First body fat reference curves for Macedonian children and adolescents: the MAKFIT study

Introduction: childhood obesity is a worldwide chief health problem. Along with body mass index, body fat percentile values can also be used to predict future cardiovascular and metabolic health risks. Objective: the study's aim is to define the percentile values and curves about the fat tissue percentage through which the childhood and adolescent overweight/obesity in the Republic of North Macedonia will be diagnosed. Methods: the research was conducted on a sample of 15,075 children and adolescents aged six to 14 years (7,627 boys and 7,448 girls). Body fat percentage was established by bioelectrical impedance. The LMS method was used in percentile values and curves' construction. Results: the boys' 50th percentile curve shows that the body fat percentage average value has a slight growth from seven to ten years of age, but after their 10th it begins to drop continuously until the age of 14 years. At the same time, the girls' body fat percentage average value increases continuously from six to 14 years of age. Conclusion: since body mass index cannot always establish body fat content, the direct assessment of body fat by bioelectrical impedance would be of great advantage for pediatric and clinical decisions. Therefore, the study provides referent percentile norms for the body fat percentage of healthy Macedonian children and adolescents. For this purpose, a practical and clinically applicable method was used. The obtained referent percentile norms can be useful in assessing overweight and obesity in Macedonian children and adolescents.