Prediction of body-fat percentage from skinfold and bio-impedance measurements in Indian school children

Kehoe, S.H., Krishnaveni, G.V., Lubree, H.G., Wills, A.K., Guntupalli, A.M., Veena, S.R., Bhat, D.S., Kishore, R., Fall, C.H.D., Yajnik, C.S. and Kurpad, A. (2011) Prediction of body-fat percentage from skinfold and bio-impedance measurements in Indian school children. European Journal of Clinical Nutrition. (doi:10.1038/ejcn.2011.119).

Abstract

Background/Objectives: Few equations for calculating body-fat percentage (BF%) from field methods have been developed in South-Asian children. The objective of this study was to assess agreement between BF% derived from primary reference methods and that from skinfold equations and bio-impedance analysis (BIA) in Indian children.

Subjects/Methods: We measured BF% in two groups of Indian children. In Pune, 570 rural children aged 6–8 years underwent dual-energy X-ray absorptiometry (DXA) scans. In Mysore 18O in doubly labeled water was administered to 59 urban children aged 7–9 years. We conducted BIA at 50?kHz and anthropometry, including sub-scapular and triceps skinfold thicknesses. We used the published equations of Wickramasinghe, Shaikh, Slaughter and Dezenburg to calculate BF% from anthropometric data and the manufacturer's equation for BIA measurements. We assessed agreement with values derived from DXA and doubly labeled water using Bland–Altman analysis.

Results: Children were light and thin on average compared with international standards. There was poor agreement between the reference BF% values and those from all equations. Assumptions for Bland–Altman analysis were not met for Wickramasinghe, Shaikh and Slaughter equations. The Dezenberg equations under-predicted BF% for most children (mean difference in Pune ?13.4, LOA ?22.7, ?4.0 and in Mysore ?7.9, LOA (?13.7 and ?2.2). The mean bias for the BIA equation in Pune was +5.0% and in Mysore +1.95%, and the limits of agreement were wide; ?5.0, 15.0 and –7.8, 11.7 respectively.

Conclusions: Currently available skinfold equations do not accurately predict BF% in Indian children. We recommend development of BIA equations in this population using a four-compartment model.

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Contributors

Author: S.H. Kehoe

Author: C.H.D. Fall

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