Relation of BMI to fat and fat-free mass among children and adolescents

Freedman, David S.; Wang, J; Maynard, L. Michele; Thornton, John C.; Mei, Zuguo; Pierson, Richard N.; Dietz, William H.; Horlick, Mary

doi:10.1038/sj.ijo.0802735

Cited by 398 publications

(415 citation statements)

References 37 publications

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“…Higher body fat in girls was probably responsible for higher BMI, especially beyond 14 þ years. A similar observation has been reported by Freedman et al (2005) who have estimated body fat using DEXA. The fact that these trends in body fat are observed in adolescents from White population and also confirmed in Indian Overweight adolescents and hypertension S Rao et al population, gives us confidence in the estimates of body fat based on BIA.…”

Section: Discussionsupporting

confidence: 87%

Blood pressure among overweight adolescents from urban school children in Pune, India

2006

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Objectives: To examine the magnitude of overweight and its association with blood pressure (BP) among adolescents. Design: Cross-sectional study with all children in age range 9-16 years (n ¼ 1146 boys and 1077 girls) from two schools catering to urban affluent high socio-economic class (HSE), for anthropometric measurements by trained investigators and BP measurement by a pediatrician using sphygmomanometer. Results: The prevalence of overweight based on conventional body mass index (BMI) cutoff was 27.5% for boys and 20.9% for girls but varied for different indicators. Prevalence of high systolic blood pressure (HSBP) was 12.0% in boys and 9.7% in girls and increased with increasing levels of BMI, weight, triceps skin fold thickness (TSFT) and percent body fat. Mean level of SBP among overweight children was significantly (Po0.001) higher by about 12 mm Hg, whereas that for diastolic blood pressure was higher by 8 mm Hg (Po0.001) as compared to their non-overweight (age, sex-matched) counterparts. This was true in both sexes and for all indicators used for assessing overweight. Prevalence of HSBP increased suddenly beyond BMI value of 20 kg/m 2 in boys and 21.5 kg/m 2 in girls, beyond TSFT value of 12 mm for boys and 14 mm for girls whereas such cutoffs for body fat were above 25% in both sexes. These cutoffs appear much lower than the conventional ones and therefore indicate the need for validation of conventional cutoffs in different populations. Conclusions: Our findings highlight that BP measurement needs to be a routine part of physical examination in school children, and the use of cutoffs anchored to metabolic risks may be essential for assessment of obesity.

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Section: Discussionsupporting

confidence: 87%

Blood pressure among overweight adolescents from urban school children in Pune, India

2006

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“…36 In this study we could observe that for a similar BMI value for age, girls and boys are different in relation to body composition, indicated by a significant higher BF% in girls. In a 7.5-year longitudinal study, Wen et al 6 showed that increases in fat mass explained the increases in CRP levels during pubertal growth of Finnish girls but not vice versa.…”

Section: Discussionmentioning

confidence: 63%

Ability of Measures of Adiposity in Identifying Adverse Levels of Inflammatory and Metabolic Markers in Adolescents

et al. 2016

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Background: Overweight and obesity have been associated with a pro-inflammatory state. We aimed to assess the ability of different measures of overall and abdominal adiposity for identifying adverse levels of inflammatory and metabolic markers in adolescents. Methods: This is a cross-sectional analysis with 529 Portuguese adolescents (267 girls), mean age 14.3 ± 1.7 years. Weight, height, sitting height, waist circumference (WC), and body fat percentage (BF%) were measured; and BMI, waist-to-height ratio (WHtR), and waist-to-sitting-height ratio (WsHtR) were calculated. We measured C-reactive protein (CRP), fibrinogen, erythrocyte sedimentation rate (ESR), complements C3 and C4, leptin, and adiponectin levels. Receiver operating characteristic (ROC) curves were used to estimate the ability of the adiposity measures to discriminate between low/high values of biomarkers. Results: The highest areas under the ROC curves were presented by BF% for fibrinogen and complement C3 in both sexes and for ESR, complement C4, and adiponectin only in girls; by BMI for CRP in girls and for leptin in both sexes; by WHtR for leptin in both sexes and for CRP, fibrinogen, and adiponectin only in girls; by waist circumference for CRP, fibrinogen, and complement C3 only in boys and for complement C4 in girls; and by WsHtR for complement C3 in girls; p < 0.05 for all. Conclusions: The measures that more often presented discriminatory power were, for overall adiposity, BF% in both sexes, and for abdominal adiposity, WHtR in girls and WC in boys. However, small differences in discriminatory capabilities don't allow us to clearly defend the adoption of a single measure above all others.

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“…When looking for the nutritional status in individuals, it is important to assess not only BMI values but also the body composition (Maynard et al, 2001). Even though the BMI is the most widely used measurement to define obesity, it has limitations on an individual level and is only a proxy measurement of body fat (Daniels et al, 1997;Freedman et al, 2005). Two persons with the same amount of body fat can have quite different BMI values, because BMI reflects not only body fat, but also bone, muscle and other lean tissues (Ellis et al, 1999).…”

Section: Boys Girlsmentioning

confidence: 99%

Trends in overweight and obesity and changes in the distribution of body mass index in schoolchildren of Jena, East Germany

Kromeyer-Hauschild

Zellner

2006

Eur J Clin Nutr

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Objective: Data of Jena children (Germany) show increases in the prevalence estimates of overweight and obesity between 1975 and 2001. Our objective was to determine if these increases contribute to changes in the distribution of body mass index (BMI) in the entire population of children. The decade 1985-1995, which includes the time of German reunification, is of particular interest because of the significant socio-economic changes in East Germany, in which Jena is located. Design and subjects: The analyses were based on data from four cross-sectional growth studies in 7-to 14-year-old children performed in Jena, Germany, in 1975 (n ¼ 2013), 1985 (n ¼ 1534), 1995 (n ¼ 1906 (n ¼ 1918. Overweight and obesity were estimated by German reference data and the reference of Cole et al. Mean difference plots were used to investigate the changes in the BMI distributions within sexes between the studies. Results: Between 1985 and 1995, the prevalence of overweight and obesity increased significantly in both sexes, whereas nonsignificant changes were found between 1975 and 1985. Although there is a tendency towards increased overweight between 1995 and 2001, the differences were nonsignificant. Comparing data from 1975 and 1985, the mean difference plots showed virtually no changes in the BMI distribution. In the plots comparing the BMI distribution for 1985 data and 1995 data, the whole distribution tended to shift upwards with a greater shift in the upper BMI range. The entire population of children in Jena gained weight during this period of time. This increase may be linked to a transition towards a more Western lifestyle, that is, usually by lower energy expenditure and nutritional transitions, caused by the process of reunification of Germany in 1989. Conclusions: Weight gain appears to be a characteristic feature of the entire population studied and does not seem to be a separate problem of the obese children. This suggests that reported changes in the prevalence may be underestimating the looming public health crisis.

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Relation of BMI to fat and fat-free mass among children and adolescents

Cited by 398 publications

References 37 publications

Blood pressure among overweight adolescents from urban school children in Pune, India

Blood pressure among overweight adolescents from urban school children in Pune, India

Ability of Measures of Adiposity in Identifying Adverse Levels of Inflammatory and Metabolic Markers in Adolescents

Trends in overweight and obesity and changes in the distribution of body mass index in schoolchildren of Jena, East Germany

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