Development and validation of body fat prediction models in American adults

Summary Introduction Commonly used statistical models to predict body fat percentage currently rely on skinfold measures, anthropometric measures, or some combination of the two but do not account for the wide ranges of age and body mass index (BMI) present in the American adult population. The objective of this study was to develop a statistical regression model to predict in vivo body fat percentage (dual energy X‐ray) in men and women across significant age and obesity ranges. Methods This study included 228 adults between the ages of 21 and 70, with BMI between 18.5 and 40.0 kg m −2 . The study population was split into training (n = 163) and validation (n = 65) groups, which were used to develop and validate the prediction models. The models were developed on the training group using a backwards stepwise regression analysis, with the initial predictors including age, BMI, and several anthropometric and skinfold measurements. Results The final statistical regression models included age, BMI, anthropometric measures, and skinfold measures with significant effects following the stepwise process. The models predicted body fat percentage in the testing group with average errors of less than 0.10% body fat in males and females, while the four previously existing methods (Durnin, Hodgdon, Jackson, and Woolcott) significantly underestimated or overestimated body fat in both genders, with errors ranging between 2% and 10%. Conclusions The final models included hand thickness, and the female model was dependent on waist circumference and two of the skinfold measures, while the male model used hip and thigh circumferences, along with three skinfold measures. By including the skinfold measurements separately, instead of only as sums like previous models have done, these models can account for the different relative contributions of each site to total body fat.