Anthropometric estimates of total and regional body fat in children aged 6-17 years

Equations based on anthropometric measurements for adipose tissue, body fat, or body density prediction in children and adolescents: a scoping review

PURPOSE

Assessing the body composition of children and adolescents is important to monitor their health status. Anthropometric measurements are feasible and less-expensive than other techniques for body composition assessment. This study aimed to systematically map anthropometric equations to predict adipose tissue, body fat, or density in children and adolescents, and to analyze methodological aspects of the development of anthropometric equations using skinfolds.

METHODS

A scoping review was carried out following the PRISMA-ScR criteria. The search was carried out in eight databases. The methodological structure protocol of this scoping review was retrospectively registered in the Open Science Framework ( https://osf.io/35uhc/ ).

RESULTS

We included 78 reports and 593 anthropometric equations. The samples consisted of healthy individuals, people with different diseases or disabilities, and athletes from different sports. Dual-energy X-ray absorptiometry (DXA) was the reference method most commonly used in developing equations. Triceps and subscapular skinfolds were the anthropometric measurements most frequently used as predictors in the equations. Age, stage of sexual maturation, and peak height velocity were used as complementary variables in the equations.

CONCLUSION

Our scoping review identified equations proposed for children and adolescents with a great diversity of characteristics. In many of the reports, important methodological aspects were not addressed, a factor that may be associated with equation bias.

LEVEL IV

Evidence obtained from multiple time series analysis such as case studies. (NB: dramatic results in uncontrolled trials might also be regarded as this type of evidence).

Predictive anthropometric models of total and truncal body fat in Chilean children

OBJECTIVES

This study aimed to develop predictive anthropometric models for total and truncal body fat in Chilean children using the following anthropometric measurements: weight, height, skinfold thickness, and circumference.

METHODS

This cross-sectional study included 669 Chilean children (12.0 y ± 1.3) in Tanner stage IV from the Growth and Obesity Chilean Cohort Study. Anthropometric measurements and dual-energy X-ray absorptiometry were determined to calculate total and truncal body fat. Prediction models were fitted by linear regression analysis.

RESULTS

The predictive equation for log total body fat (kg) was 0.449 + 0.049 (body mass index in kg/m²) + 0.018 (triceps skinfold in mm) + 0.012 (biceps skinfold in mm) + 0.019 (brachial circumference in cm) + 0.091 (sex: 1 = boy, 2 = girl) + 0.018 (age in y). The predictive equation for log truncal fat (kg) was -2.107 + 0.046 (waist circumference in cm) + 0.010 (subscapular skinfold in mm) + 0.259 (sex: 1 = boy, 2 = girl) + 0.006 (age in y). The test of concordance between the predictive equations of total and truncal body fat with gold standard was r = 0.85 and 0.91, respectively.

CONCLUSIONS

In Chilean children, the high correlation between observed and predicted values enabled us to develop predictive equations for total and truncal body fat for children.

Upper and lower limbs composition: a comparison between anthropometry and dual-energy X-ray absorptiometry in healthy people

The detection of changes in lean mass (LM) distribution can help to prevent disability. This study assessed the degree of association between anthropometric measurements and dual-energy X-ray absorptiometry (DXA) body composition (BC) parameters of the upper and lower limbs in a healthy general population and collected DXA age- and sex-specific values of BC that can be useful to build a reference standard.

PURPOSE

The primary aim of this study was to investigate the reliability of some widely available anthropometric measurements in the assessment of body composition (BC) at the limbs, especially in terms of muscle mass, in a large sample of healthy subjects of different age bands and sex, using fat mass (FM) and lean mass (LM) parameters derived by dual-energy X-ray absorptiometry (DXA) as the gold standard. The secondary aim was to collect DXA age- and sex-specific values of BC of left and right limbs (upper and lower) in a healthy Italian population to be used as reference standards.

METHODS

Two hundred fifty healthy volunteers were enrolled. Arm circumference (AC) and thigh circumference (ThC) were measured, and total and regional BC parameters were obtained by a whole-body DXA scan (Lunar iDXA, Madison, WI, USA; enCORE™ 2011 software version 13.6).

RESULTS

FM/LM showed only fair correlation with AC and ThC in females (r = 0.649 and 0.532, respectively); in males and in the total population, the correlation was low (r = 0.360 or lower, and p non-statistically significant). AC and ThC were not well representative of arms LM in both genders (females r = 0.452, males r = 0.530) independently of age. In general, men of all age groups showed higher values of LM and lean mass index (LMI) in both total and segmental upper and lower limbs. In males, the maximum LM and LMI were achieved in the fifth decade in both upper and lower limbs and then started to decrease with aging. In females, no significant modification with aging was identified in LM and LMI.

CONCLUSION

According to our results, anthropometry is not well representative of LM of arms in both genders, independently of age; therefore, a densitometric examination should be considered for a correct assessment of BC at limbs.

Body composition and prediction equations using skinfold thickness for body fat percentage in Southern Brazilian adolescents

OBJECTIVES

The purpose of this study was to: a) determine the nutritional status of Brazilian adolescents, and; b) present a skinfold thickness model (ST) to estimate body fat developed with Brazilian samples, using dual energy x-ray absorptiometry (DXA) as reference method.

METHODS

The main study group was composed of 374 adolescents, and further 42 adolescents for the validation group. Weight, height, waist circumference measurements, and body mass index (BMI) were collected, as well as nine ST-biceps (BI), triceps (TR), chest (CH), axillary (AX) subscapularis (SB), abdominal (AB), suprailiac (SI), medial thigh (TH), calf (CF), and fat percentage (%BF) obtained by DXA.

RESULTS

The prevalence of overweight in adolescents was 20.9%, and obesity 5.8%. Regression analysis through ordinary least square method (OLS) allowed obtainment of three equations with values of R2 = 0.935, 0.912 and 0.850, standard error estimated = 1.79, 1.78 and 1.87, and bias = 0.06, 0.20 and 0.05, respectively.

CONCLUSION

the innovation of this study lies in presenting new regression equations for predicting body fat in Southern Brazilian adolescents based on a representative and heterogeneous sample from DXA.

Are traditional body fat equations and anthropometry valid to estimate body fat in children and adolescents living with HIV?

The aim of this study was to assess the validity of traditional anthropometric equations and to develop predictive equations of total body and trunk fat for children and adolescents living with HIV based on anthropometric measurements. Forty-eight children and adolescents of both sexes (24 boys) aged 7-17 years, living in Santa Catarina, Brazil, participated in the study. Dual-energy X-ray absorptiometry was used as the reference method to evaluate total body and trunk fat. Height, body weight, circumferences and triceps, subscapular, abdominal and calf skinfolds were measured. The traditional equations of Lohman and Slaughter were used to estimate body fat. Multiple regression models were fitted to predict total body fat (Model 1) and trunk fat (Model 2) using a backward selection procedure. Model 1 had an R2=0.85 and a standard error of the estimate of 1.43. Model 2 had an R2=0.80 and standard error of the estimate=0.49. The traditional equations of Lohman and Slaughter showed poor performance in estimating body fat in children and adolescents living with HIV. The prediction models using anthropometry provided reliable estimates and can be used by clinicians and healthcare professionals to monitor total body and trunk fat in children and adolescents living with HIV.

Assessing Fat Mass of Adolescent Swimmers Using Anthropometric Equations: A DXA Validation Study

PURPOSE

The aim of the present study was to determine which of the published anthropometric equations is the most appropriate to estimate body-fat percentage (BF_%) in adolescent swimmers.

METHOD

Eighty-eight swimmers (45 boys, 43 girls) participated in this study. Following the recommendations of the International Society of the Advancement of Kinanthropometry, biceps, triceps, subscapular, iliac-crest, supraspinale, front-thigh, and medial calf skinfold thicknesses were measured. Waist, hip, midthigh, calf, relaxed arm, and arm flexed and tensed girths were also registered. BF_% was measured with dual-energy X-ray absorptiometry (DXA) to obtain the reference value. Existing anthropometric equations were applied, and BF_% results obtained from anthropometric equations were compared to DXA BF_% results with the modified Bland-Altman.

RESULTS

The Flavel, Durnin-Rahaman-Siri, and Durnin-Rahaman-Brozek were the only equations that did not demonstrate statistically significant differences when compared with DXA.

CONCLUSION

The present study showed that the best anthropometric equation from existing literature to estimate BF_% in swimmers is that proposed by Durnin-Rahaman (independently of applying the Siri or Brozek equation).

A PRISMA-driven systematic review of predictive equations for assessing fat and fat-free mass in healthy children and adolescents using multicomponent molecular models as the reference method

Simple methods to assess both fat (FM) and fat-free mass (FFM) are required in paediatric populations. Several bioelectrical impedance instruments (BIAs) and anthropometric equations have been developed using different criterion methods (multicomponent models) for assessing FM and FFM. Through childhood, FFM density increases while FFM hydration decreases until reaching adult values. Therefore, multicomponent models should be used as the gold standard method for developing simple techniques because two-compartment models (2C model) rely on the assumed adult values of FFM density and hydration (1.1 g/cm(3) and 73.2%, respectively). This study will review BIA and/or anthropometric-based equations for assessing body composition in paediatric populations. We reviewed English language articles from MEDLINE (1985-2012) with the selection of predictive equations developed for assessing FM and FFM using three-compartment (3C) and 4C models as criterion. Search terms included children, adolescent, childhood, adolescence, 4C model, 3C model, multicomponent model, equation, prediction, DXA, BIA, resistance, anthropometry, skinfold, FM, and FFM. A total of 14 studies (33 equations) were selected with the majority developed using DXA as the criterion method with a limited number of studies providing cross-validation results. Overall, the selected equations are useful for epidemiological studies, but some concerns still arise on an individual basis.