Association between body mass index, triponderal mass index, and body fat percentage in children and adolescents
DOI:
https://doi.org/10.47197/retos.v72.116843Keywords:
Adolescents , anthropometry, body composition, children, nutritional statusAbstract
Introduction: Despite its widespread use, the body mass index (BMI) still has limitations for assessing adiposity in pediatric populations, particularly due to its inability to differentiate between fat mass and muscle mass.
Objective: To examine the association between BMI, triponderal mass index (TMI), and body fat percentage (%BF) in a representative sample of children and adolescents.
Methodology: This cross-sectional study included 824 students (females n=370, males n=454) from public schools in Quintero, Chile. Participants were stratified by age: children aged 6-9 years (n=355) and adolescents aged 10-19 years (n=469). Weight and height were measured to calculate BMI-z scores, TMI (weight/height³), and %BF (Slaughter formula). Data are presented as mean and standard deviation. Pearson's correlation coefficient (r) assessed associations, while the coefficient of determination (R²) quantified effect sizes.
Results: High prevalence of overweight was observed: 51.5% in children (6-9 years) and 59.8% in adolescents (10-19 years). Significant correlations (p<0.01) were found between indices and %BF: in children, BMI showed r=0.792 with %BF and TMI showed r=0.728; in adolescents, correlations were r=0.728 for BMI and r=0.739 for TMI. TMI demonstrated greater explanatory power (R²) for %BF in girls (R²=0.571) and male adolescents (R²=0.534), while BMI was a better predictor in boys (R²=0.747) and female adolescents (R²=0.623).
Conclusions: TMI showed stronger association with %BF in girls and male adolescents, while BMI was more accurate in boys and female adolescents. These findings highlight the need to establish standardized cut-off points for TMI in pediatric populations.
References
Alarcón A, M. H., Lancellotti G, D. A., Pedreros L, A. R., Bugueño A, C. A., & Munizaga R, R. A. (2016). Estado nutricional y composición corporal en escolares de La Serena, Chile. Revista chilena de nutrición, 43, 138-145. https://doi.org/10.4067/S0717-75182016000200005
Atalah, S., Eduardo. (2012). Epidemiología de la obesidad en chile. Revista Médica Clínica Las Condes, 23(2), 117-123. https://doi.org/https://doi.org/10.1016/S0716-8640(12)70287-0
Bruneau-Chávez, J., España-Romero, V., Lang-Tapia, M., & Chillón Garzón, P. (2015). Diferencias en la Composición Corporal y Somatotipo de Escolares de Etnia Mapuche y no Mapuche de la Comu-na de Temuco - Chile. International Journal of Morphology, 33, 988-995. https://doi.org/10.4067/S0717-95022015000300029
Burton, R. F. (2007). Why is the body mass index calculated as mass/height2, not as mass/height3? Ann Hum Biol, 34(6), 656-663. https://doi.org/10.1080/03014460701732962
Carrascosa, A., Yeste, D., Moreno-Galdó, A., Gussinyé, M., Ferrández, Á., Clemente, M., & Fernández-Cancio, M. (2018). Índice de masa corporal e índice de masa triponderal de 1.453 niños no obe-sos ni malnutridos de la generación del milenio. Estudio longitudinal de Barcelona. Anales de Pediatría, 89(3), 137-143. https://doi.org/https://doi.org/10.1016/j.anpedi.2017.12.016
Curilem Gatica, C., Almagià Flores, A., Rodríguez Rodríguez, F., Yuing Farias, T., Berral de la Rosa, F., Martínez Salazar, C., Jorquera Aguilera, C., Bahamondes Ávila, C., Soís Urra, P., Cristi Montero, C., Bruneau Chávez, J., Pinto Aguilante, J., & Niedmann Brunet, L. (2016). Evaluación de la com-posición corporal en niños y adolescentes: directrices y recomendaciones. Nutr Hosp, 33(3), 285. https://doi.org/10.20960/nh.285
Díaz Martínez, X., Mena Bastías, C., Chavarría Sepúlveda, P., Rodríguez Fernández, A., & Valdivia-Moral, P. Á. (2014). Estado nutricional de escolares según su nivel de actividad física, alimenta-ción y escolaridad de la familia. Revista Cubana de Salud Pública, 39(4). https://revsaludpublica.sld.cu/index.php/spu/article/view/77
Flower, K. B., Perrin, E. M., Viadro, C. I., & Ammerman, A. S. (2007). Using body mass index to identify overweight children: barriers and facilitators in primary care. Ambul Pediatr, 7(1), 38-44. https://doi.org/10.1016/j.ambp.2006.09.008
Freedman, D. S., & Sherry, B. (2009). The validity of BMI as an indicator of body fatness and risk among children. Pediatrics, 124 Suppl 1, S23-34. https://doi.org/10.1542/peds.2008-3586E
González Jiménez, E., Aguilar Cordero, M. J., García López, P. A., Schmidt Río-Valle, J., & García García, C. J. (2012). Análisis del estado nutricional y composición corporal de una población de escola-res de Granada. Nutricion Hospitalaria, 27, 1496-1504. https://doi.org/10.3305/nh.2012.27.5.5926
Hudda, M. T., Nightingale, C. M., Donin, A. S., Fewtrell, M. S., Haroun, D., Lum, S., Williams, J. E., Owen, C. G., Rudnicka, A. R., Wells, J. C. K., Cook, D. G., & Whincup, P. H. (2017). Body mass index ad-justments to increase the validity of body fatness assessment in UK Black African and South Asian children. Int J Obes (Lond), 41(7), 1048-1055. https://doi.org/10.1038/ijo.2017.75
JUNAEB. (2019). Informe Mapa Nutricional 2018. https://www.junaeb.cl/mapa-nutricional
Kain, J., Sandoval, M. H., Orellana, Y., & Weisstaub, G. (2023). Índice de riesgo de obesidad infantil (IROBIC) para áreas administrativas pequeñas en Chile. Nutricion Hospitalaria, 40, 1144-1151. https://doi.org/10.20960/nh.04474
Klunder Klunder, M., Bravo Peregrina, M., Lopez Gonzalez, D., Clark, P., & Miranda Lora, A. L. (2018). Tri-Ponderal Mass Index. A Good Anthropometric Index to Evaluate Adiposity in Children and Adolescents. Hormone Research in Paediatrics,
Lakshman, R., Elks, C. E., & Ong, K. K. (2012). Childhood obesity. Circulation, 126(14), 1770-1779. https://doi.org/10.1161/circulationaha.111.047738
Maffeis, C., & Tatò, L. (2001). Long-term effects of childhood obesity on morbidity and mortality. Horm Res, 55 Suppl 1, 42-45. https://doi.org/10.1159/000063462
MINSAL. (2016). Norma para la evaluación nutricional de niños, niñas y adolescentes de 5 años a 19 años de edad del Ministerio de Salud de Chile. https://www.previenesalud.cl/assets/PDF/normas/2016-norma-evaluacion-nutricional.pdf
Mitchell, E. A., Stewart, A. W., Braithwaite, I., Murphy, R., Hancox, R. J., Wall, C., & Beasley, R. (2018). Factors associated with body mass index in children and adolescents: An international cross-sectional study. PLoS One, 13(5), e0196221. https://doi.org/10.1371/journal.pone.0196221
Mönckeberg B., F., & Muzzo B., S. (2015). La desconcertante epidemia de obesidad. Revista chilena de nutrición, 42, 96-102. https://doi.org/10.4067/S0717-75182015000100013
OMS. (2019). Sobrepeso y obesidad infantil, 2018. https://www.who.int/dietphysicalactivity/childhood/es/
Peterson, C. M., Su, H., Thomas, D. M., Heo, M., Golnabi, A. H., Pietrobelli, A., & Heymsfield, S. B. (2017). Tri-Ponderal Mass Index vs Body Mass Index in Estimating Body Fat During Adolescence. JAMA Pediatr, 171(7), 629-636. https://doi.org/10.1001/jamapediatrics.2017.0460
Quintana-Guzmán, E. M., Salas-Cháves, M. d. P., & Cartín-Brenes, M. (2014). Índice de masa corporal y composición corporal con deuterio en niños costarricenses. Acta pediátrica de México, 35(3), 179-189.
Ramírez-Vélez, R., Correa-Bautista, J. E., Carrillo, H. A., González-Jiménez, E., Schmidt-RioValle, J., Co-rrea-Rodríguez, M., García-Hermoso, A., & González-Ruíz, K. (2018). Tri-Ponderal Mass Index vs. Fat Mass/Height³ as a Screening Tool for Metabolic Syndrome Prediction in Colombian Children and Young People. Nutrients, 10(4). https://doi.org/10.3390/nu10040412
Slaughter, M. H., Lohman, T. G., Boileau, R. A., Horswill, C. A., Stillman, R. J., Van Loan, M. D., & Bemben, D. A. (1988). Skinfold equations for estimation of body fatness in children and youth. Hum Biol, 60(5), 709-723.
UNICEF. (2011). La adolescencia una etapa de oportunidades. https://www.unicef.org/bolivia/UNICEF_-_Estado_Mundial_de_la_Infancia_2011_-_La_adolescencia_una_epoca_de_oportunidades.pdf
Zhang, X., Liu, J., Ni, Y., Yi, C., Fang, Y., Ning, Q., Shen, B., Zhang, K., Liu, Y., Yang, L., Li, K., Liu, Y., Huang, R., & Li, Z. (2024). Global Prevalence of Overweight and Obesity in Children and Adolescents: A Systematic Review and Meta-Analysis. JAMA Pediatr, 178(8), 800-813. https://doi.org/10.1001/jamapediatrics.2024.1576
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