waist circumference (WC) and waist-to-hip ratio (WHR) associated withelevated prevalent cardiovascular disease (CVD) risk among Omani Arabs.

A community-based cross-sectional study.

The survey was conducted in the city of Nizwa in Oman in 2001.

The study contained a probabilistic random sample of 1421 adults aged≥20 years. Prevalent CVD risk was defined as the presence of atleast two of the following three risk factors: hyperglycaemia, hypertensionand dyslipidaemia. Logistic regression and receiver-operating characteristic(ROC) curve analyses were used to determine optimal cut-off points for BMI,WC and WHR in relation to the area under the curve (AUC), sensitivity andspecificity.

Over 87% of Omanis had at least one CVD risk factor (38% had hyperglycaemia,19% hypertension and 34.5% had high total cholesterol). All three indicesincluding BMI (AUC = 0.766), WC (AUC = 0.772) and WHR (AUC = 0.767)predicted prevalent CVD risk factors equally well. The optimal cut-offpoints for men and women respectively were 23.2 and 26.8 kgm−2 for BMI, 80.0 and 84.5 cm for WC, and 0.91 and0.91 for WHR.

To identify Omani subjects of Arab ethnicity at high risk of CVD, cut-offpoints lower than currently recommended for BMI, WC and WHR are needed formen while higher cut-off points are suggested for women.