Elsevier

Nutrition

Volume 60, April 2019, Pages 41-47
Nutrition

Applied nutritional investigation
Triponderal mass index rather than body mass index: An indicator of high adiposity in Italian children and adolescents

https://doi.org/10.1016/j.nut.2018.09.007Get rights and content
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open access

Highlights

  • Triponderal mass index is better than body mass index to predict fat mass in childhood.

  • Triponderal mass index can be used as indicator of high adiposity.

  • High adiposity from triponderal mass index cutoffs were superior to the International Obesity Task Force, World Health Organization, and Cacciari reference curves.

Abstract

Objective

The aims of this study were to compare body mass index (BMI) and triponderal mass index (TMI) as predictors of fat mass percentage (FM%) and to develop TMI cutoffs for screening high adiposity. Therefore, TMI- and BMI-based references against FM% criterion for indicating adiposity in Italian children and adolescents were compared.

Methods

This was a cross-sectional study conducted at the University of Rome Tor Vergata, Human Nutrition Unit, from 2008 to 2015. The sample included 485 children and adolescents from 8 to 17 y of age from central-southern Italy. Body weight (kg) and height (m) were assessed to calculate BMI and TMI. FM% was assessed by dual-energy x-ray absorptiometry. The prevalence of high adiposity was based on the 75th percentile of FM%, according to Ogden et al. curves. Statistical tests such as Mann–Whitney, Kruskal–Wallis, polynomial regression, receiver operating characteristics curve, and Cohen's κ, were performed using SPSS version 24 and MedCalc version 18.

Results

Prevalence of high adiposity according to FM% was 50.2% (95% confidence interval [CI], 43.2–57.2) in boys and 43.2% (95% CI, 37.3–49.2) in girls. TMI rather than BMI could better predict FM% for both sexes (boys R2 = 0.67 and girls R2 = 0.79 versus boys R2 = 0.44 and girls R2 = 0.74, respectively). TMI was found to present a significantly higher area under the curve than BMI for indicating high adiposity in children and adolescents. TMI sex- and age-specific cutoffs were responsible by better classification of adiposity, followed by the International Obesity Task Force, World Health Organization, and Cacciari reference curves.

Conclusion

TMI is a useful screening tool in pediatric clinical practice and epidemiologic studies concerning childhood obesity.

Keywords

Obesity
Childhood
Screening
Cutoff
Fat mass
Epidemiologic studies

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