title: The prediction of body fatness by BMI and skinfold thicknesses among children and adolescents.
abstract: BACKGROUND
  Although the body mass index (BMI, kg m(-2)) is widely used as a measure of adiposity, it is a measure of excess weight, rather than excess body fat. It has been suggested that skinfold thicknesses be measured among overweight children to confirm the presence of excess adiposity.
  
  
  OBJECTIVE
  The present study examined the additional information provided by skinfold thicknesses on body fatness, beyond that conveyed by BMI-for-age, among healthy 5- to 18-years old (n = 1196).
  
  
  METHODS
  Total body dual-energy X-ray absorptiometry (DXA) provided estimates of % body fat, and the sum of two skinfolds (triceps and subscapular) was used as an indicator of the overall skinfold thickness.
  
  
  RESULTS
  As assessed by the multiple R(2)s and the residuals of various regression models, information on the skinfold sum significantly ( p < 0.001) improved the prediction of body fatness beyond that obtained with BMI-for-age. For example, the use of the skinfold sum, in addition to BMI-for-age, increased the multiple R(2)s for predicting % body fat from 0.81 to 0.90 (boys), and from 0.82 to 0.89 (girls). The use of the skinfold sum also reduced the overall prediction errors (absolute value of the residuals) for % body fat by 20-30%, but these reductions varied substantially by BMI-for-age. Among overweight children, defined by a BMI-for-age >/=95th percentile, the skinfold sum reduced the predication errors for % body fat by only 7-9%.
  
  
  CONCLUSIONS
  Although skinfold thicknesses, when used in addition to BMI-for-age, can substantially improve the estimation of body fatness, the improvement among overweight children is small.
authors.affiliation: Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention K-26, Atlanta, Georgia. DFreedman@CDC.gov
authors.forename: David S
authors.initials: DS
authors.lastname: Freedman
authors.forename: Jack
authors.initials: J
authors.lastname: Wang
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Ogden
authors.forename: John C
authors.initials: JC
authors.lastname: Thornton
authors.forename: Zuguo
authors.initials: Z
authors.lastname: Mei
authors.forename: Richard N
authors.initials: RN
authors.lastname: Pierson
authors.forename: William H
authors.initials: WH
authors.lastname: Dietz
authors.forename: Mary
authors.initials: M
authors.lastname: Horlick
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012885:Skinfold Thickness