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J Pediatr. 2018 May;196:168-174.e1. doi: 10.1016/j.jpeds.2018.01.028. Epub 2018 Mar 15.

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

Author information

1
Department of Pediatric Newborn Medicine, Brigham & Women's Hospital, Boston, MA. Electronic address: kbell7@partners.org.
2
Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
3
Departments of Nutritional Sciences and Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI.
4
Clinical Research Center, Boston Children's Hospital, Boston, MA.
5
USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX.
6
Department of Pediatric Newborn Medicine, Brigham & Women's Hospital, Boston, MA.

Abstract

OBJECTIVES:

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/m2]) 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.

STUDY DESIGN:

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 (rs) among BMI, BMIZ, and adiposity at each time point, and between change in BMIZ and change in adiposity between time points.

RESULTS:

Infants (N = 447) were 52% male, 38% white, 31% black, and 29% Hispanic. The BMIZ was moderately correlated with BF% (rs = 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 rs = 0.72-0.76; fat mass index rs = 0.75-0.79). Changes in BMIZ were moderately correlated with adiposity changes from 1 to 4 months of age (rs = 0.44 with BF% change; rs = 0.53 with fat mass change), but only weakly correlated from 4 to 7 months of age (rs = 0.21 with BF% change; rs = 0.27 with fat mass change).

CONCLUSIONS:

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.

TRIAL REGISTRATION:

ClinicalTrials.gov: NCT00412074.

KEYWORDS:

body composition; infant

PMID:
29551311
PMCID:
PMC5924641
[Available on 2019-05-01]
DOI:
10.1016/j.jpeds.2018.01.028

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