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Tornero-Aguilera JF, Villegas-Mora BE, Clemente-Suárez VJ. Differences in Body Composition Analysis by DEXA, Skinfold and BIA Methods in Young Football Players. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1643. [PMID: 36360370 PMCID: PMC9688600 DOI: 10.3390/children9111643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/13/2022] [Accepted: 10/26/2022] [Indexed: 12/01/2023]
Abstract
The most widely used method in professional sports for fat percentage assessment is the skinfold method. However, there is the chance of bias and human error. For this reason, other more precise methods are used, such as single-frequency bioelectrical impedance analysis (BIA) or dual energy X-ray absorptiometry (DEXA). However, there are limited data that demonstrate the methodological shortcomings or congruences in fat and fat-free mass estimates including gender differences and differences in athlete populations. Thus, the aim of the present study was to compare total body fat (%BF) estimated by six skinfold thickness measurement (SKF) and single-frequency bioelectrical impedance analysis (BIA) methods, using three different sets of equations, to that assessed by the dual energy X-ray absorptiometry (DEXA) method using a DEXA Hologic Serie Discovery QDR. For this aim, 76 males and 70 females belonging to the professional Spanish football federation were evaluated. We found significant differences between the three measures. BIA significantly underestimates the fat percentage, followed by skinfolds. With DEXA being the more objective or accurate method, an equation is established by means of linear regression analysis that allows the percentage of adipose tissue to be obtained either through anthropometry or electrical bioimpedance and adjusted to that which would be obtained by the DEXA system.
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Affiliation(s)
- José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain
| | - Bella Esperanza Villegas-Mora
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain
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van Beijsterveldt IALP, Beunders VAA, Bijlsma A, Vermeulen MJ, Joosten KFM, Hokken-Koelega ACS. Body Composition Assessment by Air-Displacement Plethysmography Compared to Dual-Energy X-ray Absorptiometry in Full-Term and Preterm Aged Three to Five Years. J Clin Med 2022; 11:1604. [PMID: 35329930 PMCID: PMC8952802 DOI: 10.3390/jcm11061604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022] Open
Abstract
It is important to monitor body composition longitudinally, especially in children with atypical body composition trajectories. Dual-energy X-ray absorptiometry (DXA) can be used and reference values are available. Air-displacement plethysmography (ADP) is a relatively new technique, but reference values are lacking. In addition, estimates of fat-free mass density (Dffm), needed in ADP calculations, are based on children aged >8 years and may not be valid for younger children. We, therefore, aimed to investigate whether DXA and ADP results were comparable in young children aged 3−5 years, either born full-term or preterm, and if Dffm estimates in the ADP algorithm could be improved. In 154 healthy children born full-term and 67 born < 30 weeks of the inverse pressure-volume gestation, aged 3−5 years, body composition was measured using ADP (BODPOD, with default Lohman Dffm estimates) and DXA (Lunar Prodigy). We compared fat mass (FM), fat mass percentage (FM%) and fat-free mass (FFM), between ADP and DXA using Bland−Altman analyses, in both groups. Using a 3-compartment model as reference method, we revised the Dffm estimates for ADP. In full-term-born children, Bland−Altman analyses showed considerable fixed and proportional bias for FM, FM%, and FFM. After revising the Dffm estimates, agreement between ADP and DXA improved, with mean differences (LoA) for FM, FM%, and FFM of −0.67 kg (−2.38; 1.04), −3.54% (−13.44; 6.36), and 0.5 kg (−1.30; 2.30), respectively, but a small fixed and proportional bias remained. The differences between ADP and DXA were larger in preterm-born children, even after revising Dffm estimates. So, despite revised and improved sex and age-specific Dffm estimates, results of ADP and DXA remained not comparable and should not be used interchangeably in the longitudinal assessment of body composition in children aged 3−5 years, and especially not in very preterm-born children of that age.
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Affiliation(s)
- Inge A. L. P. van Beijsterveldt
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus Medical Center-Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands;
| | - Victoria A. A. Beunders
- Department of Pediatrics, Division of Neonatology, Erasmus Medical Center-Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands; (V.A.A.B.); (A.B.); (M.J.V.)
| | - Alja Bijlsma
- Department of Pediatrics, Division of Neonatology, Erasmus Medical Center-Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands; (V.A.A.B.); (A.B.); (M.J.V.)
| | - Marijn J. Vermeulen
- Department of Pediatrics, Division of Neonatology, Erasmus Medical Center-Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands; (V.A.A.B.); (A.B.); (M.J.V.)
| | - Koen F. M. Joosten
- Department of Pediatric Intensive Care, Sophia Erasmus Medical Center-Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands;
| | - Anita C. S. Hokken-Koelega
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus Medical Center-Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands;
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Influence of weight status on bone mineral content measured by DXA in children. BMC Pediatr 2021; 21:185. [PMID: 33879114 PMCID: PMC8056645 DOI: 10.1186/s12887-021-02665-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/12/2021] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Childhood obesity is a public health problem with repercussions in later life. As tissue formation peaks in childhood we determined how weight status influences bone mineral content. MATERIAL AND METHODS We studied 553 children aged 4-18 years over 10 years (46.8% girls). We measured age, weight, height and through bone densitometry (DXA), bone mineral content (BMC), bone mineral density (BMD), and waist, arm and hip circumferences. The patients were divided into groups using the body mass index z-score: underweight, normal weight, overweight, obese and very obese. RESULTS BMC and BMD values were highest in the normal-weight and overweight groups. Logistic regression showed bone mineralization was inversely associated with waist circumference, the association being positive for weight and age. No differences were found according to sex. DISCUSSION Studies of the relationship between weight and bone mineralization report contradictory results, often because of different study designs. Moreover, studies in children are either few or with small samples. Our findings in a large sample show the importance of weight status in bone mineralization given the risk of bone fractures or osteoporosis. CONCLUSIONS Weight status influenced bone mineralization. BMC and BMD decreased in children with a higher degree of obesity. Waist circumference correlated negatively with bone mineralization.
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Karchynskaya V, Kopcakova J, Klein D, Gába A, Madarasova-Geckova A, van Dijk JP, de Winter AF, Reijneveld SA. Is BMI a Valid Indicator of Overweight and Obesity for Adolescents? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134815. [PMID: 32635439 PMCID: PMC7369744 DOI: 10.3390/ijerph17134815] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/16/2022]
Abstract
Background: Overweight and obesity are mostly monitored via the Body Mass Index (BMI), based on self-reported or measured height and weight. Previous studies have shown that BMI as a measure of obesity can introduce important misclassification problems. The aim of this study was to assess the validity of overweight and obesity classification based on self-reported and on measured height and weight versus the proportion of body fat as the criterion. Methods: We used data on 782 adolescents (mean age = 13.5, 55.8% boys) from the Health Behaviour in School-Aged Children (HBSC) study conducted in 2018 in Slovakia. We obtained self-reported (height and weight) and objective measures (height, weight) and the proportion of fat (as the criterion measure) measured via bioimpedance body composition analysis (BIA) with an InBody 230 from the adolescents. Results: Both measured and self-reported BMI indicated overweight and obesity with relatively low sensitivity (66-82%), but high specificity (90-92%). The superior accuracy of measured BMI in comparison to self-reported BMI was confirmed by the area under the curve (AUC) based on the receiver operating characteristics (ROC) curves (AUC measured/self-reported: 0.94/0.89; p < 0.001). The misclassification of overweight and obesity was significantly higher when using self-reported BMI than when using measured BMI. Conclusion: Both self-reported and measured BMI as indicators of overweight and obesity underestimate the prevalence of adolescents with overweight and obesity.
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Affiliation(s)
- Viktoryia Karchynskaya
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia; (J.K.); (A.M.-G.)
- Graduate School Kosice Institute for Society & Health, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Correspondence: ; Tel.: +421-919-207-692
| | - Jaroslava Kopcakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia; (J.K.); (A.M.-G.)
- Graduate School Kosice Institute for Society & Health, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Daniel Klein
- Institute of Mathematics, Faculty of Natural Sciences, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia;
| | - Aleš Gába
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University in Olomouc, 771 11 Olomouc, Czech Republic;
| | - Andrea Madarasova-Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia; (J.K.); (A.M.-G.)
- Graduate School Kosice Institute for Society & Health, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University in Olomouc, 771 11 Olomouc, Czech Republic
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society & Health, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University in Olomouc, 771 11 Olomouc, Czech Republic
| | - Andrea F. de Winter
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
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Wong MC, Ng BK, Kennedy SF, Hwaung P, Liu EY, Kelly NN, Pagano IS, Garber AK, Chow DC, Heymsfield SB, Shepherd JA. Children and Adolescents' Anthropometrics Body Composition from 3-D Optical Surface Scans. Obesity (Silver Spring) 2019; 27:1738-1749. [PMID: 31689009 PMCID: PMC7883773 DOI: 10.1002/oby.22637] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/13/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to explore the accuracy and precision of three-dimensional optical (3DO) whole-body scanning for automated anthropometry and estimating total and regional body composition. METHODS Healthy children and adolescents (n = 181, ages 5-17 years) were recruited for the Shape Up! Kids study. Each participant underwent whole-body dual-energy x-ray absorptiometry and 3DO scans; multisite conventional tape measurements served as the anthropometric criterion measure. 3DO body shape was described using automated body circumference, length, and volume measures. 3DO estimates were compared with criterion measures using simple linear regression by the stepwise selection method. RESULTS Of the 181 participants, 112 were used for the training set, 49 were used for the test set, and 20 were excluded for technical reasons. 3DO body composition estimates were strongly associated with dual-energy x-ray absorptiometry measures for percent body fat, fat mass, and fat-free mass (R2 : 0.83, 0.96, and 0.98, respectively). 3DO provided reliable measurements of fat mass (coefficient of variation, 3.30; root mean square error [RMSE], 0.53), fat-free mass (coefficient of variation, 1.34; RMSE, 0.53 kg), and percent body fat (RMSE = 1.2%). CONCLUSIONS 3DO surface scanning provides accurate and precise anthropometric and body composition estimates in children and adolescents with high precision. 3DO is a safe, accessible, and practical method for evaluating body shape and composition in research and clinical settings.
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Affiliation(s)
- Michael C. Wong
- Graduate Program in Human Nutrition, University of Hawai’i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Bennett K. Ng
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Samantha F. Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Phoenix Hwaung
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - En Y. Liu
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Nisa N. Kelly
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Ian S. Pagano
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Andrea K. Garber
- Division of Adolescent & Young Adult Medicine, University of California, San Francisco, California, USA
| | - Dominic C. Chow
- John A. Burns School of Medicine, University of Hawai’i, Honolulu, Hawaii, USA
| | - Steven B. Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - John A. Shepherd
- Graduate Program in Human Nutrition, University of Hawai’i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
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Comparison of Bioelectrical Impedance Analysis, Slaughter Skinfold-Thickness Equations, and Dual-Energy X-ray Absorptiometry for Estimating Body Fat Percentage in Colombian Children and Adolescents with Excess of Adiposity. Nutrients 2018; 10:nu10081086. [PMID: 30110944 PMCID: PMC6115719 DOI: 10.3390/nu10081086] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/08/2018] [Accepted: 08/13/2018] [Indexed: 01/06/2023] Open
Abstract
Dual-energy X-ray absorptiometry (DXA) has been considered a reference method for measuring body fat percentage (BF%) in children and adolescents with an excess of adiposity. However, given that the DXA technique is impractical for routine field use, there is a need to investigate other methods that can accurately determine BF%. We studied the accuracy of bioelectrical impedance analysis (BIA) technology, including foot-to-foot and hand-to-foot impedance, and Slaughter skinfold-thickness equations in the measurement of BF%, compared with DXA, in a population of Latin American children and adolescents with an excess of adiposity. A total of 127 children and adolescents (11–17 years of age; 70% girls) from the HEPAFIT (Exercise Training and Hepatic Metabolism in Overweight/Obese Adolescent) study were included in the present work. BF% was measured on the same day using two BIA analysers (Seca® 206, Allers Hamburg, Germany and Model Tanita® BC-418®, TANITA Corporation, Sportlife Tokyo, Japan), skinfold measurements (Slaughter equation), and DXA (Hologic Horizon DXA System®, Quirugil, Bogotá, Columbia). Agreement between measurements was analysed using t-tests, Bland–Altman plots, and Lin’s concordance correlation coefficient (ρc). There was a significant correlation between DXA and the other BF% measurement methods (r > 0.430). According to paired t-tests, in both sexes, BF% assessed by BIA analysers or Slaughter equations differ from BF% assessed by DXA (p < 0.001). The lower and upper limits of the differences compared with DXA were 6.3–22.9, 2.2–2.8, and −3.2–21.3 (95% CI) in boys and 2.3–14.8, 2.4–20.1, and 3.9–18.3 (95% CI) in girls for Seca® mBCA, Tanita® BC 420MA, and Slaughter equations, respectively. Concordance was poor between DXA and the other methods of measuring BF% (ρc < 0.5). BIA analysers and Slaughter equations underestimated BF% measurements compared to DXA, so they are not interchangeable methods for assessing BF% in Latin American children and adolescents with excess of adiposity.
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Bi X, Loo YT, Henry CJ. Body Fat Measurements in Singaporean Adults Using Four Methods. Nutrients 2018; 10:E303. [PMID: 29510545 PMCID: PMC5872721 DOI: 10.3390/nu10030303] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 12/22/2022] Open
Abstract
Few studies have been conducted to measure body composition in Asian populations. In this study, we determined the percent body fat (PBF) by using dual-energy X-ray absorptiometry (DEXA), air-displacement plethysmography (ADP or BOD POD), bioelectrical impedance analysis (BIA) and skinfold (SKF) in 445 healthy Singaporean adults. We observed that the BOD POD, BIA and SKF estimates of PBF were highly correlated with that from DEXA (as a reference method) among Singaporean adults. However, they all underestimated PBF (differences of 3.9% for BOD POD, 5.6% for BIA and 12.5% for SKF). Our results filled a gap in the literature by testing the relationships between DEXA and BOD POD, BIA and SKF in a large sample with a wide range of body mass index (BMI) from 16.1 to 37.5 kg/m² and age from 21 to 69.2 years. The differences of PBF measured by different methods were dependent on age, gender and ethnicity. No significant difference was observed between DEXA and BOD POD in men aged > 40 or in BMI tertile 3. However, the mean difference between DEXA and BOD POD was significant in women. Different measuring methods of estimating PBF therefore must be cautiously interpreted.
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Affiliation(s)
- Xinyan Bi
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore 117609, Singapore.
| | - Yi Ting Loo
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore 117609, Singapore.
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore 117609, Singapore.
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore.
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A comparison of body composition estimates using dual-energy X-ray absorptiometry and air-displacement plethysmography in South African neonates. Eur J Clin Nutr 2016; 70:1254-1258. [PMID: 27245207 DOI: 10.1038/ejcn.2016.91] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Neonatal body composition is an important predictor of future metabolic risk; however, the comparability of objective assessment techniques, particularly in African populations undergoing rapid health transition, is not known. This paper compares body composition estimates by air-displacement plethysmography (ADP) and dual-energy X-ray absorptiometry (DXA) in South African neonates. SUBJECTS/METHODS Fat mass, fat-free mass and body fat percentage (%fat) estimates by ADP and DXA were compared in 88 urban, black South African neonates. The level of agreement between the techniques was assessed using Bland-Altman analyses. RESULTS Significant correlations were observed between ADP and DXA measurements of fat mass (r=0.766), fat-free mass (r=0.942) and %fat (r=0.630); however, ADP estimates of fat mass (408±172 g vs 337±165 g; P<0.001) and %fat (12.9±4.4% vs 9.9±4%; P<0.001) were significantly higher and fat-free mass (2681±348 g vs 2969±375 g; P<0.001) significantly lower than those by DXA. Fat-free mass estimates showed greater consistency in the level of agreement between the techniques compared with fat and %fat estimates where the differences between methods were less predictable. CONCLUSION Although ADP and DXA body composition estimates are highly correlated in neonates, significant differences are observed between the techniques. This is particularly relevant for fat mass and %fat estimates, where differences are highly variable between methods. Further investigation is needed to minimise inter-method differences to ensure accurate and comparable assessment of body composition at birth and across longitudinal study follow-up.
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Polfuss M, Simpson P, Stolzman S, Moerchen V, Hovis S, Zhang L, Miranda H, Sawin K. The measurement of body composition in children with spina bifida: Feasibility and preliminary findings. J Pediatr Rehabil Med 2016; 9:143-53. [PMID: 27285807 DOI: 10.3233/prm-160377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To assess the feasibility of obtaining and comparing various methods of height and body composition (BC) measurements in children with spina bifida (SB). METHODS Fifteen children (7M/8F) with SB (4-18 years old) underwent weight, four height measurements (arm span, wall-mounted stadiometer, segmental and recumbent length) and five BC measurements: (BMI; BodPod®; DEXA; Bioelectrical Impedance Analysis; and skinfold). Data collectors, parents, and study participants evaluated procedures. The four heights as paired with the BC measurements were compared to the gold standard DEXA measurements. RESULTS Procedures were successfully completed in 14 of 15 children. Skinfolds and segmental length had a midlevel ranking of comfort. While no measures substituted for the DEXA scan, preliminary findings suggest that an algorithm may estimate BC in this high-risk population. Currently, arm span used within BodPod® measurements provided the closest agreement with the DEXA scan. CONCLUSION Study protocol was feasible and provided necessary information, including recommended modifications, for successful implementation of the planned subsequent study.
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Affiliation(s)
- Michele Polfuss
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.,Department of Nursing Research, Children's Hospital of Wisconsin, Milwaukee WI, USA.,Self-Management Science Center, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Pippa Simpson
- Department of Pediatrics, Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Stacy Stolzman
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
| | - Victoria Moerchen
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Susan Hovis
- Department of Nursing Research, Children's Hospital of Wisconsin, Milwaukee WI, USA
| | - Liyun Zhang
- Department of Pediatrics, Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Heidi Miranda
- Department of Nursing Research, Children's Hospital of Wisconsin, Milwaukee WI, USA
| | - Kathleen Sawin
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.,Department of Nursing Research, Children's Hospital of Wisconsin, Milwaukee WI, USA.,Self-Management Science Center, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Simmonds M, Burch J, Llewellyn A, Griffiths C, Yang H, Owen C, Duffy S, Woolacott N. The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: a systematic review and meta-analysis. Health Technol Assess 2016; 19:1-336. [PMID: 26108433 DOI: 10.3310/hta19430] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND It is uncertain which simple measures of childhood obesity are best for predicting future obesity-related health problems and the persistence of obesity into adolescence and adulthood. OBJECTIVES To investigate the ability of simple measures, such as body mass index (BMI), to predict the persistence of obesity from childhood into adulthood and to predict obesity-related adult morbidities. To investigate how accurately simple measures diagnose obesity in children, and how acceptable these measures are to children, carers and health professionals. DATA SOURCES Multiple sources including MEDLINE, EMBASE and The Cochrane Library were searched from 2008 to 2013. METHODS Systematic reviews and a meta-analysis were carried out of large cohort studies on the association between childhood obesity and adult obesity; the association between childhood obesity and obesity-related morbidities in adulthood; and the diagnostic accuracy of simple childhood obesity measures. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and a modified version of the Quality in Prognosis Studies (QUIPS) tool. A systematic review and an elicitation exercise were conducted on the acceptability of the simple measures. RESULTS Thirty-seven studies (22 cohorts) were included in the review of prediction of adult morbidities. Twenty-three studies (16 cohorts) were included in the tracking review. All studies included BMI. There were very few studies of other measures. There was a strong positive association between high childhood BMI and adult obesity [odds ratio 5.21, 95% confidence interval (CI) 4.50 to 6.02]. A positive association was found between high childhood BMI and adult coronary heart disease, diabetes and a range of cancers, but not stroke or breast cancer. The predictive accuracy of childhood BMI to predict any adult morbidity was very low, with most morbidities occurring in adults who were of healthy weight in childhood. Predictive accuracy of childhood obesity was moderate for predicting adult obesity, with a sensitivity of 30% and a specificity of 98%. Persistence of obesity from adolescence to adulthood was high. Thirty-four studies were included in the diagnostic accuracy review. Most of the studies used the least reliable reference standard (dual-energy X-ray absorptiometry); only 24% of studies were of high quality. The sensitivity of BMI for diagnosing obesity and overweight varied considerably; specificity was less variable. Pooled sensitivity of BMI was 74% (95% CI 64.2% to 81.8%) and pooled specificity was 95% (95% CI 92.2% to 96.4%). The acceptability to children and their carers of BMI or other common simple measures was generally good. LIMITATIONS Little evidence was available regarding childhood measures other than BMI. No individual-level analysis could be performed. CONCLUSIONS Childhood BMI is not a good predictor of adult obesity or adult disease; the majority of obese adults were not obese as children and most obesity-related adult morbidity occurs in adults who had a healthy childhood weight. However, obesity (as measured using BMI) was found to persist from childhood to adulthood, with most obese adolescents also being obese in adulthood. BMI was found to be reasonably good for diagnosing obesity during childhood. There is no convincing evidence suggesting that any simple measure is better than BMI for diagnosing obesity in childhood or predicting adult obesity and morbidity. Further research on obesity measures other than BMI is needed to determine which is the best tool for diagnosing childhood obesity, and new cohort studies are needed to investigate the impact of contemporary childhood obesity on adult obesity and obesity-related morbidities. STUDY REGISTRATION This study is registered as PROSPERO CRD42013005711. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Mark Simmonds
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Jane Burch
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Alexis Llewellyn
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Huiqin Yang
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Christopher Owen
- Division of Population Health Sciences and Education, St George's, University of London, London, UK
| | - Steven Duffy
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Nerys Woolacott
- Centre for Reviews and Dissemination, University of York, York, UK
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Silva AM, Fields DA, Sardinha LB. A PRISMA-driven systematic review of predictive equations for assessing fat and fat-free mass in healthy children and adolescents using multicomponent molecular models as the reference method. J Obes 2013; 2013:148696. [PMID: 23844282 PMCID: PMC3703366 DOI: 10.1155/2013/148696] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Revised: 04/09/2013] [Accepted: 04/30/2013] [Indexed: 02/07/2023] Open
Abstract
Simple methods to assess both fat (FM) and fat-free mass (FFM) are required in paediatric populations. Several bioelectrical impedance instruments (BIAs) and anthropometric equations have been developed using different criterion methods (multicomponent models) for assessing FM and FFM. Through childhood, FFM density increases while FFM hydration decreases until reaching adult values. Therefore, multicomponent models should be used as the gold standard method for developing simple techniques because two-compartment models (2C model) rely on the assumed adult values of FFM density and hydration (1.1 g/cm(3) and 73.2%, respectively). This study will review BIA and/or anthropometric-based equations for assessing body composition in paediatric populations. We reviewed English language articles from MEDLINE (1985-2012) with the selection of predictive equations developed for assessing FM and FFM using three-compartment (3C) and 4C models as criterion. Search terms included children, adolescent, childhood, adolescence, 4C model, 3C model, multicomponent model, equation, prediction, DXA, BIA, resistance, anthropometry, skinfold, FM, and FFM. A total of 14 studies (33 equations) were selected with the majority developed using DXA as the criterion method with a limited number of studies providing cross-validation results. Overall, the selected equations are useful for epidemiological studies, but some concerns still arise on an individual basis.
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Affiliation(s)
- Analiza M Silva
- Exercise and Health Laboratory, CIPER, Fac Motricidade Humana, Univ Tecn Lisboa, 1499-002 Cruz Quebrada, Portugal.
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Fields DA, Demerath EW, Pietrobelli A, Chandler-Laney PC. Body composition at 6 months of life: comparison of air displacement plethysmography and dual-energy X-ray absorptiometry. Obesity (Silver Spring) 2012; 20:2302-6. [PMID: 22522885 DOI: 10.1038/oby.2012.102] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Body composition assessment during infancy is important because it is a critical period for obesity risk development, thus valid tools are needed to accurately, precisely, and quickly determine both fat and fat-free mass. The purpose of this study was to compare body composition estimates using dual-energy x-ray absorptiometry (DXA) and air displacement plethysmography (ADP) at 6 months old. We assessed the agreement between whole body composition using DXA and ADP in 84 full-term average-for-gestational-age boys and girls using DXA (Lunar iDXA v11-30.062; Infant whole body analysis enCore 2007 software, GE, Fairfield, CT) and ADP (Infant Body Composition System v3.1.0, COSMED USA, Concord, CA). Although the correlations between DXA and ADP for %fat (r = 0.925), absolute fat mass (r = 0.969), and absolute fat-free mass (r = 0.945) were all significant, body composition estimates by DXA were greater for both %fat (31.1 ± 3.6% vs. 26.7 ± 4.7%; P < 0.001) and absolute fat mass (2,284 ± 449 vs. 1,921 ± 492 g; P < 0.001), and lower for fat-free mass (5,022 ± 532 vs. 5,188 ± 508 g; P < 0.001) vs. ADP. Inter-method differences in %fat decreased with increasing adiposity and differences in fat-free mass decreased with increasing infant age. Estimates of body composition determined by DXA and ADP at 6 months of age were highly correlated, but did differ significantly. Additional work is required to identify the technical basis for these rather large inter-method differences in infant body composition.
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Affiliation(s)
- David A Fields
- Department of Pediatrics, University of Oklahoma Health Sciences Center and Harold Hamm Diabetes Center, Oklahoma City, Oklahoma, USA.
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Cardel M, Higgins PB, Willig AL, Keita AD, Casazza K, Gower BA, Fernández JR. African genetic admixture is associated with body composition and fat distribution in a cross-sectional study of children. Int J Obes (Lond) 2011; 35:60-5. [PMID: 20877287 PMCID: PMC3804117 DOI: 10.1038/ijo.2010.203] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Although differences in body composition parameters among African American (AA), Hispanic American (HA) and European American (EA) children are well documented, the factors underlying these differences are not completely understood. Environmental and genetic contributors have been evaluated as contributors to observed differences. This study evaluated the extent to which African or European ancestral genetic background influenced body composition and fat distribution in 301 peripubertal AA (n = 107), HA (n = 79) and EA (n = 115) children aged 7-12. DESIGN Estimates of African admixture (AFADM) and European admixture (EUADM) were obtained for every subject using 142 ancestry informative DNA markers. Dual energy X-ray absorptiometry and computed tomography scanning were used to determine body composition and abdominal fat distribution, respectively. Multiple regression models were conducted to evaluate the contribution of admixture estimates to body composition and fat distribution. RESULTS Greater AFADM was associated with lower fat mass (P = 0.0163), lower total abdominal adipose tissue (P = 0.0006), lower intra-abdominal adipose tissue (P = 0.0035), lower subcutaneous abdominal adipose tissue (P = 0.0115) and higher bone mineral content (BMC) (P = 0.0253), after adjusting for socio-economic status, sex, age, height, race/ethnicity and pubertal status. Greater EUADM was associated with lower lean mass (LM) (P = 0.0056). CONCLUSION These results demonstrate that ancestral genetic background contributes to racial/ethnic differences in body composition above and beyond the effects of racial/ethnic classification and suggest a genetic contribution to total body fat accumulation, abdominal adiposity, LM and BMC.
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Affiliation(s)
- M Cardel
- Department of Nutrition Sciences and the Nutrition and Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA
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14
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Ewane C, McConkey SA, Kreiter CD, Fuller M, Tabor A, Bosch J, Mews J, Baldwin K, Van Dyke DC. Is air-displacement plethysmography a reliable method of detecting ongoing changes in percent body fat within obese children involved in a weight management program? Obes Res Clin Pract 2010; 4:e247-342. [DOI: 10.1016/j.orcp.2010.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Accepted: 03/26/2010] [Indexed: 10/19/2022]
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Comparison of dual-energy X-ray absorptiometry, air displacement plethysmography and bioelectrical impedance analysis for the assessment of body composition in severely obese Caucasian children and adolescents. Br J Nutr 2008; 100:918-24. [PMID: 18279552 DOI: 10.1017/s0007114508922558] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The objectives of the present study were to compare body composition assessed by dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP) and bioelectrical impedance analysis (BIA) in severely obese Caucasian children and adolescents and to develop and validate new equations for predicting body composition from BIA using DXA as the reference method. Body composition was assessed in fifty-eight obese children and adolescents (BMI 34·4 (sd 4·9) kg/m2) aged 10–17 years by DXA, ADP and BIA. ADP body fat content was estimated from body density using equations devised by Siri (ADPSiri) and Lohman (ADPLohman). In the whole sample, the Bland–Altman test showed that ADPSiri and ADPLohman underestimated percentage fat mass (%FM) by 2·1 (sd 3·4) and by 3·8 (sd 3·3) percent units (P < 0·001), respectively, compared to DXA. In addition, compared to DXA, BIA underestimated %FM by 5·8 (sd 4·6) percent units in the whole group (P < 0·001). A new prediction equation (FFM (kg) = 0·87 × (stature2/body impedance)+3·1) was developed on the pooled sample and cross-validated on an external group of sixty-one obese children and adolescents. The difference between predicted and measured FFM in the external group was − 1·6 (sd 2·9) kg (P < 0·001) and FFM was predicted accurately (error < 5 %) in 75 % of subjects. In conclusion, DXA, ADP and the BIA are not interchangeable for the assessment of %FM in severely obese children and adolescents. The new prediction equation offers an alternative approach to DXA for the estimation of body composition in severely obese children and adolescents.
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Buison AM, Ittenbach RF, Stallings VA, Zemel BS. Methodological agreement between two-compartment body-composition methods in children. Am J Hum Biol 2006; 18:470-80. [PMID: 16788892 DOI: 10.1002/ajhb.20515] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Increases in childhood obesity have emphasized the importance of accurate and accessible body composition assessment, especially in monitoring prevention and treatment efforts. Previous pediatric studies, comparing measures from air-displacement plethysmography (ADP) to dual-energy X-ray absorptiometry (DXA) and anthropometry (ANTH, skinfold measures), were performed in small numbers of children or in children across large age and body-size ranges. The objectives of this study were: 1) to compare body fat percentage (%BF), fat mass (FM), and fat-free mass (FFM) from ADP with DXA and ANTH, to determine the agreement between techniques; 2) to identify factors that influence agreement or lack of agreement; and 3) to determine if the agreement is constant over a range of body fatness. Healthy children (n = 125), 7-10 years old, participating in a longitudinal pediatric bone health study, were evaluated. Body composition was assessed by ADP, DXA, and ANTH to determine %BF, FM, and FFM. ADP underestimated %BF compared to DXA and ANTH by 5.0% and 1.4%, respectively. Agreement between techniques was influenced by body fatness, height, age, and gender (all P < 0.05). Relatively good agreement was observed between ADP and both DXA and ANTH for FM and FFM. In conclusion, the underestimation of %BF by ADP compared to DXA may be of a magnitude that is clinically significant, especially when using %BF in children to confirm a diagnosis of obesity. Further development of body-composition techniques for young children need to account for variability in age, gender, and level of fatness.
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Affiliation(s)
- Anne M Buison
- Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
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Ittenbach RF, Buison AM, Stallings VA, Zemel BS. Statistical validation of air-displacement plethysmography for body composition assessment in children. Ann Hum Biol 2006; 33:187-201. [PMID: 16684692 DOI: 10.1080/03014460500519925] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Body composition assessment of children has been hindered by the absence of a safe, quick, and easily tolerated gold standard technique. Existing validation studies of air-displacement plethysmography (ADP) have been based on small, narrowly defined samples, using simple linear regression or Bland-Altman analyses. AIM Correlations within a multitrait-multimethod matrix (MTMM) and factor analytic methodologies were used to evaluate ADP as a valid and reliable body composition technique for children. SUBJECTS AND METHODS Fat mass (FM), fat-free mass (FFM) and per cent body fat (%BF) were measured in 139 children, 7-10 years old, by ADP, dual energy X-ray absorptiometry (DXA) and anthropometry (ANTH). MTMM and factor analysis were used to compare assessment techniques. RESULTS Reliability estimates were lower for ADP than for either ANTH or DXA. Convergent and discriminant correlations between ADP and ANTH or DXA were high for identical as well as non-identical measures. Two body composition factors (Fatness, Leanness) and two technique-related factors (Bod Pod, Anthropometry) were identified. CONCLUSION ADP offers a valid and reliable means of assessing body composition in children but does not perform as well as ANTH or DXA. MTMM and factor analytic methodologies offer an effective alternative to assessing body composition.
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Affiliation(s)
- Richard F Ittenbach
- Biostatistics and Data Management Core, University of Pennsylvania School of Medicine, PA 19104, USA.
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Abstract
PURPOSE OF REVIEW Air-displacement plethysmography holds promise as an alternative to more traditional body composition techniques, although our understanding of air-displacement plethysmography is less than complete. Specifically, factors that influence its validity and application in certain populations, for example children, the obese, and athletes, must be better understood. This review will summarize recent findings on the validity and precision of air-displacement plethysmography and will focus primarily on papers published since 2004, with particular attention on its use in infants. RECENT FINDINGS The most significant recent findings in the air-displacement plethysmography literature are mechanistic in nature specifically dealing with measurement issues such as heat, moisture, clothing, and recently, inter-device variability. SUMMARY It is important to recognize that air-displacement plethysmography can be a practical instrument in the evaluation of body composition in a wide range of populations. Therefore, based on the body of literature that has emerged, air-displacement plethysmography appears to be a suitable and reliable instrument in the assessment of body composition. Of particular interest is its use in pediatric and obese individuals, areas requiring further study. Research is also needed to help us better understand sources of measurement error.
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Affiliation(s)
- David A Fields
- Department of Pediatrics, University of Oklahoma Health Science Center, Children's Medical Research Institute's Metabolic Research Center, Oklahoma City, Oklahoma 73104, USA.
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