Body mass index as a measure of body fatness: age- and sex-specific prediction formulas

In 1229 subjects, 521 males and 708 females, with a wide range in body mass index (BMI; 13.9-40.9 kg/m2), and an age range of 7-83 years, body composition was determined by densitometry and anthropometry. The relationship between densitometrically-determined body fat percentage (BF%) and BMI, taking age and sex (males = 1, females = 0) into account, was analysed. For children aged 15 years and younger, the relationship differed from that in adults, due to the height-related increase in BMI in children. In children the BF% could be predicted by the formula BF% = 1.51 x BMI-0.70 x age - 3.6 x sex + 1.4 (R2 0.38, SE of estimate (SEE) 4.4% BF%). In adults the prediction formula was: BF% = 1.20 x BMI + 0.23 x age - 10.8 x sex - 5.4 (R2 0.79, SEE = 4.1% BF%). Internal and external cross-validation of the prediction formulas showed that they gave valid estimates of body fat in males and females at all ages. In obese subjects however, the prediction formulas slightly overestimated the BF%. The prediction error is comparable to the prediction error obtained with other methods of estimating BF%, such as skinfold thickness measurements or bioelectrical impedance.