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Updated: Jul 9, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Tri-ponderal mass index as a screening tool for obesity prediction in children aged 6-9 years
Yang Niu1,2, Yajie Zhang1,3,4, Jinye Sheng1
1Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China.
Insights
Tri-ponderal mass index (TMI) is an effective tool for early obesity screening in Chinese children aged 6-9 years. It shows good agreement with body mass index z-scores (BMI-Z) and percentage of body fat (PBF).
Area of Science:
- Pediatrics
- Public Health
- Anthropometry
Background:
- Childhood obesity is a growing global health concern.
- Accurate screening tools are crucial for early detection and intervention in pediatric populations.
Purpose of the Study:
- To evaluate the efficiency of tri-ponderal mass index (TMI) in identifying obesity among Chinese children aged 6-9 years.
- To compare TMI with percentage of body fat (PBF) and body mass index z-scores (BMI-Z) as obesity indicators.
Main Methods:
- A cross-sectional study involving 5365 children aged 6-9 years in Shanghai.
- Measurements included height, weight, BMI, TMI, waist circumference, waist-to-height ratio (WHtR), and PBF.
- Statistical analyses included receiver operating characteristics curve and kappa statistic to assess agreement.
Main Results:
- TMI remained relatively constant with age, unlike BMI and PBF which increased significantly.
- TMI cutoff values for obesity were established as 14.60 kg/m³ for boys and 14.84 kg/m³ for girls.
- High agreement was found between TMI and BMI-Z (kappa=0.826 for boys, 0.709 for girls).
Conclusions:
- Tri-ponderal mass index (TMI) demonstrates potential as a reliable and constant screening tool for childhood obesity.
- TMI can be a valuable alternative for early identification of obesity risk in children aged 6-9 years.
Objective:
This study aimed to evaluate the efficiency of tri-ponderal mass index (TMI) in determining obesity in Chinese children aged 6-9 years, using the criteria of percentage of body fat (PBF) and body mass index z-scores (BMI-Z).
Methods:
The cross-sectional study included 5365 children, aged 6-9 years, who participated in the project survey "Group prevention and treatment of obesity among students and school health promotion in Shanghai" from September 2007 to September 2009. Height, weight, waist circumference, body mass index (BMI), TMI, waist-to-height ratio (WHtR), and PBF were recorded. Statistical analyses including Kolmogorov-Smirnov test, chi-square test, receiver operating characteristics curve, and kappa chi-square test were performed.
Results:
TMI for both sexes was relatively constant with increasing age, and statistically significant differences were not observed at some ages (P > 0.05 at 6, 7, 8, and 9 years). WHtR showed subtle changes, while BMI and PBF increased significantly with age in boys and girls (P < 0.01). Using BMI-Z criteria as the measure of general obesity, the results indicated that TMI cutoff values for 6-9 years were 14.60 kg/m3 for boys and 14.84 kg/m3 for girls (P < 0.001). Analysis of the agreement between TMI and BMI-Z showed that the kappa statistic was 0.826 in boys and 0.709 in girls (P < 0.001).
Conclusion:
TMI, as a constant tool, holds great potential as an alternative screening method for identifying children aged 6-9 years who may be at risk of obesity at an early stage.
