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Body composition, energy expenditure and physical activity

Is BMI a relevant marker of fat mass in 4 year old children? Results from the MINISTOP trial

European Journal of Clinical Nutrition volume 72, pages 1561–1566 (2018)Cite this article

Subjects

Abstract

Background/objectives

Due to the increase in childhood obesity, identifying children with excess body fat as early as possible is essential. Body mass index (BMI) is commonly used as a marker of body fat in children, adolescents, and adults, yet whether BMI is a valid marker of body fat in pre-school aged children remains to be confirmed. Therefore, we analyzed the associations of BMI with fat and fat-free mass in healthy 4-year-old Swedish children.

Subjects/methods

The study comprised of 303 children (135 girls) participating in the MINISTOP obesity prevention trial. Fat and fat-free mass were measured using air displacement plethysmography and we computed fat mass index (FMI) and fat free mass index (FFMI) as fat and fat free mass (kg)/height2 (m).

Results

BMI was positively yet weakly associated with percent fat mass (boys: r2 = 0.120, P < 0.001 and girls: r2 = 0.224, P < 0.001). There was a strong association between BMI and the FMI (boys: r2 = 0.468, P < 0.001 and girls r2 = 0.598, P < 0.001) as well as between BMI and the FFMI (boys: r2 = 0.621, P < 0.001 and girls: r2 = 0.499, P < 0.001). Children classified as normal weight had a wide range of percent fat mass (12.3 to 35.3%) and FMI (1.75 to 5.78 kg/m2).

Conclusions

BMI was strongly associated to both FMI and FFMI. Therefore, caution is needed when interpreting body fat status based on BMI values in pre-school children.

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Acknowledgements

The MINISTOP team would like to thank all of the children and parents that participated in this study.

Funding

Funding

The MINISTOP project was funded by the Swedish Research Council (project no. 2012-2883) (ML), the Swedish Research Council for Health, Working Life and Welfare (2012-0906) (ML), Bo and Vera Axson Johnsons Foundation (ML), Karolinska Institutet (ML), and the Swedish Nutrition Foundation (CDN). PH was supported by grants from Henning and Johan Throne-Holst Foundation and the Strategic Research Area Health Care Science, Karolinska Institutet/Umeå University and HH was supported by grants from the Swedish Society of Medicine and the County Council of Östergötland, Sweden.

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Authors and Affiliations

  1. Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden

    Christine Delisle Nyström, Pontus Henriksson, Anna Ek, Francisco B Ortega, Jonatan R Ruiz & Marie Löf

  2. PROFITH “PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain

    Pontus Henriksson, Hanna Henriksson, Francisco B Ortega & Jonatan R Ruiz

Authors
  1. Christine Delisle Nyström
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Correspondence to Christine Delisle Nyström.

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The authors declare that they have no conflict of interest.

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Delisle Nyström, C., Henriksson, P., Ek, A. et al. Is BMI a relevant marker of fat mass in 4 year old children? Results from the MINISTOP trial. Eur J Clin Nutr 72, 1561–1566 (2018). https://doi.org/10.1038/s41430-018-0133-y

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