Standards for total body fat and fat-free mass in infants.

Bruin, N. C. De; Velthoven, K. A. M. Van; Ridder, Maria de; Stijnen, Theo; Juttmann, Rikard E.; Degenhart, H. J.; Visser, Henk

doi:10.1136/adc.74.5.386

Cited by 52 publications

(19 citation statements)

References 29 publications

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“…The study indicates that body composition changes very rapidly in the first 6 wk of life with % body fat doubling in this period. Other studies have performed cross-sectional assessments only (10,11), studied only one or two ages before 6 mo (12,28), not commenced at birth (10,12,28), or pooled data collected from infants at a wide range of ages in the first month (14). Because of our finding of large rapid changes in body composition from birth to 6 wk, data obtained 2-4 wk after birth cannot be regarded as indicative of birth values or compared with birth measurements.…”

Section: Discussionmentioning

confidence: 42%

“…Early data were based on chemical analysis of a small number of stillborn infants (6,7). More recently, body composition has been measured using dual-energy x-ray absorptiometry (DXA) (8,9), total body electrical conductivity (TOBEC) (10), magnetic resonance imaging (11), or multicompartment models based on total body water, total body potassium, and bone mineral content measurements (12). However, many of these studies did not measure body composition at birth, and no studies have taken maternal body composition into account.…”

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confidence: 99%

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Body Composition From Birth to 4.5 Months in Infants Born to Non-Obese Women

2010

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Infant body composition is affected by maternal obesity, which results in increased % body fat in the infant. With the rapidly increasing incidence of obesity, it is important that normative data are available for infant body composition that is not affected by this trend in maternal obesity. This study assessed body composition in infants born at term to women with a BMI between 18.5 and 25. Infant % body fat, fat mass (FM), and fat free mass (FFM) were assessed at birth, 6 wk, 3 mo, and 4.5 mo of age by air displacement plethysmography, using the PEA POD body composition system. The effects of age, gender, GA, and feeding mode on these parameters were assessed. The % body fat doubled between birth and 6 wk of age and then increased at a slower rate. FFM was higher in male infants at all ages, whereas % body fat was higher in female infants at 4.5 mo. There was a trend to increased % fat and decreased FFM in breastfed (BF) infants. The study provides unique data regarding changes in infant body composition and growth in infants born to women in the healthy weight range. (Pediatr Res 68: 84-88, 2010) B ody composition in early life may play a key role in the programming of a variety of health outcomes, including hypertension, stroke, type 2 diabetes, obesity, and cardiovascular disease (1). The Barker hypothesis states that undernutrition and small size at birth are associated with increased risk of cardiovascular disease and type 2 diabetes later in life (2). Observational evidence also suggests that faster growth during infancy is associated with an increased risk of obesity (2-5). This is an area of very active research, and in this environment, it is important to establish normal values for infant body composition and growth. In addition, the assessment of feeding interventions for preterm infants may be improved by measuring changes in fat free mass (FFM) vs. fat mass (FM). Deviations from normal developmental patterns of body composition may program these infants for later health problems (2-5). Again, it is critical that normative data be established for infant body composition.Historically, growth has been monitored by serial measurements of weight, length, and head circumference, with little information available on the compositional nature of infant growth. Early data were based on chemical analysis of a small number of stillborn infants (6,7). More recently, body composition has been measured using dual-energy x-ray absorptiometry (DXA) (8,9), total body electrical conductivity (TOBEC) (10), magnetic resonance imaging (11), or multicompartment models based on total body water, total body potassium, and bone mineral content measurements (12). However, many of these studies did not measure body composition at birth, and no studies have taken maternal body composition into account. Because it has been shown that maternal overweight/obesity is associated with increased body fat in the newborn infant (13,14), and the prevalence of maternal obesity is increasing, there is a need to establish norma...

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Section: Discussionmentioning

confidence: 42%

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confidence: 99%

Body Composition From Birth to 4.5 Months in Infants Born to Non-Obese Women

2010

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“…The most extensive and reliable data are those derived from 423 infants in the first year of life using TOBEC 34. In that study, results are presented for percentage fat, fat mass, and fat-free mass plotted against weight, length, and age.…”

Section: The Need For New Reference Datamentioning

confidence: 99%

A critique of the expression of paediatric body composition data

Wells¹

2001

Arch Dis Child

227

192

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There is increasing interest in body composition in paediatric research, as distinct from growth and nutritional status, as almost all diseases have adverse eVects on either fatness or the fat-free mass. However, the approaches used to assess growth and nutritional status are not appropriate for separate evaluations of body fatness and lean mass. Traditional measurements such as body mass index and skinfold thickness do not measure fat in accurate quantitative terms. Various techniques have been used in recent years which divide body weight into fat mass and fat-free mass; however, the data tend not to be appropriately expressed. Body fatness is generally expressed as a percentage of weight, while fat-free mass typically remains unadjusted for size. A more appropriate approach is to normalise both body fatness and fat-free mass for height. This recommendation is relevant both to studies comparing patients with controls and to the expression of new reference data on body composition which are needed to allow informative comparisons. The same approach is appropriate for the classification of childhood obesity.

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“…For fat mass, and considering the relatively low fat-mass content at the time of discharge, the sensitivity appears to be better than could be obtained by other indirect methods (6). Considering that DXA provides an assessment of the whole body in three separate compartments, it appears to be one of the most interesting noninvasive methods presently available for investigating whole body composition in preterm infants.…”

Section: )mentioning

confidence: 99%

“…With respect to weight gain composition, the minimal differences required to reach significance are 2.1 g⅐kg In recent decades, with the progressive increase in the survival of preterm infants, there has been increased interest in their nutritional evaluation in the light of knowledge that adequate feeding in the early weeks of life influences shortand long-term development (1,2). Measurement of body composition is of fundamental importance in the nutritional care for preterm infants, and many techniques have been developed (3)(4)(5)(6)(7). Metabolic balances associated with indirect calorimetry allowed the composition of weight gain in preterm infants to be defined (8,9).…”

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confidence: 99%

Weight Gain Composition in Preterm Infants with Dual Energy X-Ray Absorptiometry

et al. 2001

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Whole body composition was investigated using dual energy x-ray absorptiometry in 54 healthy preterm infants, birth weight Ͻ 1750 g, who were fed fortified human milk (n ϭ 20) and preterm formula (n ϭ 34) when full enteral feeding was attained and then again 3 wk later at around the time of discharge. Weight gain composition was calculated from the difference between the earlier and later measurement. The minimal detectable changes in whole body composition over time according to the variance of the population (within groups of 20 infants) and the minimal detectable changes according to the dietary intervention (between two groups of 20 infants) were determined at 5% significance and 80% power. Whole body composition was similar in the two groups at the initial measurement, but all the measured variables differed at the time of the second measurement. Formula-fed infants showed a greater weight gain (19.9 Ϯ 3.2 versus 15.9 Ϯ 2.2 g⅐kg -1 ⅐d -1 , p Ͻ 0.05), fat mass deposition (5.1 Ϯ 1.9 versus 3.3 Ϯ 1.3 g⅐kg -1 ⅐d -1 , p Ͻ 0.05), bone mineral content gain (289 Ϯ 99 versus 214 Ϯ 64 mg⅐kg -1 ⅐d -1 , p Ͻ 0.05), and increase in bone area (1.6 Ϯ 0.4 versus 1.3 Ϯ 0.3 cm 2 ⅐kg -1 ⅐d -1 , p Ͻ 0.05) compared with the fortified human milk group. From these data, a minimal increase from the first measurement of 111 g lean body mass, 68 g fat mass, and 3.1 g bone mineral content is needed to be detectable in a longitudinal study that includes 20 infants. For significance between two groups of 20 infants around the time of discharge, dietary intervention needs to achieve minimal differences of 160 g lean body mass, 86 g fat mass, and 4.1 g bone mineral content. With respect to weight gain composition, the minimal differences required to reach significance are 2.1 g⅐kg In recent decades, with the progressive increase in the survival of preterm infants, there has been increased interest in their nutritional evaluation in the light of knowledge that adequate feeding in the early weeks of life influences shortand long-term development (1, 2). Measurement of body composition is of fundamental importance in the nutritional care for preterm infants, and many techniques have been developed (3-7). Metabolic balances associated with indirect calorimetry allowed the composition of weight gain in preterm infants to be defined (8, 9). The complexity of such techniques and the fact that weight gain composition could only be obtained over a short period of time resulted in the need for a new and reliable method of study. DXA has emerged as an accurate, precise, and reproducible technique for measuring whole body composition in vivo in humans. Determination of lean body mass, fat mass, bone area, and bone mineral content can all be done using DXA (10 -14). Reference values of body composition in preterm and term infants at birth have been reported (11,12). Our aim in the present study was to measure body composition and weight gain composition by DXA in preterm infants fed exclusively on either FHM or PTF and to evaluate the sensitivity of t...

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Standards for total body fat and fat-free mass in infants.

Cited by 52 publications

References 29 publications

Body Composition From Birth to 4.5 Months in Infants Born to Non-Obese Women

Body Composition From Birth to 4.5 Months in Infants Born to Non-Obese Women

A critique of the expression of paediatric body composition data

Weight Gain Composition in Preterm Infants with Dual Energy X-Ray Absorptiometry

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