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Which anthropometric measures best reflect neonatal adiposity?



Studying the determinants and the long-term consequences of fetal adipose accretion requires accurate assessment of neonatal body composition. In large epidemiological studies, in-depth body composition measurement methods are usually not feasible for cost and logistical reasons, and there is a need to identify anthropometric measures that adequately reflect neonatal adiposity.


In a multiethnic Asian mother–offspring cohort in Singapore, anthropometric measures (weight, length, abdominal circumference, skinfold thicknesses) were measured using standardized protocols in newborn infants, and anthropometric indices (weight/length, weight/length2 (body mass index, BMI), weight/length3 (ponderal index, PI)) derived. Neonatal total adiposity was measured using air displacement plethysmography (ADP) and abdominal adiposity using magnetic resonance imaging (MRI). Correlations of the anthropometric measures with ADP- and MRI-based adiposity were assessed using Pearson’s correlation coefficients (rp), including in subsamples stratified by sex and ethnicity.


Study neonates (n=251) had a mean (s.d.) age of 10.2 (2.5) days. Correlations between ADP-based fat mass (ADPFM) and anthropometric measures were moderate (rp range: 0.44–0.67), with the strongest being with weight/length, weight, BMI and sum of skinfolds (rp=0.67, 0.66, 0.62, 0.62, respectively, all P<0.01). All anthropometric measures except skinfold thicknesses correlated more strongly with ADP-based fat-free mass than ADPFM, indicating that skinfold measures may have more discriminative power in terms of neonatal total body adiposity. For MRI-based measures, weight and weight/length consistently showed strong positive correlations (rp0.7) with abdominal adipose tissue compartments. These correlations were consistent in boys and girls, across different ethnic groups, and when conventional determinants of neonatal adiposity were adjusted for potential confounding. Abdominal circumference was not strongly associated with ADPFM or abdominal fat mass.


Simple anthropometric measures (weight and weight/length) correlated strongly with neonatal adiposity, with some evidence for greater discriminative power for skinfold measures. These simple measures could be of value in large epidemiological studies.

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The authors thank the GUSTO study group, which includes Allan Sheppard, Amutha Chinnadurai, Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Arijit Biswas, Bee Wah Lee, Birit FP Broekman, Boon Long Quah, Borys Shuter, Carolina Un Lam, Chai Kiat Chng, Cheryl Ngo, Choon Looi Bong, Christiani Jeyakumar Henry, Claudia Chi, Cornelia Yin Ing Chee, Yam Thiam Daniel Goh, Doris Fok, E Shyong Tai, Elaine Tham, Elaine Quah Phaik Ling, Evelyn Xiu Ling Loo, Fabian Yap, Falk Mueller-Riemenschneider, George Seow Heong Yeo, Helen Chen, Heng Hao Tan, Hugo PS van Bever, Iliana Magiati, Inez Bik Yun Wong, Ivy Yee-Man Lau, Izzuddin Bin Mohd Aris, Jeevesh Kapur, Jenny L Richmond, Jerry Kok Yen Chan, Joanna D Holbrook, Joanne Yoong, Joao N Ferreira, Jonathan Tze Liang Choo, Jonathan Y Bernard, Joshua J Gooley, Keith M Godfrey, Kenneth Kwek, Kok Hian Tan, Krishnamoorthy Niduvaje, Kuan Jin Lee, Leher Singh, Lieng Hsi Ling, Lin Lin Su, Ling-Wei Chen, Lourdes Mary Daniel, Lynette Pei-Chi Shek, Marielle V Fortier, Mark Hanson, Mary Foong-Fong Chong, Mary Rauff, Mei Chien Chua, Melvin Khee-Shing Leow, Michael Meaney, Mya Thway Tint, Neerja Karnani, Ngee Lek, Oon Hoe Teoh, PC Wong, Paulin Tay Straughan, Peter D Gluckman, Pratibha Agarwal, Queenie Ling Jun Li, Rob M van Dam, Salome A Rebello, Seang-Mei Saw, See Ling Loy, S Sendhil Velan, Seng Bin Ang, Shang Chee Chong, Sharon Ng, Shiao-Yng Chan, Shirong Cai, Shu-E Soh, Sok Bee Lim, Stella Tsotsi, Chin-Ying Stephen Hsu, Sue Anne Toh, Swee Chye Quek, Victor Samuel Rajadurai, Walter Stunkel, Wayne Cutfield, Wee Meng Han, Wei Wei Pang, Yap-Seng Chong, Yin Bun Cheung, Yiong Huak Chan, Yung Seng Lee and Zhongwei Huang. We also thank Ms Pei Ting Tan for assisting in literature review. This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore- NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore. Study sponsors were not involved in the design of the study, statistical analysis and results interpretation. KMG is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union’s Seventh Framework Programme (FP7/2007–2013), projects EarlyNutrition and ODIN (Food-Based Solutions for Optimal Vitamin D Nutrition and Health through the Life Cycle) under grant agreements nos 289346 and 613977. identifier: NCT01174875.

Author contributions

L-WC conducted statistical analysis, interpreted the data and wrote the first draft of the paper. L-WC, M-TT and IMA contributed to data collection, cleaning and analysis. M-TT acquired and analyzed ADP and MRI measurements. LP-CS, KHT, PDG, Y-SC, FY, KMG, VSR and YSL designed and led the GUSTO study. MVF led the magnetic resonance imaging domain in the GUSTO study. S-YC, KMG, MSK and YSL advised on interpretation of results. All authors critically revised the manuscript. YSL had primary responsibility for the final content. All authors have read and approved the final manuscript.

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Correspondence to Y S Lee.

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Competing interests

KMG, Y-SC, and YSL have received reimbursement for speaking at conferences sponsored by companies selling nutritional products. S-YC, KMG and Y-SC are part of an academic consortium that has received research funding from Abbott Nutrition, Nestec and Danone. The remaining authors declare no conflict of interest.

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Chen, LW., Tint, MT., Fortier, M. et al. Which anthropometric measures best reflect neonatal adiposity?. Int J Obes 42, 501–506 (2018).

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