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Objective: To present body fat patterning reference standards to identify children with a predominant distribution of body fat in the abdominal or truncal region of the body. Design: Cross-sectional study in a representative sample of Spanish adolescents aged 13-18 years. Subjects: A total of 2160 adolescents with a complete set of anthropometric measurements (1109 males and 1051 females). Measurements: Weight, height, body mass index, skinfold thickness (biceps, triceps, subscapular, suprailiac, thigh, calf) and waist and hip circumferences. Results: In the majority of the age groups, subscapular/triceps skinfolds ratio, trunk-to-total skinfolds percent (TTS%)and waist circumference values were significantly higher in males than in females; hip circumference was higher in females than in males, except at 15.5 years. In males, age showed a significant effect for all the body fat distribution indices; however, in females, the effect was only significant for triceps skinfold, waist and hip circumferences and waist-to-hip ratio. Smoothed age-and sexspecific triceps skinfold, subscapular skinfold, subscapular/triceps skinfolds ratio, TTS%, waist circumference and hip circumference, waist-to-hip and waist-to-height ratio percentile values for male and female adolescents have been established. Conclusion: These reference data for waist circumference and the other fat patterning indices, together with data from other countries, will help to establish international central obesity criteria for adolescents. The presented percentile values will give the possibility to estimate the proportion of adolescents with high or low regional adiposity amounts.

Objective: To describe the prevalence of overweight and obesity in the Spanish adolescent population and its relationship with the socioeconomic status, and to assess their body fat composition and compare these results with previous data from our own country. Design: Cross-sectional multicenter study conducted in five Spanish cities (Granada, Madrid, Murcia, Santander and Zaragoza) in 2000–2002. Subjects: 2,320 adolescents with complete set of anthropometric measurements, 1,192 boys and 1,128 girls. Measurements: Body mass index calculated from weight and height measurements, and body fat percentage calculated from skinfold thickness measurements. Results: Overweight + obesity prevalences were 25.69 and 19.13% in boys and girls, respectively. Overweight + obesity prevalence increased in boys from high to medium-low socioeconomic status categories (p = 0.015); meanwhile, there was not a significant effect of socioeconomic status in girls. In males, overweight + obesity prevalence changed from 1985 to 2000–2002 from 13 to 35% and in females from 16 to 32%. The rate of change in overweight + obesity prevalences seems to increase in the last years; from 0.88 (1985 to 1995) to 2.33%/year (1995 to 2000–2002) in males and from 0.5 (1985 to 1995) to 1.83%/year (1995 to 2000–2002) in females. The rate of body fat percentage increase was similar between 1980 and 1995 and between 1995 and 2000–2002: 0.26 and 0.23%/year, respectively, at 13 years of age, and 0.16 and 0.17%/year, respectively, at 14 years of age. Conclusion: We observed elevated overweight and obesity prevalences in Spanish adolescents, similar to those observed in other European countries. There is a significant inverse relationship between socioeconomic status and overweight + obesity, but only in boys. The rate of change in overweight prevalence in Spanish adolescents seems to increase, and the rate of increase of body fat percentage seems to be similar as in previous years.

Objective: To determine reference values for body mass index (BMI), sum of six skinfolds ( P 6 skinfolds) and body fat percentage (BF%) in Spanish adolescents aged 13-18 years, included in the AVENA Study (Alimentació n y Valoració n del Estado Nutricional en Adolescentes: Food and Assessment of the Nutritional Status of Adolescents). Design: Multicentre cross-sectional study. Setting: Representative sample of Spanish adolescents. Subjects: The population was selected by means of a multiplestep, simple random sampling. The final number of subjects included in the AVENA Study was 2859 adolescents; 2160 adolescents had a complete set of anthropometric measurements and were then included in this study (1109 males and 1051 females). Interventions: Weight, height and six skinfold thicknesses were measured. As indices of total adiposity, we calculated BMI, P 6 skinfolds and BF% with the formulas described by Slaughter et al. Results: P 6 skinfolds and BF% in each age group were significantly higher in females than in males. In males, age showed a significant effect for BMI, P 6 skinfolds and BF%; however, in females, the effect was only significant for BF%. The percentile distribution was more disperse towards higher P 6 skinfolds and BF% values in males when compared with females. Conclusions: The presented percentile values will help us to classify adolescents in comparison with a well-established reference population, and to estimate the proportion of adolescents with high or low adiposity amounts.