INT. J. BIOL. BIOTECH. 14 (4): 485-502, 2017 *Correspondence: Prof. Dr. S. Arif Kamal (http://ngds-ku.org/kamal), PhD (Mathematical Neuroscience), MA, Johns Hopkins, Baltimore, MD, United States; Director, SF-Growth-and-Imaging Laboratory and Project Director, the NGDS Pilot Project (http://ngds-ku.org); Ex-Chairman, Department of Health, Physical Education and Sports Sciences; Ex-Dean, Faculty of Science and Faculty of Engineering; Ex-Acting Vice Chancellor, B-19, Staff Town, University of Karachi, Karachi 75270, Pakistan. INTEGRATION OF BMI-BASED-OPTIMAL MASS AND HEIGHT-PERCENTILE- BASED-OPTIMAL MASS TO PROPOSE THE SIXTH-GENERATION SOLUTION OF CHILDHOOD OBESITY Syed Arif Kamal* SF-Growth-and-Imaging Laboratory, the NGDS Pilot Project, University of Karachi, Karachi 75270, Pakistan; e-mail: sakamal@uok.edu.pk ABSTRACT Childhood obesity is a manifestation of discrepancy between energy intake and expenditure, which disturbs the original steady state causing to form a fresh steady state at an elevated level, with the consequence of increased body-fat storage. Balance must be established between tissue synthesis, resulting in gain of height, and fat storage, resulting in gain in mass, in order to avert childhood obesity. Many definitions of childhood obesity are available. During the last five years, our group put forward the First- to the Fifth- Generation Solutions of Childhood Obesity. The last one consisted of a mathematical definition of childhood obesity, related to the logical definition. This paper proposes a range for 6 monthly mass-management targets instead of single values, by fitting two parabolic curves, both originating at the age of the most-rent checkup. One of these curves meets tangentially, at the age of 10 years, the straight line, which represents reference percentile at the age of the most-recent checkup, whereas the other curve meets the straight line, which represents percentile of BMI-based-optimal mass at the age of the most-rent checkup. The range is obtained by 6 line segments drawn parallel to vertical (percentile) axis drawn at the date of check up for the next 6 successive months. The range of mass-management goals may render the task of optimal-mass management easier instead of a single value. Keywords: Growth-and-Obesity Vector-Roadmap 2.0, definitions of childhood obesity, height and mass management, instantaneous obesity, true obesity, instantaneous wasting, true wasting LIST OF ABBREVIATIONS cm: centimeter(s) • m: meter(s) • ft: foot(feet) • in: inch(es) • lb: pound(s) • oz: ounce(s) • kg: kilogram(s) AC: Army-Cutoff EC III: Energy-Channelization III AM: Acute Malnutrition MP: Mid-Parental BMI: Body-Mass Index NGDS: National Growth and Developmental Standards CDC: Centers for Disease Control and Prevention, for the Pakistani Children http://ngds-ku.org Atlanta, GA, United States http://www.cdc.gov ON: Over-Nutrition ECOG: European Childhood Obesity Group P: Percentile EC I: Energy-Channelization I SGPP: Sibling Growth Pilot Project EC II: Energy-Channelization II UN: Under-Nutrition INTRODUCTION Childhood obesity is the outcome of a complex web of biological, cultural, environmental and psychological influences. It has become a universal problem, associated with severe physical, psychological and social consequences. The complications associated with childhood obesity include cardiovascular, gastrointestinal, musculoskeletal, neurologic, psychosocial, pulmonary and renal problems. Childhood, being a key period of life for formation of health habits, is the ideal period to diagnose the condition at an early stage to plan and to implement efficient and effective intervention strategies. In this work, 6 monthly targets for mass management of children are simplified by suggesting a range instead of a single value. In this process, a unified picture of the two optimal masses, one of them height-percentile-based optimal mass and the other BMI-based-optimal mass, is obtained. DEFINITIONS OF CHILDHOOD OBESITY Obesity is a manifestation of discrepancy between intake and output of energy. The original steady state disappears and a new one forms at a higher level. The net result is increased body-fat storage (Wabitsch, 2000). One must be aware of the fact that energy expenditure varies between school-going months and holiday months (Zinkel et al., 2013). Poskitt (1995), representing European Childhood Obesity Group (ECOG), stated that researchers were bothered by absence of a proper definition of childhood obesity. She defines relative BMI (body-mass index) as BMI of a 50 th centile youngster. BMI was renamed from Quetelet index in 1972 (Keys et al., 1972). The expression   ( / 2 h repre-