Toward Body Composition Reference Data for Infants, Children, and Adolescents

Abstract

Growth charts for weight and height have provided the basis for assessment of children’s nutritional status for over half a century, with charts for body mass index (BMI) introduced in the 1990s. However, BMI does not provide information on the proportions of fat and lean mass; and within the past decade, growth charts for children’s body composition have been produced by using techniques such as skinfold thicknesses, body circumferences, bioelectrical impedance analysis (BIA), and dual-energy X-ray absorptiometry (DXA). For public health research, BIA and skinfold thicknesses show negligible average bias but have wider limits of agreement than specialized techniques. For patients, DXA is the best individual method, but multicomponent models remain ideal because they address perturbations in lean mass composition. Data can be expressed in age- and sex-specific SD scores, in some cases adjusting for height. Most such reference data derive from high-income countries, but techniques such as air-displacement plethysmography allow infant body composition growth charts to be developed in low- and middle-income settings, where the data may improve understanding of the effects of low birth weight, wasting, and stunting on body composition. Recent studies suggest that between-population variability in body composition may derive in part from genetic factors, suggesting a universal human body composition reference may not be viable. Body composition growth charts may be extended into adult life to evaluate changes in fat and lean mass through the entire life course. These reference data will improve the understanding of the association between growth, body composition, health, and disease.

Crecimiento físico en jóvenes futbolistas chilenos: propuesta de percentiles por edad cronológica y biológica

“…2 Por lo general, las tablas de crecimiento físico se utilizan para detectar anomalías individuales en la trayectoria del crecimiento, así como para la investigación y monitorización de la salud pública. 3 Esta información p u e d e a y u d a r a e n t e n d e r l a v a r i a b i l i d a d y l a s t e n d e n c i a s seculares sobre el crecimiento de niños y adolescentes deportistas y no deportistas.…”

Development of body composition and its relationship with physical activity in healthy Swedish children : A longitudinal study until 4.5 years of age including evaluation of methods to assess physical activity and energy intake

“…In children, age-and sex-specific cut-offs for overweight and obesity have been established by Cole et al in 2-18-year-old children (11) . However, as pointed out by Wells (12) , BMI is a global proxy of nutritional status and cannot differentiate between the components of body weight, i.e. the total body fat (TBF) and the fat-free mass (FFM).…”

“…Indeed, we have previously shown in 4-year-old children that BMI explained only about 15 % of the variation in TBF% (13) , which is much lower than the corresponding figure (50-70 %) in adults (14) . It is also relevant to note that TBF% has limitations, since it reflects not only the proportion of TBF but also the proportion of FFM in the body (12) . A commonly used alternative is to divide BMI into two measures, the fat mass index (FMI; TBF/height 2 ) and the fat-free mass index (FFMI; FFM/height 2 ) (12) .…”

“…It is also relevant to note that TBF% has limitations, since it reflects not only the proportion of TBF but also the proportion of FFM in the body (12) . A commonly used alternative is to divide BMI into two measures, the fat mass index (FMI; TBF/height 2 ) and the fat-free mass index (FFMI; FFM/height 2 ) (12) .…”

Obesidade e políticas públicas: concepções e estratégias adotadas pelo governo brasileiro

“…Evidence points to the need to develop component curves of body composition for the clinical and epidemiological diagnosis of nutritional status 50 . However, the use of BMI as a criterion for identifying overweight/obesity as a risk factor for NCDs, and not for nutritional diagnosis per se, still appears adequate, particularly in health services.…”