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Percentage body fat in apparently healthy school children from northern India

Indian Pediatrics volume 50, pages 859–866 (2013)Cite this article

Abstract

Context

Increased prevalence of obesity in childhood and adolescence, defined by the use of body mass index (BMI), has drawn attention towards direct measurement of body fat

Objective

To develop age-and sex-specific reference distribution of body fat in apparently healthy North-Indian children in the age group of 7–17 years and to assess agreement between obesity (defined by BMI) and excess body fat

Design

Study subjects for this cross sectional study included1640 apparently healthy school children (825 boys; 815 girls) aged 7–17 years. Total body fat was measured by dual energy X-rays absorptiometry (DXA). The excess body fat by DXA was defined by two methods, prevalence matching and with the use of 85th and 95th centile cutoffs.

Results

The mean ± SD, 3rd, 10th, 25th, 50th, 75th, 90th and 97th centile values of percentage body fat (PBF) are presented. PBF was highly correlated with BMI in both boys and girls (all boys: r=0.76, P<0.0001; all girls r=0.81, P<0.0001). There was no significant difference noted in PBF between boys and girls at the age of 7–8 years. From 9 years onwards, girls had significantly higher PBF than boys. Moderate degree of agreement was observed between BMI and PBF by DXA by both methods.

Conclusions

Smoothened reference distribution of PBF for North-Indian children and adolescents in Delhi are provided. Indian children accumulate more body fat during peri-pubertal years in comparison with US children.

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References

  1. de Onis M, Blössner M & Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr. 2010:92;1257–1264.

    PubMed  Article  Google Scholar 

  2. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000:320;1240–1243.

    PubMed  Article  CAS  Google Scholar 

  3. Freedman DS, Wang J, Maynard LM, Thornton JC, Mei Z, Pierson Jr RN, et al. Realtion of BMI to fat and fat free mass among children and adolescents. Int J Obesity 2005: 29;1–8.

    Article  CAS  Google Scholar 

  4. Field AE, Laird N, Steinberg E, Fallon E, Semega-Janneh M, Yanovski JA. Which metric of relative weight best captures body fatness in children? Obes Res. 2003:11;1345–1352.

    PubMed  Article  Google Scholar 

  5. Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy X-ray absorptiometry for total-body and regional bonemineral and soft-tissue composition. Am J Clin Nutr. 1990:51;1106–1112.

    PubMed  CAS  Google Scholar 

  6. Fields DA, Goran MI. Body composition techniques and the four-compartment model in children J Appl Physiol. 2000:89;613–620.

    PubMed  CAS  Google Scholar 

  7. Cameron N, Griffiths PL, Wright MM, Blencowe C, Davis NC, Pettifor JM, et al. Regression equations to estimate percentage body fat in African prepubertal children aged 9 y. Am J Clin Nutr. 2004:80;70–75.

    PubMed  CAS  Google Scholar 

  8. Eisenmann JC, Heelan KA, Welk GJ. Assessing body composition among 3 to 8-year-old children: anthropometry, BIA, and DXA. Obes Res. 2004:12;1633–1640.

    PubMed  Article  Google Scholar 

  9. Elberg J, McDuffie JR, Sebring NG, Salaita C, Keil M, Robotham D, et al. Comparison of methods to assess change in children’s body composition. Am J Clin Nutr. 2004:80;64–69.

    PubMed  CAS  Google Scholar 

  10. Frisard MI, Greenway FL, Delany JP. Comparison of methods to assess body composition changes during a period of weight loss. Obes Res. 2005:13;845–854.

    PubMed  Article  Google Scholar 

  11. Going SB, Massett MP, Hall MC, Bare LA, Root PA, Williams DP, et al. Detection of small changes in body composition by dual-energy X-ray absorptiometry. Am J Clin Nutr. 1993:57;845–850.

    PubMed  CAS  Google Scholar 

  12. Johansson AG, Forslund A, Sjödin A, Mallmin H, Hambraeus L, Ljunghall S. Determination of body composition a comparison of dual-energy X-ray absorptiometry and hydrodensitometry. Am J Clin Nutr. 1993:57;323–326.

    PubMed  CAS  Google Scholar 

  13. Boot AM, Bouquet J, de Ridder MA, Krenning EP, de Muinck Keizer-Schrama SM. Determinants of body composition measured by dual-energy X-ray absorptiometry in Dutch children and adolescents. Am J Clin Nutr. 1997:66;232–238.

    PubMed  CAS  Google Scholar 

  14. Freedman DS, Sherry B. The validity of BMI as an indicator of body fatness and risk among children. Pediatrics. 2009:124;S23–S34.

    PubMed  Article  Google Scholar 

  15. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004:363;157–163.

    Article  Google Scholar 

  16. Shaw NJ, Crabtree NJ, Kibirige MS, Fordham JN. Ethnic and gender differences in body fat in British schoolchildren as measured by DXA. Arch Dis Child. 2007:92;872–875.

    PubMed  Article  Google Scholar 

  17. Freedman DS, Wang J, Thornton JC, Mei Z, Pierson RN Jr, Dietz WH, et al. Racial/ethnic differences in body fatness among children and adolescents. Obesity (Silver Spring). 2008:16;1105–1111.

    PubMed  Article  Google Scholar 

  18. Chatterjee S, Chatterjee P, Bandyopadhyay A. Skinfold thickness, body fat percentage and body mass index in obese and non-obese Indian boys. Asia Pac J Clin Nutr. 2006:15;231–235.

    PubMed  Google Scholar 

  19. Kehoe SH, Krishnaveni GV, Lubree HG, Wills AK, Guntupalli AM, Veena SR, et al. Prediction of body-fat percentage from skinfold and bio-impedance measurements in Indian school children. Eur J Clin Nutr. 2011:65;1263–1270.

    PubMed  Article  CAS  Google Scholar 

  20. Marwaha RK, Khadgawat R, Tandon N, Kanwar R, Narang A, Sastry A, et al. Reference intervals of serum calcium, ionized calcium, phosphate and alkaline phosphatase in healthy Indian school children and adolescents. Clin Biochem. 2010:43;1216–1219.

    PubMed  Article  CAS  Google Scholar 

  21. World Health Organization, Expert Committee on Physical Status. Physical Status: The Use and Interpretation of Anthropometry. Geneva, Switzerland: World Health Organization; 1995:420. WHO technical report 854.

    Google Scholar 

  22. Freedman DS, Wang J, Thornton JC, Mei Z, Sopher AB, Pierson RN Jr, et al. Classification of body fatness by body mass index-for-age categories among children. Arch Pediatr Adolesc Med. 2009:63;805–811.

    Article  Google Scholar 

  23. Cole TJ. The LMS method for constructing normalized growth standards. Eur J Clin Nutr. 1990:44;45–60.

    PubMed  CAS  Google Scholar 

  24. Ogden CL, Li Y, Freedman DS, Borrud LG, Flegal KM. Smoothed percentage body fat percentiles for U.S. children and adolescents, 1999–2004. Natl Health Stat Report. 2011;43:1–7.

    PubMed  Google Scholar 

  25. Mei Z, Grummer-Strawn LM, Wang J, Thornton JC, Freedman DS, Pierson RN Jr, Dietz WH, Horlick M. Do skinfold measurements provide additional information to body mass index in the assessment of body fatness among children and adolescents? Pediatrics. 2007;9:e1306–1313.

    Article  Google Scholar 

  26. Steinberger J, Jacobs DR, Raatz S, Moran A, Hong CP, Sinaiko AR. Comparison of body fatness measurements by BMI and skinfolds vs dual energy X-ray absorptiometry and their relation to cardiovascular risk factors in adolescents. Int J Obes (Lond). 2005:29; 1346–1352.

    Article  CAS  Google Scholar 

  27. Goel K, Gupta N, Misra A, Poddar P, Pandey RM, Vikram NK, et al. Predictive equations for body fat and abdominal fat with DXA and MRI as reference in Asian Indians. Obesity (Silver Spring). 2008:16;451–456.

    PubMed  Article  Google Scholar 

  28. Goran MI, Driscoll P, Johnson R, Nagy TR, Hunter G. Cross-calibration of body-composition techniques against dual-energy X-ray absorptiometry in young children. Am J Clin Nutr. 1996:63;299–305.

    PubMed  CAS  Google Scholar 

  29. Ellis KJ, Shypailo RJ, Pratt IA, Pond WG. Accuracy of dual-energy x-ray absorptiometry for body-composition measurements in children. Am J Clin Nutr. 1994:60; 660–605.

    PubMed  CAS  Google Scholar 

  30. Brunton IA, Bayley HS, Atkinson SA. Validation and application of dual-energy x-ray absorptiometry to measure bone mass and body composition in small infants. Am J Clin Nutr. 1993:58;839–845.

    PubMed  CAS  Google Scholar 

  31. Pintauro 5, Nagy TR, Duthie C, Goran MI. Crosscalibration of fat and lean measurements by dual-energy X-ray absorptiometry to pig carcass analysis in the pediatric body weight range. Am J Clin Nutr. 1995:63;293–298.

    Google Scholar 

  32. Duncan JS, Duncan EK, Schofield G. Accuracy of body mass index (BMI) thresholds for predicting excess body fat in girls from five ethnicities Asia Pac J Clin Nutr. 2009:18;404–41

    PubMed  Google Scholar 

  33. Deurenberg-Yap M, Schmidt G, van Staveren WA, Deurenberg P. The paradox of low body mass index and high body fat percentage among Chinese, Malays and Indians in Singapore. Int J Obes Relat Metab Disord 2000:24;1011–1017.

    PubMed  Article  CAS  Google Scholar 

  34. Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y. healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr. 2000:72;694–701.

    PubMed  CAS  Google Scholar 

  35. Gurrici S, Hartriyanti Y, Hautvast JG, Deurenberg P. Relationship between body fat and body mass index: differences between Indonesians and Dutch Caucasians. Eur J Clin Nutr. 1998:52;779–783.

    PubMed  Article  CAS  Google Scholar 

  36. Chung S, Song MY, Shin HD Kim DY, He Q, Heshka S, Wang J, et al. Korean and Caucasian overweight premenopausal women have different relationship of body mass index to percent body fat with age. J Appl Physiol. 2005:99;103–107.

    PubMed  Article  Google Scholar 

  37. Deurenberg P, Deurenberg-Yap M, Foo LF, Schmidt G, Wang J. Differences in body composition between Singapore Chinese, Beijing Chinese and Dutch children. Eur J Clin Nutr. 2003:57;405–409.

    PubMed  Article  CAS  Google Scholar 

  38. Mehta S, Mahajan D, Steinbeck KS, Bermingham MA. Relationship between measures of fatness, lipids and ethnicity in a cohort of adolescent boys. Ann Nutr Metab. 2002:46;192–199.

    PubMed  Article  CAS  Google Scholar 

  39. Ogden CL, Li Y, Freedman DS, Borrud LG, Flegal KM. Smoothed percentage body fat percentiles for U.S. children and adolescents, 1999–2004. Natl Health Stat Report. 2011:43;1–7.

    PubMed  Google Scholar 

  40. Forbes GB. Body composition in adolescence. In: Falkner F and Tanner JM (eds). Human Growth: 2: Postnatal Growth. Bailliere Tindall: London, 1978. p. 239–272.

    Chapter  Google Scholar 

  41. McCarthy HD, Cole TJ, Fry T, Jebb SA, Prentice AM. Body fat reference curves for children. Internat J Obesity. 2006:30;598–602.

    Article  CAS  Google Scholar 

  42. Sopher AB, Thornton JC, Wang J, Pierson Jr RN, Heymsfield SB, et al. Measurement of percentage of body fat in 411 children and adolescents: a comparison of dualenergy X-ray absorptiopmetry with a four-compartment model. Pediatrics. 2004:113;1285–1290.

    PubMed  Article  Google Scholar 

  43. Williams JE, Wells JC, Wilson CM, Haroun D, Lucas A, Fewtrell MS. Evaluation of Lunar Prodigy dual-energy Xray absorptiometry for assessing body composition in healthy persons and patients by comparison with the criterion 4-component model. Am J Clin Nutr. 2006:83;1047–1054.

    PubMed  CAS  Google Scholar 

  44. Krishnaveni GV, Hill JC, Veena SR, Leary SD, Saperia J, Chachyamma KJ, et al. Truncal adiposity is present at birth and in early childhood in South Indian children. Indian Pediatr. 2005;42:527–538.

    PubMed  CAS  Google Scholar 

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Author information

Affiliations

  1. All India Institute of Medical Sciences, New Delhi, India

    R. Khadgawat, N. Tandon & A. D. Upadhyay

  2. Institute of Nuclear Medicine and Allied Sciences, Delhi, India

    R. K. Marwaha, A. Sastry & K. Bhadra

  3. SUR Medical College, Delhi, India

    N. Mehan

  4. Gautam Apartments, Gautam Nagar, New Delhi, 110 049, India

    R. K. Marwaha

Authors
  1. R. Khadgawat
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  2. R. K. Marwaha
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  3. N. Tandon
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  4. N. Mehan
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  5. A. D. Upadhyay
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  6. A. Sastry
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  7. K. Bhadra
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Corresponding author

Correspondence to R. K. Marwaha.

Additional information

Both, RK and RKM should be considered as joint first authors for this study

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Khadgawat, R., Marwaha, R.K., Tandon, N. et al. Percentage body fat in apparently healthy school children from northern India. Indian Pediatr 50, 859–866 (2013). https://doi.org/10.1007/s13312-013-0237-3

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  • DOI: https://doi.org/10.1007/s13312-013-0237-3

Keywords

  • Percentage body fat
  • Obesity
  • Adolescents
  • Reference values
  • India
  • Assessment values