PT  - JOURNAL ARTICLE
AU  - Linda P Hunt
AU  - Anna Ford
AU  - Matthew A Sabin
AU  - Elizabeth C Crowne
AU  - Julian P H Shield
TI  - Clinical measures of adiposity and percentage fat loss: which measure most accurately reflects fat loss and what should we aim for?
AID  - 10.1136/adc.2006.103986
DP  - 2007 May 01
TA  - Archives of Disease in Childhood
PG  - 399--403
VI  - 92
IP  - 5
4099  - http://adc.bmj.com/content/92/5/399.short
4100  - http://adc.bmj.com/content/92/5/399.full
SO  - Arch Dis Child2007 May 01; 92
AB  - Objective: To determine which clinical measure of childhood obesity should be monitored to best reflect change in adiposity in a weight management programme and estimate the degree of change needed to be relatively certain of fat reduction. Subjects: 92 obese children with a mean (range) age of 12.8 (6.9–18.9) years and a mean body mass index standard deviation score (BMI SDS) of +3.38 (+2.27 to +4.47) attending a hospital-based clinic on a regular, 3 monthly basis. Measurements: Pairs of weight and height measured up to 2.41 years apart used to derive BMI as kg/m2, and adjusted for age and gender to give weight and BMI SDS (BMI-z score) using British 1990 Growth Reference Data. Contemporaneous adiposity estimated by fatness measured by a bioimpedance segmental body composition analyser. Results: Changes in BMI-z scores, compared to BMI, weight and weight SDS, most accurately reflected loss of fat. Reductions of 0.25, 0.5, 0.75, and 1 BMI SDS equate to expected mean falls in total body fat percentage of 2.9%, 5.8%, 8.7% and 11.6%. Approximate 95% prediction intervals indicated that a fall in BMI SDS of at least 0.6 over 6–12 months (or 0.5 over 0–6 months) is consistent with actual fat loss. Conclusion: Change in BMI-z score best reflects percentage fat loss compared to BMI, weight and weight SDS. The wide variation in likely percentage fat loss for a given BMI SDS reduction means a loss of 0.5–0.6 is required to be relatively certain of definite percentage fat reduction.