Development and validation of skinfold-thickness prediction equations with a 4-compartment model

BACKGROUND: Skinfold-thickness measurements are commonly obtained for the indirect assessment of body composition. OBJECTIVE: We developed new skinfold-thickness equations by using a 4-compartment model as the reference. Additionally, we compared our new equations with the Durnin and Womersley and Jackson and Pollock skinfold-thickness equations to evaluate each equation's validity and precision. DESIGN: Data from 681 healthy, white adults were used. Percentage body fat (%BF) values were calculated by using the 4-compartment model. The cohort was then divided into validation and cross-validation groups. Equations were developed by using regression analyses and the 4-compartment model. All equations were then tested by using the cross-validation group. Tests for accuracy included mean differences, R(2), and Bland-Altman plots. Precision was evaluated by comparing root mean squared errors. RESULTS: Our new equations' estimated means for %BF in men and women (22.7% and 32.6%, respectively) were closest to the corresponding 4-compartment values (22.8% and 32.8%). The Durnin and Womersley equation means in men and women (20.0% and 31.0%, respectively) and the Jackson and Pollock mean in women (26.2%) underestimated %BF. All equations showed a tendency toward underestimation in subjects with higher %BF. Bland-Altman plots showed limited agreement between Durnin and Wormersley, Jackson and Pollock, and the 4-compartment model. Precision was similar among all the equations. CONCLUSIONS: We developed accurate and precise skinfold-thickness equations by using a 4-compartment model as the method of reference. Additionally, we found that the skinfold-thickness equations frequently used by clinicians and practitioners underestimate %BF.     

A comparison of prediction equations for the estimation of body fat percentage in non-obese and obese older Caucasian adults in the United States

Objectives: The predictive capabilities of skinfold regression equations are limited across populations and current equations may not be well suited for the prediction of body fat in older adults or obese Americans. The goal of this study was to compare percent body fat (%BF) predicted by several skinfold regression equations to %BF determined by Dual-Energy X-ray Absorptiometry (DXA) in obese and non-obese Caucasian men and women in the United States over the age of 65 years. Design: A block design was used with two blocks: obesity (non-obese/obese) and gender (male/female). All subjects underwent the same testing procedures in one visit. Setting: University of Pittsburgh Clinical and Translation Research Center. Participants: Seventy-eight older healthy adults were recruited for participation. Measurements: Actual percent body fat was determined from a whole body DXA scan. Estimated percent body fat (%BF) was calculated using skinfold measurements and established regression equations. The predictive accuracy of the regression equations was evaluated by comparing the estimated %BF to the actual %BF measured with DXA using a within subject ANOVA (α=0.05). This was done within subgroups: obese males, obese females, non-obese males and nonobese females. Results: Durnin and Womersly and Jackson and Pollock had reasonably good agreement with DXA in older Caucasian American females and males, respectively. The remaining equations significantly overestimated %BF in older Caucasian American males. Mixed results were found in females with Gause-Nilsson and Jackson and Pollock significantly underestimating %BF, while Visser and Kwok overestimated %BF. Conclusion: Numerous factors of a population including age, race, ethnicity, gender and obesity should be considered when selecting a skinfold regression equation to estimate %BF. While Durnin and Womersly and Jackson and Pollock are recommended for predicting %BF in older Caucasian American females and males, respectively, there exists a need to develop accurate regression models that consider obesity, gender, race or ethnicity when predicting %BF in a diverse geriatric American population.     

Anthropometry in blacks: applicability of generalized skinfold equations and differences in fat patterning between blacks and whites

To test the accuracy of generalized skinfold (SF) equations in blacks and to compare fat patterning in black and white adults, percent body fat (%BF) was assessed in 90 blacks and 89 whites by deuterium oxide dilution (D2O) and by generalized SF equations [Durnin and Womersely (DW), and Jackson and Pollock and Jackson et al (JP)] by using two calipers (Lange and Holtain). In blacks, JP significantly underpredicted (2.95%) and DW overpredicted (1.74%) D2O %BF with the Lange caliper. With the Holtain caliper DW successfully predicted D2O %BF (r = 0.91, SEE = 3.8%). In whites, DW overpredicted D2O %BF more than in blacks (4.94% vs 1.74%). Lower triceps-subscapular and thigh-subscapular skinfold-thickness ratios in black females and lower suprailiac-subscapular ratios in black males and females were found. It was concluded that blacks may have more visceral and upper-body fat deposition.     

In vivo isotope-fractionation factors and the measurement of deuterium- and oxygen-18-dilution spaces from plasma, urine, saliva, respiratory water vapor, and carbon dioxide

In vivo isotope-fractionation factors were determined for hydrogen and oxygen between plasma water samples and samples of urine, saliva, respiratory water vapor, and carbon dioxide in 20 normal adults. The isotope-fractionation factors ranged from 0.944 to 1.039 for 2H in breath water vapor and for 18O in breath CO2, respectively. When corrected for isotope fractionation, the 2H- and 18O-dilution spaces determined from urine, saliva, respiratory water, and CO2 were within -0.10 +/- 1.09 kg (mean +/- SD, n = 60) and 0.04 +/- 0.68 kg (n = 80), respectively, of the values determined from plasma. In the absence of these corrections, we observed a 6% overestimation of 2H-dilution space and a 1% overestimation of 18O-dilution space from the use of respiratory water values. A 4% underestimation of the 18O-dilution space was observed for breath CO2 without correction for isotope fractionation.     

Field methods for body composition assessment are valid in healthy chinese adults

There is little information on the accuracy of simple body composition methods in non-Western populations. We determined the percentage of body fat (%BF) by isotope dilution [oxygen-18 (H(2)(18)O) and deuterium oxide ((2)H(2)O)] and anthropometry in 71 healthy, urban Chinese adults aged 35-49 y [body mass index (BMI) 18-35 kg/m(2)]. The accuracy of several prediction equations for assessment of %BF from skinfold measurements was evaluated against %BF determined by H(2)(18)O dilution. We also assessed the relationship between BMI and %BF, and the fat-free mass (FFM) hydration coefficient for our population. All skinfold equations yielded means within approximately 2%BF of H(2)(18)O-derived %BF. However, on the basis of residual plot analysis and the 95% confidence interval (CI) for the mean difference between methods, the equations of Durnin and Womersley (for assessment of body density from skinfolds) coupled with that of Brozek et al. (for assessment of %BF from body density) provided the most valid assessment for individuals. In addition, the FFM hydration coefficient averaged 0.734 +/- 0.002 (SEM), indicating that the usually assumed value of 0.732 is appropriate for this population. Finally, although BMI had high specificity (90%) for classifying individuals as having body fat within the normal range (<24%BF for men, and <35%BF for women), it had poor sensitivity (66%) for identifying individuals as having high body fat. We conclude that compared with H(2)(18)O dilution, skinfold thickness can provide an accurate and reliable assessment of body composition in healthy Chinese adults. Furthermore, using the equation of Brozek et al. may be preferable to using Siri's equation to predict %BF from body density in populations in which individuals have >30%BF.     

Improved prediction of body fat by measuring skinfold thickness, circumferences, and bone breadths

OBJECTIVE: To develop improved predictive regression equations for body fat content derived from common anthropometric measurements. RESEARCH METHODS AND PROCEDURES: 117 healthy German subjects, 46 men and 71 women, 26 to 67 years of age, from two different studies were assigned to a validation and a cross-validation group. Common anthropometric measurements and body composition by DXA were obtained. Equations using anthropometric measurements predicting body fat mass (BFM) with DXA as a reference method were developed using regression models. RESULTS: The final best predictive sex-specific equations combining skinfold thicknesses (SF), circumferences, and bone breadth measurements were as follows: BFM(New) (kg) for men = -40.750 + {(0.397 x waist circumference) + [6.568 x (log triceps SF + log subscapular SF + log abdominal SF)]} and BFM(New) (kg) for women = -75.231 + {(0.512 x hip circumference) + [8.889 x (log chin SF + log triceps SF + log subscapular SF)] + (1.905 x knee breadth)}. The estimates of BFM from both validation and cross-validation had an excellent correlation, showed excellent correspondence to the DXA estimates, and showed a negligible tendency to underestimate percent body fat in subjects with higher BFM compared with equations using a two-compartment (Durnin and Womersley) or a four-compartment (Peterson) model as the reference method. DISCUSSION: Combining skinfold thicknesses with circumference and/or bone breadth measures provide a more precise prediction of percent body fat in comparison with established SF equations. Our equations are recommended for use in clinical or epidemiological settings in populations with similar ethnic background.     

Body composition predicted from skinfolds in African women: a cross-validation study using air-displacement plethysmography and a black-specific equation

Skinfold thickness (SF) measurements are commonly used for the indirect assessment of body composition. It is necessary to know how large the bias is when using Caucasian SF-based prediction equations Africans, as no specific equations exist. Our first aim was to test the validity of the equation of Durnin & Womersley for predicting body density from SF in Africans. The second aim was to determine the effect of calculating percentage body fat (%BF) from body density using a black-specific formula rather than the Siri equation, thus taking into account the higher fat-free mass (FFM) density in blacks than in whites. A total of 196 African women volunteered. Mean age was 29.5 (sd 8.7) years and mean BMI was 22.5 (sd 4.6) kg/m2. We compared body density values predicted from SF with those measured by air-displacement plethysmography, and %BF values obtained from body density using the Siri equation or the black-specific calculation. The bias (reference minus prediction) was 0.0100 kg/cm3 in body density (P<10(-4)) and 6.5 % BF (P<10(-4)), and the error (sd of the bias) 0.0097 kg/l and 4.5 % BF. With the black-specific equation, the bias was reduced by 1.9 % BF, while error remained similar. As the %BF prediction required an SF-based equation followed by a body density-based calculation, the lack of validity we observed in Africans may be due to known differences between blacks and whites in the distribution of subcutaneous adipose tissue and, as demonstrated, in the FFM density. Equations thus need to be established using SF values specific to Africans.     

Comparison of body composition methods: a literature analysis

OBJECTIVE: To examine the comparability of different methods to assess percentage body fat (BF%) against underwater weighing (UWW). DESIGN: A meta-analysis on 54 papers, published in 1985-96, on healthy, adult Caucasians. METHODS: The mean BF% from different studies were treated as single data points. In addition to UWW, the studies included one or more of the following methods: 3- or 4-component model, dual-energy X-ray absorptiometry (DXA), dual-energy photon absorptiometry, isotope dilution, bioimpedance (BIA), skinfolds or near-infrared interactance (NIR). Within each of the methods, the analyses were done separately for different mathematical functions, techniques or instruments. MAIN OUTCOME MEASURES: Bias (mean difference) and error (s.d. of difference) between BF% measured by UWW and the other methods. RESULTS: The 4-component model gave 0.6 (95% confidence interval for the mean, CI: 0.1 to 1.2) BF% higher results than UWW. Also the 3-component model with body density and total body water (+1.4 BF%, 95% CI: +0.3 to +2.6), deuterium dilution (+1.5 BF%, 95% CI: +0.7 to +2.3), DXA by Norland (+7.2 BF%, 95% CI: 2.6 to 11.8) and BIA by Lukaski et al. (+2.0 BF%, 95% CI: 0.2 to 3.8) overestimated BF%, whereas BIA by Valhalla Scientific (-2.6 BF%, 95% CI: -4.5 to -0.6) and skinfold equations by Jackson et al. (-1.20, 95% CI: -2.3 to -0.1) showed a relative underestimation. The mean bias for the skinfold equation by Durnin & Womersley, against UWW, was 0.0 BF% (95% CI: -1.3 to 1.3). The correlation between the size of measurement and the mean difference was significant for only NIR (r = -0.77, P = 0.003). CONCLUSIONS: The difference between any method and UWW is dependent on the study. However, some methods have a systematical tendency for relative over- or underestimation of BF%.     

Comparisons of body composition derived from anthropometric and bioelectrical impedance methods

This study compared bioelectrical impedance analysis (BIA) measurements with current bedside techniques for determination of body composition in 18 normal volunteers to evaluate the relative usefulness of these methods as adjuncts to assessment in surgical nutrition. Anthropometrics (weight, height, and two skinfold thicknesses) and age and sex were used to derive body density (D) or total body water (TBW) by two methods. Method 1: D was calculated from the logarithm of skinfold thickness according to Durnin and Womersley, adapted for age and sex. Method 2: TBW was calculated from height, weight, and sex according to Hume and Weyers. Resistance and reactance were measured with a four terminal impedance plethysmograph; from these data plus height, weight, and sex, lean body mass (LBM) was derived. In each instance, Siri's and Pace and Rathburn's equations were used to derive the remaining parameters of body composition: D, total body fat (TBF), TBW, and LBM. Using the paired t-test, no statistically significant differences were seen in any parameter determined by the different methods. These results show that D, TBW, TBF, and LBM in a population of healthy individuals under steady-state conditions can be estimated by anthropometric-derived formulas with the same relative accuracy as that provided from estimates based upon BIA measurements.     

Comparisons of body composition derived from anthropometric and bioelectrical impedance methods.

This study compared bioelectrical impedance analysis (BIA) measurements with current bedside techniques for determination of body composition in 18 normal volunteers to evaluate the relative usefulness of these methods as adjuncts to assessment in surgical nutrition. Anthropometrics (weight, height, and two skinfold thicknesses) and age and sex were used to derive body density (D) or total body water (TBW) by two methods. Method 1: D was calculated from the logarithm of skinfold thickness according to Durnin and Womersley, adapted for age and sex. Method 2: TBW was calculated from height, weight, and sex according to Hume and Weyers. Resistance and reactance were measured with a four terminal impedance plethysmograph; from these data plus height, weight, and sex, lean body mass (LBM) was derived. In each instance, Siri's and Pace and Rathburn's equations were used to derive the remaining parameters of body composition: D, total body fat (TBF), TBW, and LBM. Using the paired t-test, no statistically significant differences were seen in any parameter determined by the different methods. These results show that D, TBW, TBF, and LBM in a population of healthy individuals under steady-state conditions can be estimated by anthropometric-derived formulas with the same relative accuracy as that provided from estimates based upon BIA measurements.     

Estimations of body fat by anthropometry or bioelectrical impedance differ from those by dual-energy X-ray absorptiometry in prefrail community-dwelling older women

This study aimed to compare different methods to assess body fat (BF). We hypothesized that bioelectrical impedance analysis (BIA) or anthropometry may be used to estimate BF in prefrail older women, equivalently to dual-energy X-ray absorptiometry (DXA). The cross-sectional study included 72 prefrail community-dwelling older women (71.13 ± 4.65 years old; body mass index [BMI] 28.89 ± 4.23 kg/m²). The BF percentage (%BF) was estimated using anthropometry with the Durnin & Womersley (D&W) and Petroski's predictive equations, BIA with 2 Baumgartner predictive equations (BIA 1 and BIA 2), and DXA. All methods differed significantly from DXA according to assessments using repeated measures ANOVA and pairwise comparisons. The mean %BF varied between 39.99 ± 3.42% (D&W) and 43.93 ± 5.06% (DXA). Multiple regression analysis with age and BMI as covariates showed positive correlations (R² = 0.91) in models with D&W equation and BMI, and with BIA 2 and BMI; however, BMI explained more of the model (71%) than the equations. Furthermore, Bland-Altman test revealed a proportional bias for D&W and for BIA 2, with underestimation of BF varying across different %BF values. Petroski's skinfold equation showed a positive correlation on linear regression (R² = 0.74) and no proportional bias; however, Bland-Altman analysis revealed high limits of agreement (-13.6 to -0.05), thus compromising clinical application. To conclude, compared with DXA, all the equations tested showed a high disagreement and wide limits of agreement, restricting their use in clinical practice to estimate the BF in prefrail older women.     

Comparison of methods to assess change in children's body composition

BACKGROUND: Little is known about how simpler and more available methods to measure change in body fatness compare with criterion methods such as dual-energy X-ray absorptiometry (DXA) in children. OBJECTIVE: Our objective was to determine the ability of air-displacement plethysmography (ADP) and formulas based on triceps skinfold thickness (TSF) and bioelectrical impedance analysis (BIA) to estimate changes in body fat over time in children. DESIGN: Eighty-six nonoverweight and overweight boys (n = 34) and girls (n = 52) with an average age of 11.0 +/- 2.4 y underwent ADP, TSF measurement, BIA, and DXA to estimate body fatness at baseline and 1 +/- 0.3 y later. Recent equations were used to estimate percentage body fat by TSF measurement (Dezenberg equation) and by BIA (Suprasongsin and Lewy equations). Percentage body fat estimates by ADP, TSF measurement, and BIA were compared with those by DXA. RESULTS: All methods were highly correlated with DXA (P < 0.001). No mean bias for estimates of percentage body fat change was found for ADP (Siri equation) compared with DXA for all subjects examined together, and agreement between body fat estimation by ADP and DXA did not vary with race or sex. Magnitude bias was present for ADP relative to DXA (P < 0.01). Estimates of change in percentage body fat were systematically overestimated by BIA equations (1.37 +/- 6.98%; P < 0.001). TSF accounted for only 13% of the variance in percentage body fat change. CONCLUSION: Compared with DXA, there appears to be no noninvasive and simple method to measure changes in children's percentage body fat accurately and precisely, but ADP performed better than did TSF or BIA. ADP could prove useful for measuring changes in adiposity in children.     

Bioelectrical impedance analysis: population reference values for phase angle by age and sex

BACKGROUND: Phase angle is an indicator based on reactance and resistance obtained from bioelectrical impedance analysis (BIA). Although its biological meaning is still not clear, phase angle appears to have an important prognostic role. OBJECTIVE: The aim of this study was to estimate population averages and SDs of phase angle that can be used as reference values. DESIGN: BIA and other methods used to evaluate body composition, including hydrodensitometry and total body water, were completed in 1967 healthy adults aged 18-94 y. Phase angle was calculated directly from body resistance and reactance, and fat mass (FM) was estimated from the combination of weight, hydrodensitometry, and total body water by using the 3-compartment Siri equation. Phase angle values were compared across categories of sex, age, body mass index (BMI), and percentage FM. RESULTS: Phase angle was significantly (P < 0.001) smaller in women than in men and was lower with greater age (P < 0.001). Phase angle increased with an increase in BMI and was significantly inversely associated with percentage fat in men. Phase angle was significantly predicted from sex, age, BMI, and percentage FM in multiple regression models. CONCLUSIONS: Phase angle differs across categories of sex, age, BMI, and percentage fat. These reference values can serve as a basis for phase angle evaluations in the clinical setting.     

Differences in the relationship between BMI and percentage body fat between Japanese and Australian-Caucasian young men

This cross-sectional study aimed to determine ethnic and environmental influences on the relationship between BMI and percentage body fat, using a sample of 144 Japanese and 140 Australian-Caucasian men living in Australia, and eighty-eight Japanese men living in Japan. Body composition was assessed by anthropometry using standard international methods (International Society for the Advancement of Kinanthropometry protocol). Body density was predicted using Durnin and Womersley's (1974) equation, and percentage body fat was calculated from Siri's (1961) equation. Significant (P<0.05) ethnic differences in stature, body mass and BMI were observed between Japanese and Australian men, but no ethnic differences were observed in their percentage body fat and height-corrected sum of skinfold thicknesses. No differences were found in the BMI-percentage body fat relationship between the Japanese subjects living in Australia and in Japan. Significant (P<0.05) ethnic differences in the BMI-percentage body fat relationship observed from a comparison between pooled Japanese men (aged 18-40 years, BMI range 16.6-32.8 kg/m2) and Australians (aged 18-39 years, BMI range 16.1-31.4 kg/m2) suggest that Japanese men are likely to have a greater percentage body fat than Australian men at any given BMI value. From the analyses, the Japanese men were estimated to have an equivalent amount of body fat to the Australian men at BMI values that were about 1.5 units lower than those of the Australians (23.5 kg/m2 and 28.2 kg/m2, respectively). It was concluded that Japanese men have greater body fat deposition than Australian-Caucasians at the same BMI value. Japanese men may therefore require lower BMI cut-off points to identify obese individuals compared with Australian-Caucasian men.     

Measurement of body fat with bioelectric impedance, skinfold thickness, and equations based on anthropometric measurements. Comparative analysis

BACKGROUND: There is growing clinical interest in estimating body fat percentages (%FM). The aim of this study was a comparison of body fat measurement by anthropometric equations, skinfold thickness (SFT) and bioelectrical impedance (BIA) methods. METHODS: Cross-sectional study. 149 healthy individuals (83 males and 66 females) were recruited. Height, weight, waist circumference, skinfold of biceps, triceps, subscapular and suprailiac regions, sum and log10 sum of four folds were obtained. %FM were calculated using the Siri equation (for sex or age-sex), Brozeck (sex or age-sex), Deurenberg, Lean and segmental BIA (Omron BF 300). Methodological differences among the various methods were analyzed with Spearman (SCC) and intraclass (ICC) correlation coefficients and Bland-Altman method. The reference method is the Siri-age-sex equation. RESULTS: The means of %FM were 26.8 +/- 8.3% (Siri-age-sex), 25.7 +/- 8.1% (Siri-sex), 25.97 +/- 7.6% (Brozeck-age-sex), 24.9 +/- 7.5% (Brozeck-sex), 25.6 +/- 8.8% (BIA), 28.6 +/- 8.2% (Deurenberg), 29.7 +/- 8.2% (Lean-waist circumference) and 29.4 +/- 9.3% (Lean-triceps-waist). The %FM values for all methods were highly intercorrelated (all SCC > 0.83 and CCI > 0.85). Brozeck-age-sex (average difference 0.8%; limits of agreement -0.48 to 2.08%) and BIA (1.17%; -6.21 to 8.55%) show the best agreement according to Bland and Altman analysis with Siri-age-sex equation. CONCLUSIONS: Deurenberg and Lean equations provide different body fat mass estimates than those derived from SFT measurement and BIA and thus should not be used interchangeably. The use of Siri-Brozeck equations is recommended for %FM assessment. The results suggest that segmental BIA-Omron BF 300 may be a valid alternative method.     

The impact of adjustment of a weight-height index (W/H2) for frame size on the prediction of body fatness

The impact of frame-size categories in weight-height tables was studied by comparing the efficiency of the body-mass index (weight/height2 (W/H2] and weight adjusted for body-height and a body-diameter, W/(H2Dp), in predicting body fatness. Body-weight, body-height, six body-diameters and four skinfold thicknesses were measured in ninety-five men and seventy women, aged between 23 and 35 years. Percentage of body fat was calculated from skinfold thicknesses using regression equations according to Durnin & Womersley (1974). The inclusion of a body-diameter increased the explained variation of body fatness from 57% to 62% (knee) and 63% (shoulder) in men and from 63% to 69% (knee) in women. It can be concluded that in the present population the efficiency of the prediction of percentage of body fat was not improved markedly by the inclusion of a body-diameter in the body-mass index, thus giving no support for the inclusion of frame-size categories in weight-height tables.     

A proposed method for the evaluation of body fat in Japanese adults that predicts obesity

The present study was designed to develop a simple predictive equation for the percent body fat (%BF) in Japanese adults based on variables collected during health examinations. We hypothesized that a benchmark for defining metabolic syndrome and obesity could be based on %BF, which was measured by underwater weighing (UW) as a gold standard for body composition assessment. Thus, we developed a predictive equation for %BF derived from UW that may contribute to the assessment of obesity status, characterized by an excess accumulation of visceral or subcutaneous fat. The subjects were 810 Japanese participants (283 men, 527 women, ages 18-59 years). Anthropometric variables, including height, weight, 7 circumferences, and 8 skinfold thicknesses, were measured. The developed predictive equation was as follows: %BF = 10.558 × sex (1 for men; 2 for women) + 0.069 × age + 0.667 × body mass index + 0.314 × abdominal circumference − 35.881.The coefficient of determination (r²) was 0.69. The predicted %BF derived from this equation was highly correlated with UW-measured values and did not show underestimation or overestimation in either sex. These data suggested that this predictive equation for %BF can be used for all Japanese adults and does not require the use of medical equipment and special measurement techniques. By combining the equation for %BF developed in this study with a %BF cutoff value of metabolic syndrome and obesity (>25.0% in men and >30.0% in women), all Japanese adults can easily and conveniently assess obesity status.     

Body composition and physical activity in New Zealand Maori, Pacific and European children aged 5-14 years

Body fatness and the components of energy expenditure in children aged 5-14 years were investigated. In a group of seventy-nine healthy children (thirty-nine female, forty male), mean age 10.0 (sd 2.8) years, comprising twenty-seven Maori, twenty-six Pacific Island and twenty-six European, total energy expenditure (TEE) was determined over 10 d using the doubly-labelled water method. Resting metabolic rate (RMR) was measured by indirect calorimetry and physical activity level (PAL) was calculated as TEE:RMR. Fat-free mass (FFM), and hence fat mass, was derived from the (18)O-dilution space using appropriate values for FFM hydration in children. Qualitative information on physical activity patterns was obtained by questionnaire. Maori and Pacific children had a higher BMI than European children (P<0.003), but % body fat was similar for the three ethnic groups. The % body fat increased with age for girls (r 0.42, P=0.008), but not for boys. Ethnicity was not a significant predictor of RMR adjusted for FFM and fat mass. TEE and PAL, adjusted for body weight and age, were higher in Maori than European children (P<0.02), with Pacific children having intermediate values. PAL was inversely correlated with % body fat in boys (r -0.43, P=0.006), but was not significantly associated in girls. The % body fat was not correlated with reported time spent inactive or outdoors. Ethnic-related differences in total and activity-related energy expenditure that might account for higher obesity rates in Maori and Pacific children were not seen. Low levels of physical activity were associated with increased body fat in boys but not in girls.     

Predictive accuracy of three field methods for estimating relative body fatness of nonobese and obese women.

Three methods of body composition assessment were used to estimate percent body fat (%BF) in nonobese (n = 77) and obese (n = 71) women, 20-72 yrs of age. Skinfolds (SKF), bioelectrical impedance (BIA), and near-infrared interactance (NIR) methods were compared to criterion-derived %BF from hydrostatic weighing (%BFHW). Nonobese subjects had < 30% BFHW and obese subjects had > or = 30% BFHW. The Jackson, Pollock, and Ward SKF equation and the manufacturer's equations for BIA (Valhalla) and NIR (Futrex-5000) were used. For nonobese women there were no significant differences between mean %BFHW and %BFSKF, %BFBIA, and %BFNIR. The rs and SEEs were 0.65 and 3.4% BF for SKF, 0.61 and 3.6% BF for BIA, and 0.58 and 3.7% BF for NIR for nonobese subjects. For obese women, mean %BFHW was significantly underestimated by the SKF, BIA, and NIR methods. The rs and SEEs for the obese group were 0.59 and 3.4% BF for SKF, 0.56 and 3.5% BF for BIA, and 0.36 and 3.9% BF for NIR. The total errors of the equations ranged from 5.6 to 8.0% BF in the obese group. It is concluded that all three field methods accurately estimate %BF for nonobese women; however, none of the methods is suitable for estimating %BF for obese women.     

Human-milk intake measured by administration of deuterium oxide to the mother: a comparison with the test-weighing technique

A comparison was made between the dose-to-the-mother deuterium-dilution method and the conventional test-weighing technique for determining human-milk intake in five exclusively breast-fed infants and in four breast-fed infants who received supplemental foods. After administration of 2H to the mothers human milk and infant urine were sampled over 14 d and analyzed for 2H:1H ratios by gas-isotope-ratio mass spectrometry. Infant total body water was determined by 18O dilution. The test-weighing procedure was conducted for 5 d consecutively. The intake of human milk (mean +/- SD) estimated by 2H dilution was 648 +/- 63 g/d and estimated by test-weighing was 636 +/- 84 g/d. The mean difference between the two methods was not significantly different from 0. The 2H-dilution and test-weighing techniques provide similar estimates of human-milk intake.