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Validity of Body Mass Index as a Measure of Adiposity in Infancy

Bell, Katherine A ; Wagner, Carol L ; Perng, Wei ; Feldman, Henry A ; Shypailo, Roman J ; Belfort, Mandy B

The Journal of Pediatrics, May 2018, Vol.196, pp.168-174.e1 [Peer Reviewed Journal]

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  • Title:
    Validity of Body Mass Index as a Measure of Adiposity in Infancy
  • Author/Creator: Bell, Katherine A ; Wagner, Carol L ; Perng, Wei ; Feldman, Henry A ; Shypailo, Roman J ; Belfort, Mandy B
  • Language: English
  • Subjects: Body Composition ; Infant ; Medicine
  • Is Part Of: The Journal of Pediatrics, May 2018, Vol.196, pp.168-174.e1
  • Description: To assess the validity of body mass index (BMI) and age- and sex-standardized BMI z-score (BMIZ) as surrogates for adiposity (body fat percentage [BF%], fat mass, and fat mass index [kg/m ]) at 3 time points in infancy (1, 4, and 7 months) and to assess the extent to which the change in BMIZ represents change in adiposity. We performed a secondary analysis of 447 full-term infants in a previous trial of maternal vitamin D supplementation during lactation. Study staff measured infant anthropometrics and assessed body composition with dual-energy x-ray absorptiometry at 1, 4, and 7 months of age. We calculated Spearman correlations (r ) among BMI, BMIZ, and adiposity at each time point, and between change in BMIZ and change in adiposity between time points. Infants (N = 447) were 52% male, 38% white, 31% black, and 29% Hispanic. The BMIZ was moderately correlated with BF% (r  = 0.43, 0.55, 0.48 at 1, 4, and 7 months of age, respectively). BMIZ correlated more strongly with fat mass and fat mass index, particularly at 4 and 7 months of age (fat mass r  = 0.72-0.76; fat mass index r  = 0.75-0.79). Changes in BMIZ were moderately correlated with adiposity changes from 1 to 4 months of age (r  = 0.44 with BF% change; r  = 0.53 with fat mass change), but only weakly correlated from 4 to 7 months of age (r  = 0.21 with BF% change; r  = 0.27 with fat mass change). BMIZ is moderately correlated with adiposity in infancy. Changes in BMIZ are a poor indicator of adiposity changes in later infancy. BMI and BMIZ are limited as surrogates for adiposity and especially adiposity changes in infancy. : .
  • Identifier: ISSN: 0022-3476 ; E-ISSN: 1097-6833 ; DOI: 10.1016/j.jpeds.2018.01.028