Ethnic and gender differences in body fat in British schoolchildren as measured by DXA

Shaw, Nicholas; Crabtree, Nicola; Kibirige, M S; Fordham, J N

doi:10.1136/adc.2007.117911

Cited by 109 publications

(118 citation statements)

References 18 publications

(15 reference statements)

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“…Diet and physical activity explained most of these differences [30]. To our knowledge, only a few studies have been carried out in Europe to analyze ethnic differences in general and abdominal fat distribution in childhood, and they have suggested ethnic differences in the percentage of fat [24,31]. We measured the total body fat, android/gynoid fat mass ratio (which reflects the waist-to-hip ratio), and preperitoneal fat (which reflects the visceral adipose tissue).…”

Section: Interpretation Of the Main Findingsmentioning

confidence: 99%

Ethnic Disparities in General and Abdominal Adiposity at School Age: A Multiethnic Population-Based Cohort Study in The Netherlands

Gishti

Kruithof²,

Felix³

et al. 2014

Ann Nutr Metab

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Background/Aims: Ethnic differences in obesity prevalence have been reported. We examined ethnic differences in general and abdominal fat distribution in school-age children and the influence of parental prepregnancy, pregnancy, and childhood factors on these differences. Methods: We performed a multiethnic population-based prospective cohort study among 5,244 children with information about prepregnancy factors, pregnancy, and childhood factors. At the age of 6 years, the BMI, total fat mass, android/gynoid fat mass ratio, and preperitoneal fat mass were assessed via dual-energy X-ray absorptiometry and abdominal ultrasound. Results: The overweight and obesity prevalences among Dutch children were 10.0 and 2.1%, respectively. Higher prevalences were observed among Cape Verdean (21.0 and 10.3%), Dutch Antillean (18.4 and 13.8%), Moroccan (20.6 and 7.7%), Surinamese-Creole (13.4 and 7.7%), Surinamese-Hindustani (12.3 and 6.2%), and Turkish (23.8 and 12.0%) children. In the models adjusted for age and sex only, Moroccan, Surinamese-Hindustani, and Turkish children had a higher total fat mass than Dutch children, whereas Surinamese-Creole children had a lower total fat mass. Compared to Dutch children, the android/gynoid fat mass ratio was higher in Moroccan, Surinamese-Hindustani, and Turkish children, whereas the preperitoneal fat mass was higher among Dutch Antillean, Moroccan, Surinamese-Hindustani, and Turkish children (all p < 0.05). Prepregnancy factors explained up to 73% of these differences. In addition to prepregnancy factors, pregnancy factors explained up to 34% of the differences. Childhood factors did not significantly explain these associations. Conclusions: All ethnic minority groups had higher risks of overweight and obesity than Dutch children. Moroccan, Surinamese-Hindustani, and Turkish children also had an adverse body fat profile. Prepregnancy and pregnancy might be critical periods for preventive strategies focused on the reduction of ethnic disparities in childhood adiposity.

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Section: Interpretation Of the Main Findingsmentioning

confidence: 99%

Ethnic Disparities in General and Abdominal Adiposity at School Age: A Multiethnic Population-Based Cohort Study in The Netherlands

Gishti

Kruithof²,

Felix³

et al. 2014

Ann Nutr Metab

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show abstract

“…Increasing BMI is also shown to be associated with higher risk of metabolic complications [3]. However, BMI criteria for obesity may not identify differences in body fat or their distribution [4]. Thus, BMI is an appropriate screening test to identify children requiring further evaluation and follow-up, though it may not be diagnostic of the level of adiposity.…”

Section: Editorialsmentioning

confidence: 99%

“…These differences in body composition are evident from childhood and become more pronounced during adolescence. Shaw, et al [4] from UK demonstrated that from age of 5 years onwards, South Asian girls and boys have higher PBF as compared to the White or African Caribbean ethnic groups, the difference increasing with age. This relative excess of adipose tissue at a given BMI makes Asians more predisposed to metabolic complications like type 2 diabetes (T2DM), hypertension and dyslipidemia [5].…”

mentioning

confidence: 99%

Relevance of measuring body fat in children

Seth

2013

Indian Pediatr

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EDITORIALST he adverse health consequences associated with obesity are related to increase in body fat rather than body weight per se. Thus, it stands to logic that measuring body fat would be a better tool for identifying risk as compared to any indirect measures of adiposity. Accurate measurement of body fat can be done by various techniques like under-water weighing, dual energy X-ray absorptiometry (DEXA), bioelectric impedance, etc. In recent times, DEXA has emerged as a tool of choice for body composition studies. However, use of these methods is largely restricted to research settings because of their complexity and cost. In clinical setting, anthropometric measurements such as skin fold thickness, waist circumference, waist-stature or waist-hip ratio and various height and weight-based indices like body mass index (BMI) are the common tools used to assess adiposity and its related complications.Body mass index has been validated as a simple, low cost tool to assess body fatness for routine clinical evaluation in children and adolescents [1], and is found to be strongly correlated with adiposity [2]. Increasing BMI is also shown to be associated with higher risk of metabolic complications [3]. However, BMI criteria for obesity may not identify differences in body fat or their distribution [4]. Thus, BMI is an appropriate screening test to identify children requiring further evaluation and follow-up, though it may not be diagnostic of the level of adiposity. Attempts have been made to link percentage body fat (PBF) estimates derived by DEXA with BMI and describe PBF values associated with BMI classification of over-weight and obesity [1]. There are age-related and sex-related variations in PBF and thus a single PBF value may not be suitable for classifying children as over-weight or obese.As an ethnic group, Asians tend to have a smaller body size and a relative deficit of lean body mass as compared to Europeans/Americans. Thus, at an equivalent body mass index (BMI), there is a relative excess of body fat in Asians. They also tend to have a more central rather than peripheral distribution of fat. These differences in body composition are evident from childhood and become more pronounced during adolescence. Shaw, et al. [4] from UK demonstrated that from age of 5 years onwards, South Asian girls and boys have higher PBF as compared to the White or African Caribbean ethnic groups, the difference increasing with age. This relative excess of adipose tissue at a given BMI makes Asians more predisposed to metabolic complications like type 2 diabetes (T2DM), hypertension and dyslipidemia [5]. These disorders also tend to occur a lower BMI in Asians as compared to their Western counterparts [6]. Like the increase in body fat, the risk of metabolic complications also starts becoming evident from adolescence itself. In UK, the relative risk of developing T2DM in childhood is reported to be 14 times greater in South Asian than in White European children [7]. In another study from UK, children of South Asian origin ...

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“…The present study therefore serves to indicate that this approach possibly has limitations in certain ethnic groups. Further, a recent study found ethnic differences to increase with age (44) , and this effect of age on the extent to which body composition methods are ethnic-specific requires further investigation.…”

Section: Study Strengths and Weaknessesmentioning

confidence: 99%

“…The appropriateness of using all anthropometric measures, and body composition methods in particular, in ethnic groups is in slight doubt (44) . The extent to which reference data for weight or BMI or body fat should be ethnic-specific is not clear currently, but an important issue is that, at present, all recommended methods for children and adolescents are universal.…”

Section: Study Strengths and Weaknessesmentioning

confidence: 99%

Body fatness or anthropometry for assessment of unhealthy weight status? Comparison between methods in South African children and adolescents

Craig

Reilly

Bland

2012

Public Health Nutr.

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Objective: A variety of methods are available for defining undernutrition (thinness/ underweight/under-fat) and overnutrition (overweight/obesity/over-fat). The extent to which these definitions agree is unclear. The present cross-sectional study aimed to assess agreement between widely used methods of assessing nutritional status in children and adolescents, and to examine the benefit of body composition estimates. Design: The main objective of the cross-sectional study was to assess underweight, overweight and obesity using four methods: (i) BMI-for-age using WHO (2007) reference data; (ii) BMI-for-age using Cole et al. and International Obesity Taskforce cut-offs; (iii) weight-for-age using the National Centre for Health Statistics/WHO growth reference 1977; and (iv) body fat percentage estimated by bio-impedance (body fat reference curves for children of McCarthy et al., 2006). Comparisons were made between methods using weighted kappa analyses. Setting: Rural South Africa. Subjects: Individuals (n 1519) in three age groups (school grade 1, mean age 7 years; grade 5, mean age 11 years; grade 9, mean age 15 years). Results: In boys, prevalence of unhealthy weight status (both under-and overnutrition) was much higher at all ages with body fatness measures than with simple anthropometric proxies for body fatness; agreement between fatness and weight-based measures was fair or slight using Landis and Koch categories. In girls, prevalence of unhealthy weight status was also higher with body fatness than with proxies, although agreement between measures ranged from fair to substantial. Conclusions: Methods for defining under-and overnutrition should not be considered equivalent. Weight-based measures provide highly conservative estimates of unhealthy weight status, possibly more conservative in boys. Simple body composition measures may be more informative than anthropometry for nutritional surveillance of children and adolescents.

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Ethnic and gender differences in body fat in British schoolchildren as measured by DXA

Cited by 109 publications

References 18 publications

Ethnic Disparities in General and Abdominal Adiposity at School Age: A Multiethnic Population-Based Cohort Study in The Netherlands

Ethnic Disparities in General and Abdominal Adiposity at School Age: A Multiethnic Population-Based Cohort Study in The Netherlands

Relevance of measuring body fat in children

Body fatness or anthropometry for assessment of unhealthy weight status? Comparison between methods in South African children and adolescents

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