The variations of body mass index and body fat in adult Thai people across the age spectrum measured by bioelectrical impedance analysis

Kaweesak Chittawatanarat^1,2, Sakda Pruenglampoo³, Siriphan Kongsawasdi⁴, Busaba Chuatrakoon⁴, Vibul Trakulhoon⁵, Winai Ungpinitpong⁶, Jayanton Patumanond^2
1Department of Surgery, Faculty of Medicine, ²Clinical Epidemiology Unit, ³Research Institute for Health Sciences, ⁴Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, ⁵Department of Surgery, Bhumibol Adulyadej Hospital, Bangkok, ⁶Surgical Unit, Surin Hospital, Surin, Thailand

Background: The measurements of body mass index (BMI) and percentage of body fat are used in many clinical situations. However, special tools are required to measure body fat. Many formulas are proposed for estimation but these use constant coefficients of age. Age spectrum might affect the predicted value of the body composition due to body component alterations, and the coefficient of age for body fat prediction might produce inconsistent results. The objective of this study was to identify variations of BMI and body fat across the age spectrum as well as compare results between BMI predicted body fat and bioelectrical impedance results on age.
Methods: Healthy volunteers were recruited for this study. Body fat was measured by bioelectrical impedance. The age spectrum was divided into three groups (younger: 18–39.9; middle: 40–59.9; and older: ≥60 years). Comparison of body composition covariates including fat mass (FM), fat free mass (FFM), percentage FM (PFM), percentage FFM (PFFM), FM index (FMI) and FFM index (FFMI) in each weight status and age spectrum were analyzed. Multivariable linear regression coefficients were calculated. Coefficient alterations among age groups were tested to confirm the effect of the age spectrum on body composition covariates. Measured PFM and calculated PFM from previous formulas were compared in each quarter of the age spectrum.
Results: A total of 2324 volunteers were included in this study. The overall body composition and weight status, average body weight, height, BMI, FM, FFM, and its derivatives were significantly different among age groups. The coefficient of age altered the PFM differently between younger, middle, and older groups (0.07; P = 0.02 vs 0.13; P < 0.01 vs 0.26; P <0.01; respectively). All coefficients of age alterations in all FM- and FFM-derived variables between each age spectrum were tested, demonstrating a significant difference between the younger (<60 years) and older (≥60 years) age groups, except the PFFM to BMI ratio (difference of PFM and FMI [95% confidence interval]: 17.8 [12.8–22.8], P < 0.01; and 4.58 [3.4–5.8], P < 0.01; respectively). The comparison between measured PFM and calculated PFM demonstrated a significant difference with increments of age.
Conclusion: The relationship between body FM and BMI varies on the age spectrum. A calculated formula in older people might be distorted with the utilization of constant coefficients.

Keywords: fat mass, fat free mass, age, body mass index, Thai