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Body mass index adjustments to increase the validity of body fatness assessment in UK Black African and South Asian children.

Hudda, MT; Nightingale, CM; Donin, AS; Fewtrell, MS; Haroun, D; Lum, S; Williams, JE; Owen, CG; Rudnicka, AR; Wells, JCK; et al. Hudda, MT; Nightingale, CM; Donin, AS; Fewtrell, MS; Haroun, D; Lum, S; Williams, JE; Owen, CG; Rudnicka, AR; Wells, JCK; Cook, DG; Whincup, PH (2017) Body mass index adjustments to increase the validity of body fatness assessment in UK Black African and South Asian children. Int J Obes (Lond), 41 (7). pp. 1048-1055. ISSN 1476-5497 https://doi.org/10.1038/ijo.2017.75
SGUL Authors: Cook, Derek Gordon Nightingale, Claire Owen, Christopher Grant Whincup, Peter Hynes Donin, Angela Hudda, Mohammed Taqui

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Abstract

BACKGROUND/OBJECTIVES: Body mass index (BMI) (weight per height(2)) is the most widely used marker of childhood obesity and total body fatness (BF). However, its validity is limited, especially in children of South Asian and Black African origins. We aimed to quantify BMI adjustments needed for UK children of Black African and South Asian origins so that adjusted BMI related to BF in the same way as for White European children. METHODS: We used data from four recent UK studies that made deuterium dilution BF measurements in UK children of White European, South Asian and Black African origins. A height-standardized fat mass index (FMI) was derived to represent BF. Linear regression models were then fitted, separately for boys and girls, to quantify ethnic differences in BMI-FMI relationships and to provide ethnic-specific BMI adjustments. RESULTS: We restricted analyses to 4-12 year olds, to whom a single consistent FMI (fat mass per height(5)) could be applied. BMI consistently underestimated BF in South Asians, requiring positive BMI adjustments of +1.12 kg m(-)(2) (95% confidence interval (CI): 0.83, 1.41 kg m(-)(2); P<0.0001) for boys and +1.07 kg m(-)(2) (95% CI: 0.74, 1.39 kg m(-)(2); P<0.0001) for girls of all age groups and FMI levels. BMI overestimated BF in Black Africans, requiring negative BMI adjustments for Black African children. However, these were complex because there were statistically significant interactions between Black African ethnicity and FMI (P=0.004 boys; P=0.003 girls) and also between FMI and age group (P<0.0001 for boys and girls). BMI adjustments therefore varied by age group and FMI level (and indirectly BMI); the largest adjustments were in younger children with higher unadjusted BMI and the smallest in older children with lower unadjusted BMI. CONCLUSIONS: BMI underestimated BF in South Asians and overestimated BF in Black Africans. Ethnic-specific adjustments, increasing BMI in South Asians and reducing BMI in Black Africans, can improve the accuracy of BF assessment in these children.International Journal of Obesity advance online publication, 25 April 2017; doi:10.1038/ijo.2017.75.

Item Type: Article
Additional Information: This work is licensed under a Creative Commons Attribution- NonCommercial-NoDerivs 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ © The Author(s) 2017
Keywords: Endocrinology & Metabolism, 11 Medical And Health Sciences, 13 Education
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Int J Obes (Lond)
ISSN: 1476-5497
Language: eng
Dates:
DateEvent
July 2017Published
22 March 2017Published Online
19 February 2017Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Projects:
Project IDFunderFunder ID
PG/15/19/31336British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PG/11/42/28895British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
TBF-S09-019Bupa Foundationhttp://dx.doi.org/10.13039/501100000355
GR 10/03Child Growth FoundationUNSPECIFIED
WT094129MAWellcome Trusthttp://dx.doi.org/10.13039/100004440
PubMed ID: 28325931
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/108650
Publisher's version: https://doi.org/10.1038/ijo.2017.75

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