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Development and validation of skinfold-thickness prediction equations with a 4-compartment model^1,2,3

¹ From the VA Medical Center, Geriatric Research, Education and Clinical Center, Durham, NC (MJP); Wright State University School of Medicine, Lifespan Health Research Center, Kettering, OH (SAC and RMS); and the Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC (MJP).

Background: Skinfold-thickness measurements are commonly obtained for the indirect assessment of body composition.

Objective: We developed new skinfold-thickness equations by using a 4-compartment model as the reference. Additionally, we compared our new equations with the Durnin and Womersley and Jackson and Pollock skinfold-thickness equations to evaluate each equation’s validity and precision.

Design: Data from 681 healthy, white adults were used. Percentage body fat (%BF) values were calculated by using the 4-compartment model. The cohort was then divided into validation and cross-validation groups. Equations were developed by using regression analyses and the 4-compartment model. All equations were then tested by using the cross-validation group. Tests for accuracy included mean differences, R², and Bland-Altman plots. Precision was evaluated by comparing root mean squared errors.

Results: Our new equations’ estimated means for %BF in men and women (22.7% and 32.6%, respectively) were closest to the corresponding 4-compartment values (22.8% and 32.8%). The Durnin and Womersley equation means in men and women (20.0% and 31.0%, respectively) and the Jackson and Pollock mean in women (26.2%) underestimated %BF. All equations showed a tendency toward underestimation in subjects with higher %BF. Bland-Altman plots showed limited agreement between Durnin and Wormersley, Jackson and Pollock, and the 4-compartment model. Precision was similar among all the equations.

Conclusions: We developed accurate and precise skinfold-thickness equations by using a 4-compartment model as the method of reference. Additionally, we found that the skinfold-thickness equations frequently used by clinicians and practitioners underestimate %BF.

Key Words: Body composition • skinfold thickness • body compartments • anthropometry • adipose tissue • nutritional assessment • body fat • obesity

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