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

Kehoe, Sarah H.; Krishnaveni, Ghattu V.; Lubree, Himangi G.; Willis, Andrew K.; Guntupalli, Aravinda M.; Veena, Sargoor R.; Bhat, Dattatray S.; Kishore, Ravi; Fall, Caroline H.D.; Yajnik, Chittaranjan S. and Kurpad, Anura (2011). Prediction of body-fat percentage from skinfold and bio-impedance measurements in Indian school children. European Journal of Clinical Nutrition, 65(12) pp. 1263–1270.

DOI: https://doi.org/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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