Validation of anthropometry and foot-to-foot bioelectrical resistance against a three-component model to assess total body fat in children: the IDEFICS study

• Published in: International Journal of Obesity 2013-04, Vol.37 (4), p.520-526
• Main Authors: Bammann, K, Huybrechts, I, Vicente-Rodriguez, G, Easton, C, De Vriendt, T, Marild, S, Mesana, M I, Peeters, M W, Reilly, J J, Sioen, I, Tubic, B, Wawro, N, Wells, J C, Westerterp, K, Pitsiladis, Y, Moreno, L A
• Format: Article
• Language: English
• Subjects: 692/699/2743/393; 692/700/1720; 692/700/478; Adipose Tissue; Analysis; Anthropometry; Associated diseases and complications; Belgium - epidemiology; Biological and medical sciences; Body Composition; Body fat; Body Height; Body Mass Index; Body Weight; Child; Child, Preschool; Diabetes. Impaired glucose tolerance; Diagnosis; Electric Impedance; Elementary school students; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Epidemiology; Female; General aspects; Health aspects; Health Promotion and Disease Prevention; Health sciences; Humans; Internal Medicine; Kinesiology; Male; Medical examination; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Models, Biological; Nutrition research; Obesity; Obesity - epidemiology; Obesity in children; pediatric-original-article; Pediatrics; Pediatrik; Physiological aspects; Public Health; Reference Values; Sex Distribution; Skinfold Thickness; Spain - epidemiology; Sweden - epidemiology; United Kingdom - epidemiology; Validation studies
• ISSN: 0307-0565; 1476-5497; 1476-5497
• DOI: 10.1038/ijo.2013.13

Objective: To compare different field methods for estimating body fat mass with a reference value derived by a three-component (3C) model in pre-school and school children across Europe. Design: Multicentre validation study. Subjects: Seventy-eight preschool/school children aged 4–10 years from four different European countries. Methods: A standard measurement protocol was carried out in all children by trained field workers. A 3C model was used as the reference method. The field methods included height and weight measurement, circumferences measured at four sites, skinfold measured at two–six sites and foot-to-foot bioelectrical resistance (BIA) via TANITA scales. Results: With the exception of height and neck circumference, all single measurements were able to explain at least 74% of the fat-mass variance in the sample. In combination, circumference models were superior to skinfold models and height–weight models. The best predictions were given by trunk models (combining skinfold and circumference measurements) that explained 91% of the observed fat-mass variance. The optimal data-driven model for our sample includes hip circumference, triceps skinfold and total body mass minus resistance index, and explains 94% of the fat-mass variance with 2.44 kg fat mass limits of agreement. In all investigated models, prediction errors were associated with fat mass, although to a lesser degree in the investigated skinfold models, arm models and the data-driven models. Conclusion: When studying total body fat in childhood populations, anthropometric measurements will give biased estimations as compared to gold standard measurements. Nevertheless, our study shows that when combining circumference and skinfold measurements, estimations of fat mass can be obtained with a limit of agreement of 1.91 kg in normal weight children and of 2.94 kg in overweight or obese children.