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PubMed2001

Body composition of anorexia nervosa patients assessed by underwater weighing and skinfold-thickness measurements before and after weight gain.

BACKGROUND: Weight restoration is a crucial element in the treatment of patients with anorexia nervosa. Therefore, the validity of different methods for measuring body composition is important. OBJECTIVE: We tested the concurrent validity of hydrodensitometry (underwater weighing) and anthropometry (12 skinfold thicknesses) and assessed body composition and subcutaneous fat before and after a refeeding program and a multifaceted program of therapy in a specialized inpatient unit for eating disorders. DESIGN: The body composition of a large sample of anorexia nervosa patients (97 restricting type, 33 binging-purging type) was studied by using 2 methods both before and after weight gain. We applied a behavioral contract for weight restoration with a minimum weekly gain of 700 g and a maximum of 3 kg. Bland-Altman analysis of agreement, Pearson correlation analysis, t tests, and analysis of covariance were used. RESULTS: There was good agreement between the results obtained by underwater weighing and by skinfold-thickness measurement (r = 0.76, P < 0.001); the results produced by the 2 methods did not differ significantly. On average, a significant weight gain (11.9 kg) was observed, composed of 6.6 kg fat and 5.3 kg fat-free mass. CONCLUSIONS: Body fat estimation by skinfold-thickness equation appeared to be as accurate as underwater weighing. The refeeding program led to a significant increase in body weight, of which 55.5% was body fat. The mean ratio of fat-free mass to fat mass at the end of the treatment was 3.4:1.

Adipose Tissue↗

PubMed1998

[Body build related body composition and nutrition in adulthood--a comparison of skinfold thickness measurement and bioelectric impedance analysis].

The objective of the present study was to conduct a comprehensive analysis of body build, body composition and nutritional status. The study sample consists of 498 men and women aged from 35 to 65 years. Subjects underwent a detailed anthropometric examination incompassing thirty-one body measurements, eleven skinfold thickness measurements, and bioelectrical impedance analysis for determination of body composition. Dietary intake was assessed by a semiquantitative food frequency questionnaire. Body composition was clearly associated with age and body build. Somatometric differentiation by use of the metric index showed that percentage of body fat was significantly higher in pycnomorphic compared to leptomorphic subjects, whereas reported dietary energy intake was lower. Comparison of estimates of body fat showed considerably deviating results for skinfold thickness measurements and bioelectrical impedance analysis depending on the equations used. This was especially pronounced in obese subjects, where, on an average, bioelectrical impedance analysis resulted in higher values for percentage of body fat compared to skinfold thickness measurements. We conclude that for assessment of nutritional status body composition should be investigated taking into account body build in addition to age and sex.

Adult↗

PubMed2005

A longitudinal study of growth patterns in schoolchildren in one Taipei District. II: Sitting height, arm span, body mass index and skinfold thickness.

BACKGROUND: It has been suggested that longitudinal rather than cross-sectional growth standards be used to assess individual growth patterns. Thus, the aim of this study was to follow boys and girls throughout their pubertal years, so that a mixed longitudinal growth curve of height, weight, sitting height, arm span, skinfold thickness, body mass index (BMI), and the ratio of sitting height or arm span to stature, could be obtained. METHODS: A defined group of 1,139 healthy schoolchildren (570 boys and 569 girls) from the Shih-Pai district of Taipei were followed longitudinally for 4 years. Anthropometric measurements of height, weight, sitting height, arm span, skinfold thickness, and BMI, were obtained for each child. RESULTS: Peak sitting-height velocities of 6.1 cm/year (boys) and 6.3 cm/year (girls) were seen at 8.5 years. The second peak of sitting-height velocity occurred at a mean age of 12.5 years for boys and 11.5 years for girls. Sitting-height velocity for the whole year covering the second peak was 4.6 cm in boys and 3.2 cm in girls. Peak arm-span velocity was seen at 13.5 years for boys and 8.5 years for girls, and arm-span velocity for the whole year covering this peak was 8.4 cm/year for boys and 8.1 cm/year for girls. CONCLUSION: These data provide growth patterns for Chinese children aged 8-18 years living in a Taipei district, with percentile charts for sitting height, arm span, BMI, and skinfold thickness.

Adolescent↗

PubMedDate not supplied

Population and sex differences in arm circumference and skinfold thicknesses among Indo-Pakistani children living in the East Midlands of Britain.

Arm circumference, triceps and subscapular skinfold thicknesses of 2224 Indo-Pakistani children aged 3-10.9 years living in Nottingham and Leicestershire were measured. The children were classified into populations according to country of origin, and religion, prior to analysis. Significant between-population differences were shown for all three variables, the effect being stronger in males than in females. Sex differences in arm circumference and triceps skinfold thickness were greater than those found in the British reference populations, whilst the patterns of fat distribution differed from the British standards for all the Indo-Pakistani populations, male and female.

Anthropometry↗

PubMed2001

Overweight, obesity and skinfold thicknesses of children of African or Indian descent in Trinidad and Tobago.

BACKGROUND: To evaluate distribution of body mass index (BMI) and subcutaneous fat in children of African or Indian subcontinent descent living in Trinidad and Tobago. METHODS: A cross-sectional survey was carried out in a nationally representative sample of 66 government schools. Measurements were made of children's heights, weights, triceps and subscapular skinfold thicknesses. Data were analysed by sex and ethnic group and comparison was made with international standards for overweight and obesity and with British (1990) reference curves for BMI. RESULTS: Data were analysed for 5688/6731 (85%) eligible children including 1934 Afro-Trinidadian, 1689 Indo-Trinidadian, and 1794 of mixed ethnicity. Afro-Trinidadian and mixed children were taller, but Indo-Trinidadian children were shorter than reference. Values for BMI were lower than reference: mean standard deviation score (SDS), (95% confidence interval) Afro-Trinidadian -0.34 (-0.39 to -0.28), Indo-Trinidadian -1.32 (-1.39 to -1.25), mixed -0.67 (-0.74 to -0.61). Overall 486 (8.5%, 7.8 to 9.3%) of children were overweight and 138 (2.4%, 2.0 to 2.9%) were obese. Triceps skinfold thickness values were lower than reference (-0.45, -0.48 to -0.42 SDS) but subscapular skinfold thicknesses were higher (0.45, 0.43 to 0.47 SDS). Higher BMI were associated with higher BMI in the child's parents, higher reported birthweight, older age of the child's mother, smaller family size, and with higher maternal educational attainment. CONCLUSIONS: Overweight was prevalent and distribution of subcutaneous fat was central. Work is needed to determine whether these findings are associated with adult patterns of fat distribution and metabolic abnormalities.

Africa↗

PubMed1999

Receiver operating characteristic analysis of body mass index, triceps skinfold thickness, and arm girth for obesity screening in children and adolescents.

BACKGROUND: Valid and practical methods based on health-related criteria for obesity screening in children and adolescents are not available. Arbitrarily defined body mass index (BMI) cutoffs have been proposed to select adolescents at high risk of developing obesity in adulthood. OBJECTIVE: We assessed the usefulness of BMI, triceps skinfold thickness, and upper arm girth for screening for obesity by using a health-related definition of obesity (> or = 25% body fat in boys and > or = 30% body fat in girls) and a criterion method (dual-energy X-ray absorptiometry) that estimates percentage fat without the potential bias associated with other methods in adolescents. DESIGN: This was a cross-sectional study of Portuguese boys (n = 165) and girls (n = 163) aged 10-15 y. Nonparametric receiver operating characteristic (ROC) analysis was used to define the best tradeoff between true-positive and false-positive rates. RESULTS: True-positive rates ranged from 67% to 87% and from 50% to 100% in girls and boys, respectively, and false-positive rates ranged from 0% to 19% and from 5% to 26%, respectively. For children aged 10-11 y, the areas under the curves (AUCs) for ROCs, an index of diagnostic accuracy, were close to 1.0, suggesting very good accuracy. For older boys and girls, AUCs for triceps skinfold thickness were similar to or greater than AUCs for BMI and upper arm girth. CONCLUSIONS: The results suggest that triceps skinfold thickness gives the best results for obesity screening in adolescents aged 10-15 y. BMI and upper arm girth were reasonable alternatives, except in 14-15-y-old boys, in whom both indexes were only marginally able to discriminate obesity.

Absorptiometry, Photon↗

PubMed1987

Changes of skinfold thickness during puberty induced by pulsatile gonadotrophin-releasing hormone therapy.

We have analysed the changes in triceps and subscapular skinfold thickness ratios of 66 (46 male, 20 female) children with constitutional delay of growth and puberty who progressed through puberty spontaneously and 16 (7 male, 9 female) children with delayed puberty who were treated with pulsatile gonadotrophin-releasing hormone (GnRH). The pattern of change in skinfold thickness in both groups were identical and indistinguishable from standards of normal children when later chronological ages of the patients were allowed for. We observed a decrease in skinfold ratio just prior to the onset of puberty in boys, and such an assessment may be a useful early predictor of the onset of puberty. Our data provided further evidence that all aspects of human puberty are entirely GnRH-dependent.

Adolescent↗

PubMed1988

Secular trends in body mass index and skinfold thickness with socioeconomic factors in young adult women.

Secular trends in the relationship of body mass index (BMI) and skinfold thickness to educational and income levels were examined for white and black women aged 18-34 y over the period 1960-80 with data from three successive national surveys: NHES Cycle I, NHANES I, and NHANES II. Statistical models were fitted to assess the variability in mean BMI over time within levels of education or income. Mean BMI and skinfold thickness were negatively associated with both education and income. Over the 20-y period mean BMI increased for both white and black women at all levels of income and education. Because the increase in mean BMI was greater at lower educational levels, the differentiation of BMI by educational level increased over time, yielding a stronger negative association. In contrast differentiation of BMI by income category decreased over time. Black-white differences in mean BMI at comparable educational and income levels persisted over this period.

Adult↗

PubMed2000

Skinfold thickness varies directly with spring coefficient and inversely with jaw pressure.

PURPOSE: The main aims of this study were to: 1) determine whether heavy use of Harpenden calipers caused deterioration of the spring coefficient (force per unit length), 2) to quantify the change in skinfold thickness per unit change in jaw closing (downscale) pressure, and 3) to develop a calibration range for these calipers. METHODS: Part a) The change in spring force per unit length after at least 100,000 cycles of opening and closing five different springs was measured on a load cell. Part b) The dynamic downscale jaw pressure exerted by six pairs of Harpenden springs was measured on one caliper. Two were new pairs of springs (N1 and N2), two were 25-yr-old springs (O1 and O2), and two pairs (S1 and S2) had been used for less 1 yr. The six spring pairs were used to measure skinfold thicknesses at nine sites, in triplicate, on 20 subjects with the order of springs randomized and counterbalanced. Part c) The downscale jaw pressure of 78 Harpenden calipers was measured at eight jaw gaps. RESULTS: Part a) The springs did not change their characteristics after >100,000 cycles. Part b) At each skinfold site, the lowest thickness was recorded for S2 which exerted the highest jaw pressure (9.04 g x mm(-2)) and conversely the highest thickness was for N1 which exerted the lowest jaw pressure (8.02 g x mm(-2)). Increasing the downscale jaw closing pressure from 8.0 to 9.0 g x mm(-2) reduced a skinfold thickness by approximately 10%. Part c) The mean downscale jaw pressure was 7.82 +/- 0.25 g x mm(-2). CONCLUSIONS: In summary, it is suggested that if accurate skinfold measures between different Harpenden calipers are required, the downscale jaw pressure should be in the range of 7.40-7.82 and 7.85-8.21 g x mm(-2), at jaw gaps of 5 and 40 mm, respectively. These jaw pressures can be achieved by servicing the caliper pivot and indicator gauge to minimize frictional losses, adjusting the caliper jaw alignment, and by selecting springs that have a spring coefficient in the range 1.10-1.15 N x mm(-1).

Calibration↗

PubMed1994

A comparison of skinfold thickness, body mass index, bioelectrical impedance analysis and dual-energy X-ray absorptiometry in assessing body composition in obese subjects before and after weight loss.

The assessment of body composition in obese subjects by anthropometric means (skinfolds), presents many difficulties. This study compares the estimates provided of fat free mass in 21 obese subjects (mean body mass index 36.6 +/- 1.2 kg/m(2)) using body mass index and skinfold thickness, with those obtained using the more recently developed techniques of bioelectrical impedance analysis and dual-energy X-ray absorptiometry. Despite highly significant correlations between some of the methods (r(2) = 0.94 for dual-energy X-ray absorptiometry versus bioelectrical impedance analysis), there was a considerable lack of agreement in the measurements, particularly when skinfold thickness was compared with dual-energy X-ray absorptiometry (limits of agreement -21.9 to -1.5 kg for fat free mass estimated from dual-energy X-ray absorptiometry and skinfold thickness) and even for dual-energy X-ray absorptiometry and bioelectrical impedance analysis (limits of agreement -10.7 to 0.4 kg). After weight loss the intermethod differences were reduced.

Journal Article↗

PubMed1983

[Centile charts of body height, body weight and skinfold thickness of Warsaw's children and adolescents from birth to 18 years of age].

The tables and centile charts of height, weight and thickness of 3 skinfolds of Warsaw children from birth up to the age of 18 are presented. The data was collected in the years 1976-80. The results were compared with the data of the 60s for Warsaw children and with present figures for urban children from other towns of Poland. The acceleration of growth of Warsaw children has been established and it was stated that they were the tallest of all Polish children.

Adolescent↗

PubMed1992

Body composition of rural Beninese women in different seasons assessed by skinfold thickness and bioelectrical-impedance measurements and by a deuterium oxide dilution technique.

Body composition of 24 rural Beninese women was assessed in a pre- and a postharvest season by using skinfold-thickness measurements, bioelectrical-impedance analysis (BIA), and deuterium oxide (D2O) dilution. Fat mass assessed by D2O dilution was 12.3 +/- 3.3 kg; by skinfold-thickness measurements, 13.8 +/- 3.3 kg; and by BIA, 14.1 +/- 2.9 kg. Fat mass assessed by D2O was significantly lower (P less than 0.05) than fat mass assessed by the other two methods. Body weight in the postharvest season was 0.8 +/- 1.6 kg higher (P less than 0.05) than during the preharvest season. All three methods demonstrated that there were no significant changes in fat mass but that fat-free mass increased significantly (P less than 0.05) from pre- to postharvest season.

Adult↗

PubMed1995

The validity of estimating total body fat and fat-free mass from skinfold thickness in adults with growth hormone deficiency.

The regression equations of Durnin and Womersley for estimating total body fat (TBF) and fat-free mass (FFM) from skinfold thickness were validated for adult GH-deficient (GHD) patients by comparing the values of TBF and FFM from the prediction equations with the directly measured values from dual energy x-ray absorptiometry. Twenty-seven male and 24 female patients (aged 21-61 yr) were studied. GHD was isolated in 5 cases and was part of a spectrum of hypopituitarism due to a variety of causes in 46 cases. The mean period of GHD was 6.9 +/- 4.6 yr. All patients were receiving stable replacement therapy. The validation statistics showed no significant differences (P > 0.05) between measured and predicted values of TBF and FFM in either males (24.5 vs. 24.9 and 65.5 vs. 65.8 kg) or females (24.6 vs. 26.3 and 44.7 vs. 43.9 kg). Mean differences were smaller in males (0.4 and 0.2 kg) than females (1.7 and -0.8 kg); they were less than 1% in males and less than 2% in females. Therefore, the Durnin and Womersley equations are suitable for general use with GHD patients. Using TBF (kilograms) from dual energy x-ray absorptiometry as the dependent variable and the log of the sum of skinfold thickness as the independent variable, linear regression equations were formulated to predict TBF in GHD patients. The lowest SE of estimate was 3.8 kg in males and 4.6 kg in females. To determine their general applicability, these equations will need to be cross-validated.

Absorptiometry, Photon↗

PubMedDate not supplied

Sensitivity and specificity of body mass index and skinfold thicknesses in detecting excess adiposity in children aged 8-12 years.

PRIMARY OBJECTIVE: The study aimed to evaluate the sensitivity (SN) and specificity (SP) of body mass index (BMI) and skinfold thicknesses in detecting excess adiposity in children. RESEARCH DESIGN: Cross-sectional. MATERIALS AND METHODS: 986 children (500 females and 486 males) aged 10 +/- 1 years (mean +/- SD; range: 8-12 years) were studied. All underwent anthropometric measurements and bioelectrical impedance analysis (BIA). Dual-energy X-ray absorptiometry (DXA) was performed in 52 children to develop a population-specific algorithm for the assessment of fat-free mass (FFM) from BIA. The algorithm was applied to the remaining 934 children to estimate their FFM. Fat mass (FM) was obtained by subtracting FFM from weight (Wt). Values of FM:Wt were transformed in Z-scores and converted into 19 percentile categories (from 5 to 95 in steps of 5). The same procedure was performed with BMI and the log-transformed sum of four skinfold thicknesses (triceps, biceps, subscapular and suprailiac; lt-4SF). Excess adiposity was defined as a level of FM:Wt greater than the internally derived 85th percentile. SN and SP of each internally derived percentile of BMI and lt-4SF in detecting excess adiposity were calculated. RESULTS: In the pooled sample (n = 934), SN and SP were 0.39 and 0.99 for the 95th percentile of BMI, 0.65 and 0.95 for the 85th percentile of BMI, and 0.75 and 0.94 for the 85th percentile of lt-4SF. CONCLUSIONS: BMI percentiles employed in the present study have a high SP but a low SN in detecting excess adiposity in 8-12-year-old children. The use of the sum of four skinfolds has the potential to increase the SN of a screening programme for excess adiposity in children of this age.

Absorptiometry, Photon↗

PubMed1989

Weight reduction on lactovegetarian and mixed diets. Changes in weight, nutrient intake, skinfold thicknesses and blood pressure.

The purpose of this study was to investigate whether a weight reduction programme based on a lactovegetarian diet has any beneficial effects on the weight, nutrient intake, blood pressure and skinfold thickness of overweight subjects compared with a programme based on a balanced mixed diet. The subjects consisted of three groups of moderately overweight persons, with a mean age of 38 years and a mean overweight of 38 per cent. Two groups had a weight reduction programme for 1 year; group 1 (n = 31) had a 1200 kcal lactovegetarian diet and group 2 (n = 37) had an isocaloric mixed diet. Group 3 (n = 42) served as a control group which had no intervention. During the 1-year study period, group 1 lost 9.2 kg in weight, group 2 lost 10.4 kg and group 3 gained 1.6 kg in weight. Weight loss in both weight reduction groups was accompanied by a reduction in blood pressure, skinfold thickness and arm circumference. The results were slightly more favourable in the mixed diet group than in the lactovegetarian group. In the lactovegetarian group 7 persons were not able to follow the lactovegetarian diet throughout the whole year but ate some meat, fish and eggs during the latter part of the study year. The intake of fibre, vitamin C and calcium was greater and the intake of fat lower in the lactovegetarian than in the mixed diet group during the 1-year weight reduction period. The intake of most nutrients was above the recommended level in both weight reduction groups. The intake was somewhat below recommendations for niacin in the lactovegetarian group, for calcium in the mixed diet group and for iron for women in both groups. It seems desirable to recommend a low-calorie nutritionally well-balanced mixed diet, based on familiar foods and rich in vegetables, instead of a lactovegetarian diet, for long-term weight reduction of overweight persons. In the long term some nutrients may need to be supplemented in both diets.

Adult↗

PubMed1976

[Skinfold thickness measurement in children. The technic and normal values].

In a group of 3,644 healthy controls aged 0 to 19 years and 273 obese children the reference values for triceps and subscapular skin fold thckness were established. The technique of measurement of skinfold thickness is described. This is simple and may be used in routine practice as a measurement of the adipose cell mass. However, measurement of only the subscapular skin fold thickness of which the values are less scattered than triceps, was sufficient to measure the development of adipose tissue in children up to and including puberty. Those subjects whose skinfold thickness is above the upper limit of normal are considered to be obese.

Adolescent↗

PubMed1994

Trends in weight-for-height and triceps skinfold thickness for English and Scottish children, 1972-1982 and 1982-1990.

Data from the 1972, 1982 and 1990 surveys of the National Study of Health and Growth were used to calculate changes in height, weight, triceps skinfold thickness and weight-for-height index for children aged between 4.5 and 11.99 years. There were data for 7887, 6396 and 6420 white English children in the 3 years respectively, and data for 1586, 1191 and 1317 Scottish children. Increases in all measurements were found from 1972 to 1990, except for weight-for-height in English boys, and were generally greater from 1982 to 1990 than from 1972 to 1982. Approximately a third of the increases in weight-for-height and triceps skinfold thickness from 1972 to 1990 were associated with increases in parental body mass indices and decreases in family size. No consistent differences in trends were found between social groups. Greater trends were found for girls and for Scottish children, and Scottish boys are now heavier and fatter than their English counterparts. Trends in weight-for-height and fatness may have implications for future trends in coronary heart disease, and lessen the likelihood that the targets for reductions in obesity in the White Paper Health of the Nation will be met. Preventive measures should be directed at the entire population.

Body Height↗

PubMed1997

Skinfold thicknesses: is there a need to be very precise in their location?

Skinfold thicknesses represent a comparatively simple and reasonably accurate assessment of body fatness which is an important part of the estimation of nutritional state. However, much emphasis is placed on the necessity to be very precise in the exact position of the skinfold being measure and there is frequently concern, also, about the variability of the measurement by different observers using different types of caliper. Fifty-three women and forty-five men had four skinfolds (biceps, triceps, supra-iliac and subscapular) measured first at the standard sites (Tanner, 1953; Edwards et al. 1955), and then at deliberately chosen sites about 20 mm distant from the "correct' ones. The effect on the estimation of body fatness by this manoeuvre resulted in a difference of usually less then 1% and, at a maximum, 3%. In the light of the uncertainty of the basic assumptions which are made in extrapolating from skinfolds (or indeed densitometry, total body water, total body K, and others) to body fatness, these technical errors assume comparatively little importance.

Adult↗