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Body composition, energy expenditure and physical activity

Body fat throughout childhood in 2647 healthy Danish children: agreement of BMI, waist circumference, skinfolds with dual X-ray absorptiometry

European Journal of Clinical Nutrition volume 68, pages 664–670 (2014)Cite this article

Subjects

Abstract

Background/Objectives:

Total body fat percentage (%BF) evaluated by dual energy X-ray absorptiometry (DXA) scans (DXA %BF) is widely recognized as a precise measure of fatness. We aimed to establish national reference curves for DXA %BF, %BF calculated from skinfolds (SF %BF) and waist circumference (WC) in healthy children, and to compare agreement between the different methods.

Subjects/Methods:

Based on 11 481 physical examinations (anthropometry) and 1200 DXA scans from a longitudinal cohort of Danish children (n=2647), we established reference curves (LMS-method) for SF %BF, WC (birth to 14 years) and DXA %BF (8–14 years). Age- and sex-specific Z-scores for body mass index (BMI), WC and SF %BF were compared. Sensitivity and specificity were calculated for agreement of WC, SF %BF and BMI with DXA %BF to identify obese children (>+1 s.d.).

Results:

%BF differed with age, sex, pubertal stage and social class. SF %BF correlated strongly with DXA %BF (r=0.86). BMI and WC also correlated positively with DXA %BF (Z-scores; r= 0.78 and 0.69). Sensitivity and specificity were 79.5 and 93.8 for SF %BF, 75.9 and 90.3 for BMI and 59.2 and 95.4 for WC.

Conclusions:

SF %BF showed the highest correlation and best agreement with DXA %BF in identifying children with excess fat (+1 s.d.).

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Acknowledgements

We are very grateful to all the families who participated in this study. We also thank the medical doctors in the Nordic Cryptorchidism Study group involved in the examination of the children: Claudia Mau Kai, Kirsten A Boisen, Ida N Damgaard, Ida M Schmidt, and Anne-Maarit. We also appreciate the skilled help of assistants, students and technicians (University Department of Growth and Reproduction). Financial support was received from: Rigshospitalet’s Research Foundation, Danish Medical Research Council (9700909), The Danish Centre on Endocrine Disrupters (MST-621–00072), Svend Andersen’s Foundation and Vilhelm Bang’s Foundation.

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Authors and Affiliations

  1. Department of Growth and Reproduction, University Hospital of Copenhagen, Rigshospitalet, Denmark

    C Wohlfahrt-Veje, J Tinggaard, K Winther, A Mouritsen, C P Hagen, M G Mieritz, K T de Renzy-Martin, M Boas, J H Petersen & K M Main

  2. Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark

    J H Petersen

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Correspondence to C Wohlfahrt-Veje.

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Contributors: CWV: designed and conducted the research, analyzed the data, performed statistical analysis and wrote the paper. KW and KMM: designed the research project and were involved in the data analysis. JHP: performed statistical analysis. JT, MB, AM, MGM, CPH, KTR: conducted the research and were involved in the data analysis.

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Wohlfahrt-Veje, C., Tinggaard, J., Winther, K. et al. Body fat throughout childhood in 2647 healthy Danish children: agreement of BMI, waist circumference, skinfolds with dual X-ray absorptiometry. Eur J Clin Nutr 68, 664–670 (2014). https://doi.org/10.1038/ejcn.2013.282

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