Prediction of body-fat percentage from skinfold and bio-impedance measurements in Indian school children

Eur J Clin Nutr. 2011 Dec;65(12):1263-70. doi: 10.1038/ejcn.2011.119. Epub 2011 Jul 6.


Background/objectives: Few equations for calculating body-fat percentage (BF%) from field methods have been developed in South-Asian children. The objective of this study was to assess agreement between BF% derived from primary reference methods and that from skinfold equations and bio-impedance analysis (BIA) in Indian children.

Subjects/methods: We measured BF% in two groups of Indian children. In Pune, 570 rural children aged 6-8 years underwent dual-energy X-ray absorptiometry (DXA) scans. In Mysore (18)O in doubly labeled water was administered to 59 urban children aged 7-9 years. We conducted BIA at 50 kHz and anthropometry, including sub-scapular and triceps skinfold thicknesses. We used the published equations of Wickramasinghe, Shaikh, Slaughter and Dezenburg to calculate BF% from anthropometric data and the manufacturer's equation for BIA measurements. We assessed agreement with values derived from DXA and doubly labeled water using Bland-Altman analysis.

Results: Children were light and thin on average compared with international standards. There was poor agreement between the reference BF% values and those from all equations. Assumptions for Bland-Altman analysis were not met for Wickramasinghe, Shaikh and Slaughter equations. The Dezenberg equations under-predicted BF% for most children (mean difference in Pune -13.4, LOA -22.7, -4.0 and in Mysore -7.9, LOA (-13.7 and -2.2). The mean bias for the BIA equation in Pune was +5.0% and in Mysore +1.95%, and the limits of agreement were wide; -5.0, 15.0 and -7.8, 11.7 respectively.

Conclusions: Currently available skinfold equations do not accurately predict BF% in Indian children. We recommend development of BIA equations in this population using a four-compartment model.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Absorptiometry, Photon
  • Adipose Tissue*
  • Anthropometry / methods*
  • Body Composition*
  • Body Weight*
  • Child
  • Electric Impedance*
  • Female
  • Humans
  • India
  • Male
  • Mathematics
  • Reference Values
  • Reproducibility of Results
  • Skinfold Thickness*
  • Thinness*