title: Percentile reference values for anthropometric body composition indices in European children from the IDEFICS study.
abstract: BACKGROUND
  To characterise the nutritional status in children with obesity or wasting conditions, European anthropometric reference values for body composition measures beyond the body mass index (BMI) are needed. Differentiated assessment of body composition in children has long been hampered by the lack of appropriate references.
  
  
  OBJECTIVE
  The aim of our study is to provide percentiles for body composition indices in normal weight European children, based on the IDEFICS cohort (Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and infantS).
  
  
  METHODS
  Overall 18,745 2.0-10.9-year-old children from eight countries participated in the study. Children classified as overweight/obese or underweight according to IOTF (N=5915) were excluded from the analysis. Anthropometric measurements (BMI (N=12 830); triceps, subscapular, fat mass and fat mass index (N=11,845-11,901); biceps, suprailiac skinfolds, sum of skinfolds calculated from skinfold thicknesses (N=8129-8205), neck circumference (N=12,241); waist circumference and waist-to-height ratio (N=12,381)) were analysed stratified by sex and smoothed 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentile curves were calculated using GAMLSS.
  
  
  RESULTS
  Percentile values of the most important anthropometric measures related to the degree of adiposity are depicted for European girls and boys. Age- and sex-specific differences were investigated for all measures. As an example, the 50th and 99th percentile values of waist circumference ranged from 50.7-59.2 cm and from 51.3-58.7 cm in 4.5- to <5.0-year-old girls and boys, respectively, to 60.6-74.5 cm in girls and to 59.9-76.7 cm in boys at the age of 10.5-10.9 years.
  
  
  CONCLUSIONS
  The presented percentile curves may aid a differentiated assessment of total and abdominal adiposity in European children.
authors.affiliation: Department of Pediatrics, University of Pécs, Pécs, Hungary.
authors.forename: P
authors.initials: P
authors.lastname: Nagy
authors.affiliation: Department of Pediatrics, University of Pécs, Pécs, Hungary.
authors.forename: E
authors.initials: E
authors.lastname: Kovacs
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
authors.forename: L A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: National Institute for Health Development, Tallinn, Estonia.
authors.forename: T
authors.initials: T
authors.lastname: Veidebaum
authors.affiliation: Research and Education Institute of Child Health, Strovolos, Cyprus.
authors.forename: M
authors.initials: M
authors.lastname: Tornaritis
authors.affiliation: Research and Education Institute of Child Health, Strovolos, Cyprus.
authors.forename: Y
authors.initials: Y
authors.lastname: Kourides
authors.affiliation: Institute of Food Sciences, Unit of Epidemiology & Population Genetics, National Research Council, Avellino, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Siani
authors.affiliation: Institute of Food Sciences, Unit of Epidemiology & Population Genetics, National Research Council, Avellino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Lauria
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Sioen
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Claessens
authors.affiliation: Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Mårild
authors.affiliation: Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Lissner
authors.affiliation: 1] Institute for Public Health and Nursing Research (ipp), Bremen University, Bremen, Germany [2] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Bammann
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Intemann
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Buck
authors.affiliation: 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, Bremen, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Pigeot
authors.affiliation: 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, Bremen, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Ahrens
authors.affiliation: Department of Pediatrics, University of Pécs, Pécs, Hungary.
authors.forename: D
authors.initials: D
authors.lastname: Molnár
mesh_terms: D050154:Adiposity; D000367:Age Factors; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004032:Diet; D005060:Europe / Q000453:epidemiology; D015444:Exercise; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D063766:Pediatric Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D012016:Reference Values; D019282:Wasting Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D044465:White People