Abstract
Obesity is becoming global problem among youngsters, with rise in incidence of childhood obesity throughout the world. This paper fine-tunes earlier mathematical solutions of childhood obesity, proposed during 2013-2016, by fitting a parabolic curve to desired percentile trajectories originating at the age of the most-recent checkup and terminating at 10 years (lower limit of the peripubertal phase). Both height and mass percentiles are made to approach the reference percentile (maximum of height percentile at the most-recent checkup, the mid-parental percentile, computed from the target height, and the army-cutoff percentile, 2.72 for the Pakistani boys and 19.36 for the Pakistani girls), as the child nears 10th birthday. As compared to ‘Growth-and-Obesity Scalar-Roadmap’, proposed last year, which tries to cover up height and mass deficiencies within half-a-year, ‘Growth-and-Obesity Vector-Roadmap’, proposed in this paper, sets up softer targets for height and mass management during a time span of 6 months. These targets are expected to avoid unwanted stress on the body of a youngster and are in harmony with the fact that height gain represents tissue synthesis and must be managed through a process, which is quasi-static. ‘Growth-and-Obesity Vector-Roadmap’ is constructed from a series of height and mass measurements to least counts of 0.005 cm and 0.005 kg, respectively, by reproducible anthopometrists following laiddown, standardized protocols — child barefoot, stripped to short underpants, elbows and knees not flexed, instructed to inhale completely. These measurements are fed in software to generate profiles for each checkup from the first to the mostrecent using ‘Extended CDC Growth Charts and Tables’, which have heights and masses listed for extreme percentiles — 0.01th, 0.1 th and 1st as well as 99th, 99.9th and 99.99th, in addition to entries between 3rd and 97th percentiles. Values of height and mass percentiles at age of the most-recent checkup as well as the reference percentile are substituted in mathematical framework of the vector model to draw the desired percentile trajectories. Height- and mass-month-wise targets are determined by reading off values, where these trajectories intersect with lines parallel to the percentile (vertical) axis. These lines cross the age (horizontal) axis at the ages for which targets are proposed.
