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Evaluation of BMI Metrics to Assess Change in Adiposity in Children with Overweight and Moderate and Severe Obesity
Author(s) -
Barlow Sarah E.,
Salahuddin Meliha,
Durand Casey,
Pont Stephen J.,
Hoelscher Deanna M.,
Butte Nancy F.
Publication year - 2020
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.22858
Subject(s) - bioelectrical impedance analysis , medicine , body mass index , percentile , overweight , obesity , demography , waist , cohort , mathematics , statistics , sociology
Objective This study aimed to examine the relation between change in different BMI metrics and change in adiposity over a 12‐month weight management intervention. Methods Baseline and 12‐month weights and heights from 399 children aged 2 to 12 years with BMI ≥ 85th percentile were used to calculate BMI, %BMI p95 , %BMI p50 , BMI z ‐score (BMI z ), and modified BMI z ‐score (BMIm z ). Changes (Δ) in these measures were compared with changes in body fat percent (Δfat%) from bioelectrical impedance assessment. Correlation and regression models predicting associations between ΔBMI metrics and Δfat% were examined. Results A total of 89% of the cohort was Hispanic, and 34% had class 2 or 3 obesity. In models predicting Δfat% adjusting for age, sex, and weight category, R 2 for ΔBMI, ΔBMI z , BMIm z , Δ%BMI p95 , and Δ%BMI p50 were 0.53, 0.38, 0.45, 0.53, and 0.54, respectively (all P < 0.001). Only the ΔBMI z model had an interaction with weight status. Among the models with the highest R 2 , age group and sex interacted with the Δ%BMI p95 model but not ΔBMI or ΔBMI p50 models. Conclusions Longitudinal analyses demonstrate the utility of several BMI metrics other than z ‐score in capturing adiposity change consistently across a range of obesity severity. Characteristics of studied groups and interpretability could influence metric choice.