Relative Body Mass Index Improves the BMI Percentile Performance for Detection and Monitoring of Excess Adiposity in Adolescents
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Study Variables
2.3. Definitions
2.4. Statistical Analysis
2.5. Ethical Considerations
3. Results
3.1. Baseline Characteristics
3.2. Correlation of BF% with BMI% and RBMI in Total Sample and by Sex and Race
3.3. Comparing Performance of BMI to RBMI at Both Different Levels of BF% and Specific Cut Points to Detect and Categorize Increased BF% by Sex and Race
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total | Males | Females | p | African Americans | Caucasians | p | |
---|---|---|---|---|---|---|---|
N (%) | 567 (100) | 149 (26.3) | 418 (73.7) | 210 (37.0) | 357 (63.0) | ||
Age (y) | 13.2 (12.0–14.7) | 14.0 (12.2–15.6) | 12.9 (11.9–14.3) | 0.05 | 14.7 (13.0–16.1) | 12.5 (11.7–13.7) | <0.001 |
Weight (kg) | 56.1 (43.1–90.4) | 82.5 (54.2–112.2) | 51.3 (41.1–76.0) | <0.001 | 94.5 (75.8–113.9) | 46.4 (39.6–56.4) | <0.001 |
Height (cm) | 157.8 (151.3–164.8) | 162.8 (155.0–170.2) | 157.0 (150.3–163.0) | <0.001 | 162.5 (157.5–169.4) | 154.8 (149.2–161.9) | <0.001 |
BMI | 22.4 (18.2–33.4) | 31.3 (22.7–39.0) | 20.4 (17.6–29.7) | <0.001 | 35.6 (29.3–41.3) | 19.4 (17.2–22.5) | <0.001 |
BMI% | 85.0 (48.7–99.7) | 98.7 (86.5–99.5) | 74.3 (36.5–97.1) | <0.001 | 99.9 (96.7–99.5) | 60.5 (32.2–86.8) | <0.001 |
RBMI | 120.0 (99.7–173.1) | 161.6 (119.5–197.4) | 111.4 (95.3–154.0) | <0.001 | 179.2 (150.6–209.9) | 103.5 (98.6–120.6) | <0.001 |
BF% (DXA) | 32.2 (22.8–41.0) | 36.7 (29.3–42.1) | 30.0 (21.6–39.6) | <0.001 | 41.4 (34.9–46.5) | 26.2 (20.1–34.3) | <0.001 |
Measure | All Subjects | Males | Females | African Americans | Caucasians | |||||
---|---|---|---|---|---|---|---|---|---|---|
BMI% | RBMI | BMI% | RBMI | BMI% | RBMI | BMI% | RBMI | BMI% | RBMI | |
Mean (95% CI) | 71.3 (68.8–73.9) | 137.4 (133.4–141.4) | 87.4 (83.7–91.0) | 159.8 (152.2–167.3) | 65.6 (62.5–68.6) | 129.4 (124.9–133.8) | 93.1 (91.8–96.0) | 179.8 (173.7–185.8) | 58.1 (54.9–61.2) | 112.4 (109.3–115.4) |
Median | 85.0 | 118.7 | 98.7 | 161.4 | 74.3 | 11.1 | 99.0 | 179.2 | 60.5 | 103.5 |
Standard Deviation | 31.24 | 48.3 | 22.5 | 46.7 | 31.9 | 46.4 | 15.7 | 44.3 | 30.5 | 29.3 |
Min–Max | 0.2–99.9 | 75.3–347.9 | 0.2–99.9 | 75.3–252.3 | 0.7–99.9 | 76–347 | 0.2–99.9 | 75.3–272.6 | 0.7–99.7 | 76–253 |
Asymmetry | −0.75 | 0.95 | −2.2 | 0.11 | −0.52 | 1.38 | −3.93 | 0.155 | −0.25 | 1.96 |
Kolgomorov Test | 0.0001 * | 0.0001 * | 0.0001 * | 0.02 * | 0.0001 * | 0.0001 * | 0.0001 * | 0.20 | 0.0001 * | 0.0001 * |
Cut point ≥ 25% total body fat | Total | Males | Females | |||||||||
RBMI | Sen | Spe | Sum | RBMI | Sen | Spe | Sum | RBMI | Sen | Spe | Sum | |
110.11 | 84.47 | 95.16 | 179.63 | 114.76 | 89.52 | 84.00 | 173.52 | 105.67 | 87.50 | 91.93 | 179.43 | |
110.43 | 84.21 | 95.16 | 179.37 | 115.19 | 88.71 | 84.00 | 172.71 | 105.72 | 87.11 | 91.93 | 179.03 | |
110.87 | 83.95 | 95.16 | 179.11 | 116.35 | 88.71 | 88.00 | 176.71 | 105.76 | 87.11 | 92.55 | 179.66 | |
111.05 | 83.68 | 95.16 | 178.85 | 117.17 | 87.90 | 88.00 | 175.90 | 105.90 | 87.11 | 93.17 | 180.28 | |
111.10 | 83.42 | 95.16 | 178.58 | 117.54 | 87.90 | 92.00 | 179.90 | 106.05 | 87.11 | 93.79 | 180.90 | |
111.21 | 83.16 | 95.16 | 178.32 | 118.38 | 87.10 | 92.00 | 179.10 | 106.12 | 86.72 | 93.79 | 180.51 | |
111.37 | 82.89 | 95.16 | 178.06 | 119.25 | 86.29 | 92.00 | 178.29 | 106.58 | 86.33 | 93.79 | 180.12 | |
111.48 | 82.63 | 95.16 | 177.79 | 123.01 | 85.48 | 92.00 | 177.48 | 107.09 | 85.94 | 93.79 | 179.73 | |
111.62 | 82.37 | 95.16 | 177.53 | 126.98 | 84.68 | 92.00 | 176.68 | 107.26 | 85.55 | 93.79 | 179.34 | |
111.74 | 82.11 | 95.16 | 177.27 | 127.78 | 83.87 | 92.00 | 175.87 | 107.40 | 85.55 | 94.41 | 179.96 | |
Cut point ≥ 30% total body fat | Total | Males | Females | |||||||||
RBMI | Sen | Spe | Sum | RBMI | Sen | Spe | Sum | RBMI | Sen | Spe | Sum | |
109.51 | 94.97 | 85.08 | 180.05 | 117.54 | 93.52 | 75.61 | 169.13 | 109.21 | 94.29 | 88.89 | 183.17 | |
109.54 | 94.65 | 85.08 | 179.73 | 118.38 | 92.59 | 75.61 | 168.20 | 109.46 | 94.29 | 89.37 | 183.66 | |
109.59 | 94.65 | 85.48 | 180.14 | 119.25 | 92.59 | 78.05 | 170.64 | 109.54 | 93.81 | 89.37 | 183.18 | |
109.66 | 94.65 | 85.89 | 180.54 | 123.01 | 91.67 | 78.05 | 169.72 | 109.59 | 93.81 | 89.86 | 183.66 | |
109.80 | 94.65 | 86.29 | 180.94 | 126.98 | 91.67 | 80.49 | 172.15 | 109.75 | 93.81 | 90.34 | 184.15 | |
109.89 | 94.34 | 86.29 | 180.63 | 127.78 | 90.74 | 80.49 | 171.23 | 109.89 | 93.33 | 90.34 | 183.67 | |
109.93 | 94.03 | 86.29 | 180.32 | 129.33 | 89.81 | 80.49 | 170.30 | 109.93 | 92.86 | 90.34 | 183.20 | |
110.00 | 94.03 | 86.69 | 180.72 | 130.85 | 88.89 | 80.49 | 169.38 | 110.00 | 92.86 | 90.82 | 183.68 | |
110.07 | 93.71 | 86.69 | 180.40 | 131.49 | 87.96 | 80.49 | 168.45 | 110.07 | 92.38 | 90.82 | 183.20 | |
110.11 | 93.40 | 86.69 | 180.09 | 132.48 | 87.04 | 80.49 | 167.52 | 110.11 | 91.90 | 90.82 | 182.73 | |
Cut point ≥ 85th percentile total body fat | Total | Males | Females | |||||||||
RBMI | Sen | Spe | Sum | RBMI | Sen | Spe | Sum | RBMI | Sen | Spe | Sum | |
171.93 | 87.50 | 91.97 | 179.47 | 147.94 | 85.23 | 83.61 | 168.83 | 134.23 | 92.38 | 87.50 | 179.88 | |
172.76 | 87.50 | 92.24 | 179.74 | 148.57 | 84.09 | 83.61 | 167.70 | 134.55 | 92.38 | 87.82 | 180.20 | |
173.61 | 87.50 | 92.52 | 180.02 | 149.60 | 82.95 | 83.61 | 166.56 | 134.91 | 92.38 | 88.14 | 180.52 | |
175.32 | 87.50 | 92.80 | 180.30 | 150.09 | 82.95 | 85.25 | 168.20 | 135.04 | 92.38 | 88.46 | 180.84 | |
176.86 | 87.50 | 93.07 | 180.57 | 152.48 | 82.95 | 86.89 | 169.84 | 135.74 | 92.38 | 88.78 | 181.16 | |
177.21 | 85.71 | 93.07 | 178.79 | 156.98 | 81.82 | 86.89 | 168.70 | 136.48 | 91.43 | 88.78 | 180.21 | |
177.47 | 83.93 | 93.07 | 177.00 | 159.30 | 80.68 | 86.89 | 167.57 | 136.58 | 90.48 | 88.78 | 179.26 | |
177.91 | 83.93 | 93.35 | 177.28 | 159.90 | 79.55 | 86.89 | 166.43 | 136.61 | 89.52 | 88.78 | 178.31 | |
178.69 | 83.93 | 93.63 | 177.56 | 160.78 | 78.41 | 86.89 | 165.29 | 136.84 | 89.52 | 89.10 | 178.63 | |
179.21 | 82.14 | 93.63 | 175.77 | 161.38 | 77.27 | 86.89 | 164.16 | 137.15 | 89.52 | 89.42 | 178.95 | |
Cut point ≥ 95th percentile total body fat | Total | Males | Females | |||||||||
RBMI | Sen | Spe | Sum | RBMI | Sen | Spe | Sum | RBMI | Sen | Spe | Sum | |
150.34 | 95.12 | 83.52 | 178.64 | 170.52 | 91.07 | 82.80 | 173.87 | 150.02 | 92.54 | 86.57 | 179.11 | |
150.57 | 95.12 | 83.75 | 178.87 | 171.31 | 91.07 | 83.87 | 174.94 | 150.57 | 92.54 | 86.86 | 179.39 | |
151.73 | 95.12 | 83.97 | 179.09 | 171.92 | 91.07 | 84.95 | 176.02 | 151.73 | 92.54 | 87.14 | 179.68 | |
152.95 | 95.12 | 84.20 | 179.32 | 172.74 | 91.07 | 86.02 | 177.09 | 152.95 | 92.54 | 87.43 | 179.97 | |
153.07 | 95.12 | 84.42 | 179.55 | 173.90 | 91.07 | 87.10 | 178.17 | 153.07 | 92.54 | 87.71 | 180.25 | |
153.30 | 94.31 | 84.42 | 178.73 | 174.63 | 89.29 | 87.10 | 176.38 | 153.30 | 91.04 | 87.71 | 178.76 | |
154.16 | 94.31 | 84.65 | 178.96 | 174.76 | 89.29 | 88.17 | 177.46 | 154.43 | 91.04 | 88.00 | 179.04 | |
155.10 | 93.50 | 84.65 | 178.15 | 175.00 | 87.50 | 88.17 | 175.67 | 155.64 | 91.04 | 88.29 | 179.33 | |
155.64 | 93.50 | 84.88 | 178.37 | 175.19 | 85.71 | 88.17 | 173.89 | 156.61 | 91.04 | 88.57 | 179.62 | |
156.61 | 93.50 | 85.10 | 178.60 | 175.98 | 83.93 | 88.17 | 172.10 | 157.40 | 89.55 | 88.57 | 178.12 |
Categories | Males | Females | Both Sexes | |||||
---|---|---|---|---|---|---|---|---|
Traditional | Adiposity by BF% | BF Cut Points (%) | Reported RBMI Cut Points (%) | Proposed RBMI Cut Points (%) | BF Cut Points (%) | Reported RBMI Cut Points (%) | Proposed RBMI Cut Points (%) | Proposed RBMI Cut Points (%) |
NW | Normal Adiposity | <20 | <100 | ≥75–<100 | <25 | <106.1 | ≥75–<110 | ≥75–<100 |
OW | Mildly high Adiposity | ≥20–<25 | <117.6 | ≥100–<120 | ≥25–<35 | <117.7 | ≥110–<120 | ≥100–<120 |
OB | Moderately high adiposity | ≥25–<35 | <161.7 | ≥120–<160 | ≥35–<45 | <160.0 | ≥120–<160 | ≥120–<160 |
SVOB | Severely high adiposity | ≥35 | ≥161.7 | ≥160 | ≥45 | ≥160.0 | ≥160 | ≥160 |
Adiposity Categories | Total (n = 567) | Males (n = 149) | Females (n = 418) | African Americans (n = 210) | Caucasians (n = 357) | |
---|---|---|---|---|---|---|
BMI% | NW (<85th %ile) | 65.9 (62.0–69.6) | 40.2 (32.0–48.8) | 72.8 (68.6–76.6) | 9.5 (6.2–14.2) | 73.7 (68.9–78.0) |
OW (≥85th and <95th %ile) | 12.0 (9.6–14.8) | 11.8 (7.3–18.6) | 12.0 (9.4–15.3) | 8.1 (5.1–12.6) | 12.4 (9.1–15.8) | |
OB (≥95th BMI–<99th %ile) | 11.5 (9.2–14.3) | 24.4 (17.8–32.6) | 8.0 (5.9–10.8) | 31.0 (25.1–37.5) | 9.2 (6.7–12.7) | |
SVOB (≥99th %ile) | 10.6 (8.4–13.4) | 23.6 (17.1–31.7) | 7.2 (5.2–9.9) | 51.4 (44.7–58.1) | 5.0 (3.2–7.8) | |
RBMI | NW (<100%) | 36.4 (32.7–40.4) | 21.3 (15.0–29.2) | 40.5 (36.2–45.0) | 3.8 (1.9–7.3) | 37.8 (32.9–42.9) |
OW (≥100 <120%) | 31.8 (28.2–35.6) | 26.0 (19.1–34.2) | 33.3 (29.2–37.7) | 6.2 (3.6–10.3) | 35.9 (31.0–40.9 | |
OB (≥120 <160%) | 17.0 (14.2–20.2) | 22.8 (16.4–30.8) | 15.4 (12.4–18.9) | 21.4 (16.4–27.5) | 17.6 (14.0–21.9) | |
SVOB (≥160%) | 14.8 (12.2–17.8) | 29.9 (22.6–38.4) | 10.8 (8.3–13.8) | 68.6 (61.5–74.0) | 8.7 (6.2–12.1) |
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Velasquez-Mieyer, P.A.; Nieto-Martinez, R.; Neira, C.P.; De Oliveira-Gomes, D.; Velasquez Rodriguez, A.E.; Ugel, E.; Cowan, P.A. Relative Body Mass Index Improves the BMI Percentile Performance for Detection and Monitoring of Excess Adiposity in Adolescents. Nutrients 2024, 16, 703. https://doi.org/10.3390/nu16050703
Velasquez-Mieyer PA, Nieto-Martinez R, Neira CP, De Oliveira-Gomes D, Velasquez Rodriguez AE, Ugel E, Cowan PA. Relative Body Mass Index Improves the BMI Percentile Performance for Detection and Monitoring of Excess Adiposity in Adolescents. Nutrients. 2024; 16(5):703. https://doi.org/10.3390/nu16050703
Chicago/Turabian StyleVelasquez-Mieyer, Pedro A., Ramfis Nieto-Martinez, Claudia P. Neira, Diana De Oliveira-Gomes, Andres E. Velasquez Rodriguez, Eunice Ugel, and Patricia A. Cowan. 2024. "Relative Body Mass Index Improves the BMI Percentile Performance for Detection and Monitoring of Excess Adiposity in Adolescents" Nutrients 16, no. 5: 703. https://doi.org/10.3390/nu16050703
APA StyleVelasquez-Mieyer, P. A., Nieto-Martinez, R., Neira, C. P., De Oliveira-Gomes, D., Velasquez Rodriguez, A. E., Ugel, E., & Cowan, P. A. (2024). Relative Body Mass Index Improves the BMI Percentile Performance for Detection and Monitoring of Excess Adiposity in Adolescents. Nutrients, 16(5), 703. https://doi.org/10.3390/nu16050703