Academic journal article Journal of Health Population and Nutrition

Prediction Equations for Body-Fat Percentage in Indian Infants and Young Children Using Skinfold Thickness and Mid-Arm Circumference

Academic journal article Journal of Health Population and Nutrition

Prediction Equations for Body-Fat Percentage in Indian Infants and Young Children Using Skinfold Thickness and Mid-Arm Circumference

Article excerpt

INTRODUCTION

Studies in developed countries have shown that slow growth during the first two years of life is associated with an increased risk of coronary heart disease in adults, independently of birthweight (1-4). However, postnatal rapid gain in weight has also been suggested to be a risk factor for later obesity, elevated blood pressure in adolescent males, impaired glucose tolerance in young adults, and increased mortality from coronary heart disease (5-11). A recent analysis of longitudinal data in low-income and middle-income countries has shown that stunting in the first two years of life leads to shorter height in adults, lower attained schooling, and decreased birthweight of offspring (12). The analysis has also shown that stunting between 12 and 36 months of age predicts poor cognitive performance and/or lower school grades attained in middle childhood (12). Further, published work from high-income countries suggests a consistent association between intrauterine growth restriction and an increased risk of several chronic diseases in adulthood, such as coronary heart disease, diabetes, and hypertension (13-16).

In light of these findings, precise measurement of body composition, such as fat-free mass (FFM) and fat-mass (FM) in infancy and early childhood, assumes importance. Many methods for measuring body-fat percentage are sophisticated and only suitable for the research setting (17-22). Among the large number of body-composition assessment methods in common use, anthropometry, including skinfold measurements, is simple, portable, and cost-efficient field methods.

We need a technique that provides reliable and valid estimates of body-fat in infants and young children that are non-invasive and are suitable for use in the community and outside fixed facilities. Sufficiently accurate measurement of length of infants and young children for use in equations for body composition is difficult to carry out in the field, largely because portable measuring instruments are inaccurate and one needs the child's cooperation. Similarly, for measuring weight, one needs to carry weighing scales to the field. On the other hand, with adequate training, health workers can measure mid-arm circumference and skinfold thickness with portable equipment and with less burden on participants. In the present study, we developed two new equations for estimating the body-fat percentage (one for girls and the other for boys) on 6-24-month old infants using skinfold thickness (biceps, triceps, and suprailiac), mid-arm circumference, and age. We used the [D.sub.2]O dilution technique as the reference method. We also validated these equations on an independent sample of infants to estimate the body-fat percentage and compared them with the estimates derived by the reference method.

MATERIALS AND METHODS

Subjects

The study was conducted among the urban poor children attending a well baby clinic of a large charitable government hospital in the city of Kolkata, India. Sixty-nine children, aged 6-24-months, participated in the study. The socioeconomic and demographic features of the families are presented in Table 1. The equations were developed on 46 (27 girls and 19 boys) consecutively-enrolled infants and young children, and then these predictive equations were validated on 23 infants (11 girls and 12 boys) in the same age-group and from the same community enrolled for this purpose. It may be noted that regression equations fitted on a sample can only be validated on an independent sample. The sample-size was largely determined by the funds made available by the Society for Applied Studies Trust for this research project. Written informed consent was obtained from their parents, and anonymity of the subjects was strictly preserved. The prediction groups of infants were initially recruited, and the prediction equations were developed. The validation group was recruited after that. The plan was to recruit a larger number for validation. …

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