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Updated: Apr 13, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Body composition among Sri Lankan infants by ¹⁸O dilution method and the validity of anthropometric equations to
Thushari Bandara1, Manjula Hettiarachchi2, Chandrani Liyanage3
1Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka. wvthush@yahoo.com.
Insights
Body composition in Sri Lankan infants is comparable to international standards. The Durnin & Wormsley skinfold equation is the most accurate for predicting body fat in this population, showing the least bias.
Area of Science:
- Pediatrics
- Human Nutrition
- Anthropometry
Background:
- Accurate body composition assessment is crucial for monitoring infant growth and nutritional status.
- The (18)O dilution method offers a precise reference for measuring body composition.
- Evaluating anthropometric prediction equations against reference methods is essential for their clinical applicability.
Purpose of the Study:
- To measure Sri Lankan infant body composition using the (18)O dilution method.
- To calculate infant body fat using established skinfold prediction equations.
- To assess the accuracy of these skinfold equations for Sri Lankan infants compared to the (18)O dilution reference.
Main Methods:
- A cross-sectional study involving 25 healthy, exclusively breast-fed infants.
- Body composition measured via (18)O dilution.
- Anthropometric measurements included weight, length, skinfold thickness, and mid-upper arm circumference.
- Bland and Altman analysis compared anthropometric predictions to (18)O dilution values.
Main Results:
- Infant body weight averaged 6.5 kg and length 64.7 cm.
- (18)O dilution revealed mean total body water of 58.8%, fat-free mass of 4.6 kg, fat mass of 1.9 kg, and % fat mass of 29.5%.
- Boys exhibited significantly higher total body water and fat-free mass than girls.
- Most skinfold equations showed a bias dependent on % fat mass, unlike three specific equations (Bandana, Goran, Durnin & Wormsley).
Conclusions:
- Sri Lankan infant body composition aligns with data from industrialized nations.
- Common anthropometric equations demonstrate variable bias, influenced by body fat levels.
- The Bandana, Goran, and Durnin & Wormsley equations exhibited constant bias.
- The Durnin & Wormsley equation demonstrated the lowest bias and narrowest agreement limits against the (18)O dilution reference.
- Equation accuracy can be influenced by infant gender.
Background:
Body composition indicators provide a better guidance for growth and nutritional status of the infants. This study was designed to (1) measure the body composition of the Sri Lankan infants using a reference method, the (18)O dilution method; (2) calculate the body fat content of the infants using published skinfold prediction equations; and (3) evaluate the applicability of the skinfold equations to predict body fat among Sri Lankan infants against the (18)O dilution method.
Methods:
Twenty five healthy, exclusively breast-fed infants were randomly recruited at well-baby clinics, for this cross-sectional study. Body composition was measured using (18)O dilution. Infant body weight, length, skinfold thicknesses and mid upper-arm circumference were measured using standard procedures. The Bland and Atlman pair-wise comparison method was used to evaluate the agreement of body fat generated using the anthropometric prediction equations against the (18)O dilution values as the reference.
Results:
Mean (SD) body weight and length of the infants were 6.5 kg (0.9) and 64.7 cm (2.8) respectively. Mean total body water, fat free mass, fat mass and % fat mass as measured by (18)O dilution method were 58.8% (5.0), 4.6 kg (0.8), 1.9 (0.5) and 29.5% (6.1). Total body water and fat free mass were significantly higher in boys when compared to girls. With the exception of three prediction equations (Bandana et al., Goran et al. and Durnin and Wormsley), most of the other commonly used anthropometry-based prediction equations yielded a bias which was not constant but a function of the % fat mass.
Conclusions:
Body composition of Sri Lankan infants is comparable to the normative data available from the industrialized countries. Most of the commonly used anthropometric prediction equations generated a bias which varies with the size of the body fat. Only three prediction equations (Bandana, Goran, Durnin & Wormsley) yield a constant bias. The Durnin & Wormsely equation showed the smallest bias when compared to the (18)O dilution values with the narrowest limits of agreement. Accuracy of some of the prediction equations is a function of gender.
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