PMID- 23405220
OWN - NLM
STAT- MEDLINE
DCOM- 20130820
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 2
DP  - 2013
TI  - Defining body fatness in adolescents: a proposal of the AFAD-A classification.
PG  - e55849
LID - 10.1371/journal.pone.0055849 [doi]
LID - e55849
AB  - AIMS: Body mass index (BMI) shows several limitations as indicator of fatness. 
      Using the International Obesity Task Force (IOTF) reference and the World Health 
      Organization (WHO) standard 2007 on the same dataset yielded widely different 
      rates. At higher levels, BMI and the BMI cut-offs may be help in informing a 
      clinical judgement, but at levels near the norm additional criteria may be 
      needed. This study compares the prevalence of overweight and obesity using IOTF 
      and WHO-2007 references and interprets body composition by comparing measures of 
      BMI and body fatness (fat mass index, FMI; and waist-to-height ratio, WHtR) among 
      an adolescent population. METHODS AND RESULTS: A random sample (n = 1231) of 
      adolescent population (12-17 years old) was interviewed. Weight, height, waist 
      circumference, triceps and subscapular skinfolds were used to calculate BMI, FMI, 
      and WHtR. The prevalence of overweight and obesity were 12.3% and 15.4% (WHO 
      standards) and 18.6% and 6.1% (IOTF definition). Despite that IOTF cut-offs 
      misclassified less often than WHO standards, BMI categories were combined with 
      FMI and WHtR resulting in the Adiposity & Fat Distribution for adolescents 
      (AFAD-A) classification, which identified the following groups normal-weight 
      normal-fat (73.2%), normal-weight overfat (2.1%), overweight normal-fat (6.7%), 
      overweight overfat (11.9%) and obesity (6.1%), and also classified overweight at 
      risk and obese adolescents into type-I (9.5% and 1.3%, respectively) and type-II 
      (2.3% and 4.9%, respectively) depending if they had or not abdominal fatness. 
      CONCLUSIONS: There are differences between IOTF and WHO-2007 international 
      references and there is a misclassification when adiposity is considered. The BMI 
      limitations, especially for overweight identification, could be reduced by adding 
      an estimate of both adiposity (FMI) and fat distribution (WHtR). The AFAD-A 
      classification could be useful in clinical and population health to identify 
      overfat adolescent and those who have greater risk of developing weight-related 
      cardiovascular diseases according to the BMI category.
FAU - Bibiloni, Maria del Mar
AU  - Bibiloni Mdel M
AD  - Research Group on Community Nutrition and Oxidative Stress, University of 
      Balearic Islands, Palma de Mallorca, Spain.
FAU - Pons, Antoni
AU  - Pons A
FAU - Tur, Josep A
AU  - Tur JA
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20130206
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adipose Tissue/*pathology
MH  - *Adiposity
MH  - Adolescent
MH  - Body Composition
MH  - Body Mass Index
MH  - Child
MH  - Female
MH  - Humans
MH  - Male
MH  - Obesity/*classification/*epidemiology
MH  - Overweight/classification/epidemiology
MH  - Prevalence
MH  - Reference Values
MH  - *Waist Circumference
MH  - World Health Organization
PMC - PMC3566104
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2013/02/14 06:00
MHDA- 2013/08/21 06:00
PMCR- 2013/02/06
CRDT- 2013/02/14 06:00
PHST- 2012/07/16 00:00 [received]
PHST- 2013/01/04 00:00 [accepted]
PHST- 2013/02/14 06:00 [entrez]
PHST- 2013/02/14 06:00 [pubmed]
PHST- 2013/08/21 06:00 [medline]
PHST- 2013/02/06 00:00 [pmc-release]
AID - PONE-D-12-21668 [pii]
AID - 10.1371/journal.pone.0055849 [doi]
PST - ppublish
SO  - PLoS One. 2013;8(2):e55849. doi: 10.1371/journal.pone.0055849. Epub 2013 Feb 6.