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Validity of Body Mass Index as a Measure of Adiposity in Infancy

Katherine A Bell1, Carol L Wagner2, Wei Perng3

  • 1Department of Pediatric Newborn Medicine, Brigham & Women's Hospital, Boston, MA.

The Journal of Pediatrics
|March 20, 2018
PubMed

Insights

Body mass index (BMI) and BMI z-score (BMIZ) show moderate correlation with infant adiposity. However, BMIZ changes are poor indicators of adiposity changes later in infancy, limiting their use as surrogates.

Area of Science:

  • Pediatric Nutrition
  • Body Composition Analysis
  • Growth Monitoring

Background:

  • Accurate assessment of infant adiposity is crucial for monitoring health.
  • Body Mass Index (BMI) and BMI z-score (BMIZ) are commonly used but their validity as surrogates for adiposity in infancy is not fully established.

Purpose of the Study:

  • To evaluate the accuracy of BMI and BMIZ in representing infant body fat percentage (BF%), fat mass, and fat mass index at 1, 4, and 7 months.
  • To determine if changes in BMIZ reflect changes in adiposity during infancy.

Main Methods:

  • Secondary analysis of 447 infants from a maternal vitamin D supplementation trial.
  • Dual-energy x-ray absorptiometry (DXA) used to measure body composition at 1, 4, and 7 months.
  • Spearman correlations calculated between BMI/BMIZ and adiposity measures, and between changes in BMIZ and adiposity.

Main Results:

  • BMIZ showed moderate correlation with BF% (rs=0.43-0.55) and stronger correlation with fat mass (rs=0.72-0.76) and fat mass index (rs=0.75-0.79) at 1, 4, and 7 months.
  • Changes in BMIZ moderately correlated with adiposity changes from 1-4 months (rs=0.44-0.53) but weakly from 4-7 months (rs=0.21-0.27).

Conclusions:

  • BMIZ is a moderately valid surrogate for adiposity in infancy.
  • Changes in BMIZ are not reliable indicators of adiposity changes in later infancy.
  • BMI and BMIZ have limitations as surrogates for tracking adiposity changes in infants.
Abstract

Keywords:
body compositioninfant

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