Year: 2026
Type: article
Abstract: Several models using weight, height and demographic variables to estimate adult fat mass (FM) have shown promising performance but require external validation within new independent settings. Here we evaluated the performance of these models globally, using data from the International Atomic Energy Agency Doubly Labelled Water Database, which includes reference-standard FM information on individuals aged 16+ years spanning 30 countries across all World Health Organization regions. Seven published models predicting adult FM, fat-free mass or FM% using combinations of height, weight (or body mass index), age, sex and/or ethnicity were identified and evaluated. FM from each model was compared with reference-standard FM using R2, calibration and root mean square error within World Health Organization regions and then summarized across regions using meta-analysis. The validation dataset contained 8,228 individuals aged 16–101 years (38% male). Median reference-standard FM was 24.6 kg. Across regions, while models exhibited moderate-to-good R2 values (range 0.69–0.84), most demonstrated miscalibration, with pooled calibration slopes between 0.78 and 1.03, and calibration-in-the-large between 0.59 kg and 3.37 kg. Root mean square error ranged between 4.3 kg and 6.6 kg. Although most models performed well overall, systematic subgroup miscalibration and heterogeneity in predictive performance was observed, suggesting they are not suitable for routine implementation. Future models should ensure consistent high model performance within key subgroups to allow implementation. Using data from 8,228 individuals from 30 countries, this benchmark analysis investigates the performance of fat mass prediction models that use only basic anthropometric features when exposed to previously unseen data.
Source: Nature Health
Authors: Lucinda Archer, Aisha Alsaqabi, Dina Ibrahim, Noor Al-Zahraa Safar, Lenore Arab, Surabhi Bhutani, Pascal Bovet, Soren Brage, Regina Casper, Jamie A. Cooper, Sai Krupa Das, Sanjoy Deb, Lara R. Dugas, Barry W. Fudge, Melanie Gillingham, Annelies H. Goris, Sumei Hu, Peter T. Katzmarzyk, Misaka Kimura, Albert Koulman, William E. Kraus, Wantanee Kriengsinyos, Rebecca Kuriyan, Robert F. Kushner, Estelle V. Lambert, Christel L. Larsson, William R. Leonard, Marie Löf, Corby K. Martin, Marian L. Neuhouser, Kay Nguo, Robert M. Ojiambo, Kirsi H. Pietilainen, Yannis P. Pitsiladis, Michele Polfuss, Judi Porter, Ross L. Prentice, Susan B. Racette, David A. Raichlen, Eric Ravussin, Leanne Redman, Susan Roberts, Srishti Sinha, J. Josh Snodgrass, Eric Stice, Samuel S. Urlacher, Michelle C. Venables, Sarah Whitehead, Bruce Wolfe, Brian Wood, Tsukasa Yoshida, Alexia J. Murphy-Alford, Cornelia U. Loechl, John R. Speakman, Amy Luke, Michele Novaes Ravelli, Herman Pontzer, Jennifer Rood, Hiroyuki Sagayama, Klaas R. Westerterp, William W. Wong, Yosuke Yamada, Richard D. Riley, Christopher G. Owen, Peter H. Whincup, Mohammed T. Hudda, on behalf of the IAEA DLW Database Group
Institutions: National Institute for Health and Care Research, NIHR Birmingham Biomedical Research Centre, University of Birmingham, Dasman Diabetes Institute, Kuwait University, University of California, Los Angeles, San Diego State University, Centre universitaire de médecine générale et santé publique, Lausanne, University of Cambridge, MRC Epidemiology Unit, Medical Research Council, Stanford University, University of Wisconsin–Madison, Tufts University, Jean Mayer Human Nutrition Research Center on Aging, Anglia Ruskin University, University of Cape Town, Loyola University Chicago, University of Glasgow, Oregon Health & Science University, OnePlanet Research Center, Chinese Academy of Sciences, Shenzhen Institutes of Advanced Technology, Pennington Biomedical Research Center, Kyoto University of Advanced Science, Duke University, Mahidol University, St.John's Medical College Hospital, Northwestern University, University of Gothenburg, Karolinska Institutet, University of Washington, Fred Hutch Cancer Center, Monash University, Weill Cornell Medical College in Qatar, Weill Cornell Medicine, Helsinki University Hospital, Hong Kong Baptist University, Children's Hospital of Wisconsin, University of Wisconsin–Milwaukee, Deakin University, Arizona State University, University of Southern California, Dartmouth College, University of Oregon, Baylor University, Leeds Beckett University, Max Planck Institute for Evolutionary Anthropology, Tohoku University, National Institute of Biomedical Innovation, Health and Nutrition, International Atomic Energy Agency, University of Aberdeen, Institute of Genetics and Developmental Biology, State Key Laboratory of Molecular Developmental Biology, Shenzhen University of Advanced Technology, University of Tsukuba, Maastricht University Medical Centre, Baylor College of Medicine, Children's Nutrition Research Center at Baylor College of Medicine, University of London, City St George's, University of London
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Pfizer, University Hospitals Birmingham NHS Foundation Trust, Louisiana Clinical and Translational Science Center, National Institute for Health and Care Research, International Atomic Energy Agency, Nutrition Obesity Research Center, University of North Carolina, Birmingham Biomedical Research Centre, NIHR Cambridge Biomedical Research Centre, National Institute of General Medical Sciences
OpenAlex ID: W7212309179