Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

A Hattori chart analysis of body mass index in infants and children

Abstract

BACKGROUND: Body mass index (BMI) is widely used as an index of fatness in paediatrics, but previous analysis of the BMI–fatness relationship has been insufficient.

OBJECTIVE: To consider the effects of variation in fat‐free mass (FFM) and fat mass (FM) on BMI in infants, children and Fomon's reference child (Am J Clin Nutr 1982; 35: 1169–1175).

SUBJECTS: 42 infants aged 12 weeks; 64 children aged 8–12 y; Fomon's reference child.

METHODS: FFM was measured by deuterium dilution. FFM index (FFMI) and FM index (FMI) were calculated. The effects of variation in FFM and FM on BMI were explored using Hattori's body composition chart (Am J Hum Biol 1997; 9: 573–578).

RESULTS: In both infancy and childhood, a given BMI can embrace a wide range of percentage body fat. At both time points, the s.d. of FFMI was >60% of the s.d. of FMI. Graphic analysis differentiated the effects of lean tissue and fat deposition on BMI with age in the reference child.

CONCLUSION: Although valuable for assessing short‐term changes in nutritional status in individuals, and for comparing mean relative weight between populations, BMI is of limited use as a measure of body fatness in individuals in both infancy and childhood. The development of BMI with age may be disproportionately due to either FFM and FM at different time points.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Goran MI, Driscoll P, Johnson R, Nagy TR, Hunter G . Cross‐calibration of body‐composition techniques against dual‐energy X‐ray absorptiometry in young children Am J Clin Nutr 1996 63: 299–305.

    Article  CAS  Google Scholar 

  2. Davies PDW . Estimates of body fatness in infancy and childhood Am J Hum Biol 1992 4: 621–624.

    Article  Google Scholar 

  3. Fiorotto ML, Cochran WJ, Klish WJ . Fat‐free mass and total body water of infants established from total body electrical conductivity measurements Pediatr Res 1987 22: 417–421.

    Article  CAS  Google Scholar 

  4. Boileau RA, Lohman TG, Slaughter MH, Ball TE, Going SB, Hendrix MK . Hydration of the fat‐free body in children during maturation Hum Biol 1984 56: 651–666.

    CAS  PubMed  Google Scholar 

  5. Hewitt MJ, Going SB, Williams DP, Lohman TG . Hydration of the fat‐free body mass in children and adults: implications for body composition assessment Am J Physiol 1993 265: E88–E95.

    CAS  PubMed  Google Scholar 

  6. Wells JCK, Fuller NJ, Dewit O, Fewtrell MS, Elia M, Cole TJ . Four‐component model of body composition in children: density and hydration of fat‐free mass and comparison with simpler models Am J Clin Nutr 1999 69: 904–912.

    Article  CAS  Google Scholar 

  7. Dietz WH, Robinson TN . Use of the body mass index (BMI) as a measure of overweight in children and adolescents. J Pediatr 1988 132: 191–193.

    Google Scholar 

  8. Prentice AM . Body mass index standards for children are useful for clinicians but not yet for epidemiologists Br Med J 17: 1401–1402.

    Article  CAS  Google Scholar 

  9. Bland JM, Altman DG . Statistical methods for assessing agreement between 2 methods of clinical measurement Lancet 1986 i: 307–310.

    Article  Google Scholar 

  10. Garrow JS, Webster J . Quetelet's index (W/H2) as a measure of fatness Int J Obes 1985 9: 147–153.

    CAS  PubMed  Google Scholar 

  11. Fomon SJ, Haschke F, Ziegler EE, Nelson SE . Body composition of reference children from birth to age 10 years Am J Clin Nutr 1982 35: 1169–1175.

    Article  CAS  Google Scholar 

  12. Van Itallie TB, Yang M, Heymsfield SB, Funk RC, Boileau RA . Height‐normalised indices of the body's fat‐free and fat fat mass: potentially useful indicators of nutritional status Am J Clin Nutr 1990 52: 953–959.

    Article  CAS  Google Scholar 

  13. Hattori K, Tatsumi N, Tanaka S . Assessment of body composition by using a new chart method Am J Hum Biol 1997; 9: 573–578.

    Article  Google Scholar 

  14. Hattori K . Body composition and lean body mass index for Japanese college students J Anthropol Soc Nippon 1991 99: 141–148.

    Article  Google Scholar 

  15. Wells JCK, Davies PSW . Energy cost of physical activity in twelve week old infants Am J Hum Biol 1995 7: 85–92.

    Article  CAS  Google Scholar 

  16. Wells JCK, Fewtrell MS, Jones SC, Cole TJ . Comparison of body composition by DXA and deuterium in children aged 5 to 11 years Pediatr Res 1996 40: A249.

    Article  Google Scholar 

  17. Cole TJ, Freeman JV, Preece MA . Body mass index reference curves for the UK, 1990 Arch Dis Child 1995 73: 25–29.

    Article  CAS  Google Scholar 

  18. Paul AA, Cole TJ, Ahmed EA, Whitehead RG . The need for revised standards for skinfold thickness in infancy Arch Dis Child 1998 78: 354–358.

    Article  CAS  Google Scholar 

  19. Butte NF, Wong WW, Fiorotto M, O'Brian Smith E, Garza C . Influence of early feeding mode on body composition of infants Biol Neonate 1995 67: 414–424.

    Article  CAS  Google Scholar 

  20. Goran MI, Allison DB, Poehlman ET . Issues relating to normalisation of body fat content in men and women Int J Obes 1995 19: 638–643.

    CAS  Google Scholar 

  21. Sarria A, Garcia‐Llop LA . Skinfold thickness measurements are better predictors of body fat percentage than body mass index in male Spanish children and adolescents Eur J Clin Nutr 1998 52: 573–576.

    Article  CAS  Google Scholar 

  22. Chan YL, Leung SSF, Lam WWM, Peng XH, Metreweli C . Body fat estimation in children by magentic resonance imaging, bioelectrical impedance, skinfold and body mass index: a pilot study J Paediatr Child Health 1998 34: 22–28.

    Article  CAS  Google Scholar 

  23. Pietrobelli A, Faith MS . Body mass index as a measure of adiposity among children and adolescents: a validation study J Pediatr 1998 132: 204–210.

    Article  CAS  Google Scholar 

  24. Davies PSW, Lucas A . Quetelet's index as a measure of body fatness in young infants Early Hum Dev 1989 20: 135–141.

    Article  CAS  Google Scholar 

  25. Daniels SR, Khoury PR, Morrison JA . The utility of body mass index as a measure of body fatness in children and adolescents: differences by race and gender Pediatrics 1997 99: 804–807.

    Article  CAS  Google Scholar 

  26. Van den Broeck J, Wit J‐M . Anthropometry and body composition in children Hormone Res 1997 38 (Suppl 1): 33–42.

    Article  Google Scholar 

  27. Warner JT, Cowan FJ, Dunstan FDJ, Gregory JW . The validity of body mass index for the assessment of adiposity in children with disease states Ann Hum Biol 1997 24:: 209–215.

    Article  Google Scholar 

  28. Rolland‐Cachera M‐F, Deheeger M, Bellisle F, Sempé M, Guilloud‐Bataille M, Patoid E . Adiposity rebound in children: a simple indicator for predicting obesity Am J Clin Nutr 1984 39: 129–135.

    Article  Google Scholar 

  29. Torun B, Viteri FE . Influence of exercise on linear growth Eur J Clin Nutr 1994 49 (Suppl 1): S186–189.

    Google Scholar 

  30. Vaisman N, Zadik Z, Akivias A, Voet H, Katz I, Yair S, Ashkenazi A . Changes in body composition, resting energy expenditure, and thermic effect of food in short children on growth hormone therapy Metabolism 1994 43: 1543–1548.

    Article  CAS  Google Scholar 

  31. Andersen RE, Crespo CJ, Bartlett SJ, Cheskin LJ, Pratt M . Relationship of physical and television watching with body weight and level of fatness among children JAMA 1998 279: 938–942.

    Article  CAS  Google Scholar 

  32. Stafford M, Wells JCK, Fewtrell MS . Television watching and fatness in children JAMA 1998 280: 1231–1232.

    CAS  PubMed  Google Scholar 

  33. Schaefer F, Georgi M, Wühl E, Schärer K . Body mass index and percentage fat mass in healthy German schoolchildren and adolescents Int J Obes 1998 22: 461–469.

    Article  CAS  Google Scholar 

  34. Garn SM, Leonard WR, Hawthorne VM . Three limitations of the body mass index Am J Clin Nutr 1986 44: 996–997.

    Article  CAS  Google Scholar 

  35. Flegal KM . Defining obesity in children and adolescents: epidemiologic approaches Cr Rev Food Sci Nutr 1993 33: 307–312.

    Article  CAS  Google Scholar 

  36. Power C, Lake JK, Cole TJ . Measurement and long‐term health risks of child and adolescent fatness Int J Obes 1997 21: 507–526.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wells, J. A Hattori chart analysis of body mass index in infants and children. Int J Obes 24, 325–329 (2000). https://doi.org/10.1038/sj.ijo.0801132

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0801132

Keywords

This article is cited by

Search

Quick links