Fatness and body mass index from birth to young adulthood in a rural Guatemalan population.
Body mass index (BMI; wt in kg/ht2 in m) has been proposed as a simple and valid measure for monitoring fatness. Using data from a 25-y longitudinal study of rural Guatemalans, we found that, as children, this population was stunted (mean height-for-age z = -2.6) and had low triceps skinfold thicknesses ( approximately 10% of reference medians), yet had mean BMIs above US reference medians. As young adults, mean BMIs were at the 50th and 20th percentiles for women and men, respectively. BMIs between ages 1 and 5 y were moderately correlated (r = 0.2-0.3) with those in young adulthood. BMI was correlated with subscapular (r = 0.5-0.8) and triceps (r = 0.2-0.7) skinfold thicknesses at all ages and with predicted percentage body fat in adolescence (r = 0.65) and adulthood (r = 0.8). Fatness was highly centralized, with ratios of subscapular to triceps skinfold thicknesses at the 50th-90th percentiles of reference medians at all ages. BMI was a poor indicator of central fat; the correlation between BMI and waist-to-hip ratio in 14-17-y-old males was -0.21). In stunted populations in developing countries, BMI alone should be interpreted with caution. In stunted children, BMIs may be high despite small extremity skinfold thicknesses; BMI alone may overestimate the prevalence of fatness in these children. In adults, measures in addition to BMI may be required to identify centralized adiposity in these populations.
Rollins School of Public Health of Emory University, Atlanta.
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Schroeder
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Martorell