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Relation of body mass index and skinfold thicknesses to cardiovascular disease risk factors in children: the Bogalusa Heart Study^1,2,3,4

¹ From the Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA (DSF and WHD); the Pennington Biomedical Research Center, Baton Rouge, LA (PTK); and the Tulane Center for Cardiovascular Health, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (SRS and GSB).

² The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

³ Supported by National Institute on Aging grant AG-16592.

⁴ Address reprint requests and correspondence to DS Freedman, CDC K-26, 4770 Buford Highway, Atlanta, GA 30341–3724. E-mail: dxf1{at}cdc.gov.

ABSTRACT

Background: Adverse levels of cardiovascular disease (CVD) risk factors are related to skinfold thicknesses and body mass index (BMI) among children, but the relative strengths of these associations are unknown.

Objective: The objective was to determine whether the sum of the triceps and subscapular skinfold thicknesses (SF sum) is more strongly related to levels of 6 risk factors (triglycerides, LDL and HDL cholesterol, insulin, and systolic and diastolic blood pressure) than is BMI.

Design: Cross-sectional analyses of schoolchildren examined in the Bogalusa Heart Study from 1981 to 1994 (n = 6866) were conducted. A risk factor summary index was derived by using principal components analysis.

Results: After race, sex, study period, and age were controlled for, almost all comparisons indicated that BMI was more strongly related to risk factor levels than was the SF sum. Although the differences were generally small, many were statistically significant. Associations with the risk factor summary, for example, were r = 0.50 for BMI and r = 0.47 for SF sum (P < 0.001 for difference). Furthermore, an adverse risk factor summary was observed among 62% of the children with the highest (upper 5%) BMI levels but among only 54% of children with the highest SF sum levels.

Conclusions: BMI is at least as accurate as SF sum in identifying children and adolescents who are at metabolic risk. Because of the training and errors associated with skinfold-thickness measurements, the advantages of BMI should be considered in the design and interpretation of clinical and epidemiologic studies.

Received for publication January 22, 2009. Accepted for publication April 8, 2009.

This article has been cited by other articles:

				D. S. Freedman and B. Sherry The Validity of BMI as an Indicator of Body Fatness and Risk Among Children Pediatrics, September 1, 2009; 124(Supplement_1): S23 - S34. [Abstract] [Full Text] [PDF]