Which measure of body fat distribution is best for epidemiologic research among adolescents?

Body fat distribution is a cardiovascular health risk factor in adults. The development of body fat distribution patterns in childhood remains to be explored and the appropriate index and relations of body fat distribution to cardiovascular risk factors in children is not clear. Data are available from the US Health Examination Survey (1966-1970), which included measurements of skinfold thickness, body and limb circumferences, biologic maturity, and risk factors (blood pressure, total cholesterol). Using canonical correlation analysis, the relation between sets of anthropometric variables and risk factors was explored, controlling for age, race, sex, and maturity stage. The relation of various body fat distribution and fatness indices used in adult studies to the risk factors was also explored using stepwise regression and partial correlation analyses. The first canonical correlations were significant between risk factors and both sets of anthropometric variables (skinfolds, 0.36-0.46; circumferences, 0.39-0.54). However, neither method revealed a clear cut pattern suggesting a role of centralized fatness. Rather, body fatness or size appeared to be the major correlate with risk factors in both races (black, white) and sexes and in each maturity status group. In the stepwise regression analysis, a body fatness or "size" variable (e.g., body mass index, hip circumference) invariably entered on step one. Only among the sexually mature did body fat distribution indices enter on the second step in a consistent manner. No one index seemed "better," although indices based on skinfold measures entered more often than the waist/hip ratio.