The aims of this study were to determine reference norms for a fat-free mass index (FFMI) and fat mass index (FMI) in a large population of healthy children in Japan, to observe differences in these values in three age groups between ages three and eleven, and to develop percentile distributions for these parameters. Five hundred twenty-two boys and six hundred forty-nine girls with a wide spectrum of stature, body mass, and body composition underwent bioelectrical impedance analysis (BIA) for the determination of fat-free mass (FFM) and fat mass (FM). Both FFM and FM were divided by stature 2 to give FFMI and FMI, as described previously. Normal FFMI and FMI were defined within the range of the 25th to 75th percentile of age-and gender-specific data in this study. The reference norms for FFMI (3-11 yrs) were 12.7-13.4 kg/m 2 in boys and 12.0-13.0 kg/m 2 in girls. A modest increase in boys was observed with an age increase; otherwise, there were no marked age differences in FFMI for the children as a whole. The reference norms for FMI were 2.8-3.6 kg/m 2 in boys and 3.2-3.8 kg/m 2 in girls. For each 3-year category (i.e., ages 3-5, 6-8 and 9-11 yrs.), FMI progressively increased by an average of 28.6% in boys and 18.8% in girls, compared to an increase in BMI of 11.0 and 11.3% respectively. FFMI and FMI are appropriate for many purposes, and have the advantage of expressing both aspects of body composition in common units. In conclusion, the data presented as percentiles can serve as reference in comparing a child's body composition to that of healthy children of the same age and gender. The reference standards should be appropriate for almost all children in the Japan for whom stature, body mass, and body composition can be measured satisfactorily. However, a more sophisticated approach is ultimately required for evaluating body composition. This article is a preliminary attempt to promote future research in the area of childhood body composition.

Water homeostasis is essential for healthy living. Body water turnover, meaning the replacement of body water that is lost in a given period of time, has been examined in a number of previous studies, and a review of their results has yielded the following findings. Children up to 15 years of age show higher body water turnover than adults, although it is not clear how the aging process influences body water. Among people of similar age, the rate of body water turnover seems to be higher in those who exercise than in those who are sedentary. Therefore we hypothesized that healthy individuals have a higher body water turnover than unhealthy individuals whose metabolic balance, as indicated by water turnover, has broken down, and that a prolonged condition of excessively slow body water turnover may be associated with a lower level of metabolism. If so, body water turnover can be an indicator of human health. However, there is a paucity of information regarding water turnover rates in individuals with various physical characteristics. This study indicates the need for further investigation of body water turnover levels associated with significant changes in physiological condition and metabolic state.

The validity of the BMI and fat mass index (FMI) as indicators of obesity was evaluated in a group of 3-5 yr old (nϭ486) children. Bioelectrical impedance analysis (BIA) was measured (using 50 kHz and tetrapolar electrodes) in order to calculate percent fat mass (%FM) and FMI (fat mass/stature squared). For boys, obesity was defined as м20%FM. For girls, the cutoff for obesity was м25%FM. However, obesity was defined as a BMI at or above the 90th percentile of age-and sex-specific data in this study. The percentile cutoffs for FMI were the same as for BMI using the same sample. There were correlations between BMI or FMI and %FM, but there was no significant correlation between BMI or FMI and stature. Therefore, it appears that both the BMI and FMI in this study are far more useful indices with which to assess obesity, and are reasonable indicators of fatness. However, with the use of %FM by BIA as the criterion for obesity, BMI and FMI had high specificities (95.5-96.4% for BMI and 99.5-100% for FMI) and lower but variable sensitivities (30.4-37.5% for BMI and 42.9-68.8% for FMI). Thus, almost all children who were not obese were classified correctly. In contrast, many obese children were not correctly identified by BMI and FMI. Therefore, we conclude that BMI should be used with caution as an indicator of childhood obesity. The new recommendations based on the FMI approach for defining childhood obesity are associated with a level of sensitivity that is somewhat higher than that of the BMI approach. Caution should, however, be used in generalizing from the findings in this study, and a further investigation of the issue is required.

The primary objective of this study was to determine gender differences in total body fat mass (TBFM) and body fat distribution (subcutaneous fat mass, SFM; and internal fat mass, IFM) in a cross-sectional sample of 280 children. Measurements of the body composition of 141 boys and 139 girls, all apparently healthy and aged 3-6 years were made using bioelectrical impedance. Determinations of impedance were made using a four-terminal impedance analyzer (TP-95K; Toyo Physical, Fukuoka, Japan). Lean body mass (LBM) was calculated using a previously published equation [Goran MI, Kaskoun MC, Carpenter WH, Poehlman ET, Ravussin E, Fontvieikke A-M (1993) Estimating body composition of young children by using bioelectrical resistance. J Appl Physiol 75: 1776-1780]. SFM was calculated using a modification of the equation derived by Skerjl [Skerjl B, Brozek J, Hunt EE (1953) Subcutaneous fat and age changes in body build and body form in women. Am J Phys Anthrop 11: 577-580] and Davies [Davies PSW, Jones PRM, Norgan NG (1986) The distribution of subcutaneous and internal fat in man. Ann Hum Biol 13: 189-192]. The main modifications of the equation in the present study were the introduction of: (1) mean thickness of adipose tissue over body surface/2, and (2) skin mass. IFM was calculated as the difference between TBFM and SFM. The body mass index (BMI; kg/m2) was calculated from the formula: body mass/height2. For each gender, the subjects in the lowest and highest 25th percentiles were designated as "low body mass" and "high body mass", respectively. In the present study, no gender differences in absolute TBFM, SFM and IFM were observed in either of these groups. In contrast, gender differences in relative TBFM (%Fat) and SFM (SFM/mass) were evident in girls. However, the four subgroups were similar in terms of relative IFM (IFM/mass). The TBFM was independently related to SFM, IFM and %Fat in both genders after adjustment for BMI; however, there was no significant association of SFM with IFM after adjustment for BMI in any group. Even after adjustment for BMI, IFM was independently related to %Fat in both genders, although SFM was not independently related to %Fat in any group except low-body-mass boys. This study shows that relative TBFM and SFM are higher in high-body-mass groups and tend to be higher in girls than in boys, and that the higher %Fat in high-body-mass girls than in high-body-mass boys appears to be associated with internal adipose tissue deposits. External adipose tissue mass does not appear to be related to the higher %Fat levels in high-body-mass girls. In addition, subcutaneous fat mass appears to be higher in low-body-mass girls than in low-body-mass boys, although this observation needs confirmation using more valid measures of subcutaneous fat such as computerized tomography and magnetic resonance imaging.

Total body water (TBW) measured by isotope dilution techniques can be used to assess body composition safely and accurately in children. Unfortunately, this method is not readily available for most research projects, particularly when working with large groups of people, because the equipment is complicated and highly specialized. Bioelectrical impedance (BI) method is a simple, quick, and inexpensive method for the assessment of total body water (TBW). In Japanese child population, however, a lack of prediction equations is a problem to determine TBW. The purpose of this study was to determine the prediction equation for TBW determination in Japanese children using the isotope dilution technique as the reference method. Seventy Japanese children (39 boys, 31 girls) with ages ranging between 3 and 6 years participated in this study. They were randomly divided into the validation group (26 boys, 20 girls) and cross-validation group (13 boys, 11 girls). In a forward stepwise regression analysis, 96% of the variability in TBW measured by deuterium oxide (D(2)O) dilution could be predicted by the following equation: TBW(kg)=0.149 x Resistance Index (Stature(2)/resistance, cm(2)/Omega)+0.244 x Weight(kg)+0.460 x Age(y)+0.501 x Sex (boy=1, girl=0)+1.628, with a root mean square error (RMSE) of 0.440 kg in the validation group. This equation predicted TBW in the cross-validation group with R(2)=0.946 and a pure error (PE)=0.400 kg TBW. Hence, this equation should be applicable for predicting TBW in Japanese children aged 3-6 y.

Abstract. This study was undertaken to establish an approach for the investigation of age-related changes in indices of body composition during childhood in Japan. It provides current reference values for total body fat mass (TBFM) and lean body mass (LBM) as indices of body composition in an urban population of 3-to 6-year-old Japanese children. Moreover, we assessed the age-specific patterns of body fat distribution [subcutaneous fat mass (SFM) and internal fat mass (IFM)] during childhood. Measurements of body composition by bioelectrical impedance were made in 141 boys and 139 girls, all apparently healthy, aged 3-6 years. Determinations of impedance were made using a four-terminal impedance analyzer (TP-95K; Toyo Physical, Inc., Fukuoka, Japan). LBM was calculated using the equation of Kushner et al. (1992) and Goran et al. (1993). SFM was calculated using a modification of the equation derived by Skerjl et al. (1953). IFM was calculated as the difference between TBFM and SFM. From ages 3 through 6 years, the mean LBM increased with age in boys and girls, and showed significant age differences. Between the ages of 3 and 6, the average increment in LBM was 5.1 kg in boys and 4.4 kg in girls. On average, boys gained 0.5 kg of TBFM each year, whereas girls gained 0.4 kg of TBFM each year. Furthermore, both groups gained 0.3 kg of SFM each year. Percentage body fat decreased in both genders until approximately the age of 5, and increased again slightly at the age of 6. The age-specific pattern of fat accumulation during childhood was characterized by an almost linear increase in SFM in girls, but a transient decrease in IFM in boys. We conclude that further research is required, including longitudinal assessment of body composition variables, in order to unravel the dynamics of body composition change in Japanese children.(Appl Human Sci, 18 (5): 153-160, 1999)

No abstract

This study compared the body water turnover in endurance athletes and age-matched sedentary men. Eight competitive endurance athletes (20.8+/-1.9 yr) and age-matched eight sedentary men (21.6+/-2.5 yr) participated in this study. Total body water and body water turnover were measured using the deuterium (D(2)O) dilution technique. Urine samples were obtained every day for 10 days after oral administration of D(2)O. The day-by-day concentrations were used to calculate the biological half-life of D(2)O and body water turnover. Maximal oxygen uptake (VO(2max)) and oxygen uptake corresponding to ventilatory threshold (VO(2VT)) as an index of aerobic capacity were determined during a graded exercise test. Both VO(2max) and VO(2VT) were higher in the exercise group than in the sedentary group (P<0.05). The biological half-life of D(2)O was significantly shorter in the exercise group than in the sedentary group (5.89+/-0.81 days vs. 7.52+/-0.77 days, P<0.05), and the percentage of the body water turnover was significantly higher in the exercise group than in the sedentary group (11.99+/-1.96% vs. 9.39+/-1.21%, P<0.05). The body water turnover was correlated with VO(2max) and VO(2VT), respectively (P<0.05). Based on these findings, this study speculates that a level of physical activity may induce a body water turnover higher in the healthy state, since the better trained subjects have a higher body water turnover.