Percentile curves for skinfold thickness for Canadian children and youth

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Abstract

Background. Skinfold thickness (SFT) measurements are a reliable and feasible method for assessing body fat in children but their use and interpretation is hindered by the scarcity of reference values in representative populations of children. The objective of the present study was to develop age- and sex-specific percentile curves for five SFT measures (biceps, triceps, subscapular, suprailiac, medial calf) in a representative population of Canadian children and youth.

Methods. We analyzed data from 3,938 children and adolescents between 6 and 19 years of age who participated in the Canadian Health Measures Survey cycles 1 (2007/2009) and 2 (2009/2011). Standardized procedures were used to measure SFT. Age- and sex-specific centiles for SFT were calculated using the GAMLSS method.

Results. Percentile curves were materially different in absolute value and shape for boys and girls. Percentile girls in girls steadily increased with age whereas percentile curves in boys were characterized by a pubertal centered peak.

Conclusions. The current study has presented for the first time percentile curves for five SFT measures in a representative sample of Canadian children and youth.

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Most cited references 34

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Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Marie Ng, Tom Fleming, Margaret W. Robinson … (2015)

In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.

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Smoothing reference centile curves: the LMS method and penalized likelihood.

Stewart T. Cole, Peter G. Green, Mark P. Green (1992)

Refence centile curves show the distribution of a measurement as it changes according to some covariate, often age. The LMS method summarizes the changing distribution by three curves representing the median, coefficient of variation and skewness, the latter expressed as a Box-Cox power. Using penalized likelihood the three curves can be fitted as cubic splines by non-linear regression, and the extent of smoothing required can be expressed in terms of smoothing parameters or equivalent degrees of freedom. The method is illustrated with data on triceps skinfold in Gambian girls and women, and body weight in U.S.A. girls.

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A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message--'keep your waist circumference to less than half your height'.

H D McCarthy, M. Ashwell (2006)

To examine the influence of age and gender on the waist:height ratio (WHTR) in children and to compare changes over time in WHTR, a measure of central fatness in British children. Representative cross-sectional surveys in 1977, 1987 and 1997. Great Britain and Northern Ireland. Survey 1: children aged 5-16 years measured in 1977 (boys) and 1987 (girls) (BSI, n=8135) and Survey 2: children aged 11-16 measured in 1997 (NDNS, n=773). From Survey 1, waist: height ratio related to age and sex and the proportion of children with a WHTR greater than 0.500 (a boundary value suggested for adults). From Survey 2, comparison of WHTR in children with that from Survey 1 and the actual proportion of children with a WHTR greater than 0.500 compared with the expected proportion using the survey 1 as reference. WHTR decreased with age (P<0.01 for trend), with the mean WHTR being significantly lower in girls (P<0.01). WHTR was significantly greater in children in Survey 2 compared with those measured 10 and 20 years earlier in Survey 1 (P<0.0001). The proportion of children where WHTR exceeded the 0.500 boundary value in Survey 2 was 17% of boys and 11.7% of girls (against 5.0 and 1.5%, respectively, in Survey 1, P<0.0001). The increase in WHTR in boys exceeded that in girls. Values of WHTR during the past 10-20 years have increased greatly showing that central fatness in children has risen dramatically. WHTR is more closely linked to childhood morbidity than body mass index (BMI) and we suggest it should be used as an additional or alternative measure to BMI in children as well as adults. A simple public health message that is the same for adults and children of both sexes and all ages could be stated as 'keep your waist circumference to less than half your height'.

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Author and article information

Contributors

Stefan Kuhle

Journal

Journal ID (nlm-ta): PeerJ

Journal ID (iso-abbrev): PeerJ

Journal ID (publisher-id): peerj

Journal ID (pmc): peerj

Title: PeerJ

Publisher: PeerJ Inc. (San Francisco, USA )

ISSN (Electronic): 2167-8359

Publication date (Electronic): 21 July 2016

Publication date Collection: 2016

Volume: 4

Electronic Location Identifier: e2247

Affiliations

[1 ]Departments of Pediatrics and Obstetrics & Gynaecology, Dalhousie University , Halifax, NS, Canada

[2 ]Department of Mathematics & Statistics, Dalhousie University , Halifax, NS, Canada

Article

Publisher ID: 2247

DOI: 10.7717/peerj.2247

PMC ID: 4963217

PubMed ID: 27547554

SO-VID: 419627eb-e13e-47dd-a605-38c6fc8cd8b2

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.

History

Date received : 17 May 2016

Date accepted : 22 June 2016

Funding

Funded by: IWK Health Centre Establishment

Award ID: #09020

Funded by: IWK Health Centre Research Associate Award

Award ID: #18396

This work was supported by an IWK Health Centre ( http://www.iwk.nshealth.ca) Establishment Grant awarded to Dr Stefan Kuhle (#09020) and an IWK Health Centre Research Associate Award awarded to Dr Jillian Ashley-Martin (#18396). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Percentile curves for skinfold thickness for Canadian children and youth

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Most cited references 34

Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Smoothing reference centile curves: the LMS method and penalized likelihood.

A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message--'keep your waist circumference to less than half your height'.

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