Conclusions:īMI underestimated BF in South Asians and overestimated BF in Black Africans. BMI adjustments therefore varied by age group and FMI level (and indirectly BMI) the largest adjustments were in younger children with higher unadjusted BMI and the smallest in older children with lower unadjusted BMI. However, these were complex because there were statistically significant interactions between Black African ethnicity and FMI ( P=0.004 boys P=0.003 girls) and also between FMI and age group ( P<0.0001 for boys and girls). BMI overestimated BF in Black Africans, requiring negative BMI adjustments for Black African children. BMI consistently underestimated BF in South Asians, requiring positive BMI adjustments of +1.12 kg m − 2 (95% confidence interval (CI): 0.83, 1.41 kg m − 2 P<0.0001) for boys and +1.07 kg m − 2 (95% CI: 0.74, 1.39 kg m − 2 P<0.0001) for girls of all age groups and FMI levels. We restricted analyses to 4–12 year olds, to whom a single consistent FMI (fat mass per height 5) could be applied. Linear regression models were then fitted, separately for boys and girls, to quantify ethnic differences in BMI–FMI relationships and to provide ethnic-specific BMI adjustments. A height-standardized fat mass index (FMI) was derived to represent BF. We used data from four recent UK studies that made deuterium dilution BF measurements in UK children of White European, South Asian and Black African origins. ![]() We aimed to quantify BMI adjustments needed for UK children of Black African and South Asian origins so that adjusted BMI related to BF in the same way as for White European children. However, its validity is limited, especially in children of South Asian and Black African origins. Body mass index (BMI) (weight per height 2) is the most widely used marker of childhood obesity and total body fatness (BF).
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