Bi = Bicep, Sb = Subscapular, SI = Suprailiac, Tr = Tricep.

Table IX__ Skin Fold Thicknesses Percentiles in Relation to Breast Development and Age in Girls

Indian children do not show increase in BMI between 5 to 9 years of age for 5th, 10th, 25th and 50th percentiles; there is marginal increase in this age group for 75th, 85th and 95th percentiles. As expected the BMI during adolescence is closely similar in the same SMR. This suggests that during adolescence SMR related age BMI will be a better index for assessing thinness as well as obesity. The range of obesity could be the values at 85th and 95th percentiles for overweight and obesity respectively and £5th percentiles for thinness. Therefore, children during adolescence period should be monitored for BMI in relation to SMR stages for their age.

Subcutaneous fat thickness (SFT) measurements are useful to monitor long term energy balance in adolescence. Triceps and subscapular and other measurements are associated with obesity and blood pressure. Thus these measurements could be useful to follow up body fat if reliably collected. The triceps skin folds are lower in the present study during 6.0-12.0 years of age and thereafter similar to the South African children(11,18) but lower than the Guatemalan children(19). However, the values of subscapular SFT were higher in the present study children as compared to the US children(11,18). The means for tricep and subscapular SFT were much lower in Ludhiana, a rich town in Punjab with marginally better growth parameter(20). It is recommended that those children <5th centile for skin fold thickness (combined – all four measurements or sum of triceps and sub-scapular) be used for defining thinness and >95th centile for obesity until retrospective/prospective correlation for hypertension and other morbidities becomes available for BMI and SFT on children in India or abroad. In view of the strong correlation of anthro-pometric change with sexual development during adolescence it will be reasonable to use calculated indices for sexual maturity.

Acknowledgements

We are thankful to Dabur Research Foundation, India for providing computer facilities.

Contributors: KNA had the original idea. KNA and DKA did the planning, interpretation and drafting. AS did preliminary data organization and analysis and reviewed literature. Final data analysis was done by AKB. KNA will act as the guarantor for the manuscript.

Funding: Indian Council of Medical Research.

Competing interests: None declared.

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