Measurement of body composition in children
- Sarah M Phillips, MS, RD, LD
Sarah M Phillips, MS, RD, LD
- Instructor of Pediatric Gastroenterology
- Baylor College of Medicine
- Robert J Shulman, MD
Robert J Shulman, MD
- Professor of Pediatrics
- Baylor College of Medicine
The measurement of body composition may include direct or indirect measurements of body fat, lean body mass, and bone mass, and sometimes of the distribution of fat between the visceral or subcutaneous compartments. The choice of method depends on which of these compartments is of interest, whether the measurement is for clinical purposes or research, and what degree of precision is required.
The main methods used to estimate body composition are discussed here. Measurements of growth in children and disorders of under- or over-nutrition are discussed separately. (See "Measurement of growth in children" and "Definition; epidemiology; and etiology of obesity in children and adolescents" and "Failure to thrive (undernutrition) in children younger than two years: Etiology and evaluation".)
THEORETICAL MODELS OF BODY COMPOSITION
Theoretical models of body composition divide the body into two compartments or multiple compartments:
●In the two-compartment model, the body is divided into the fat and fat-free mass. The two-compartment model is useful in clinical practice because of the ease with which body fat and fat-free mass can be measured and the simplicity with which their changes during health and disease can be assessed. However, the two-compartment model is subject to error because the methods used to measure body fat and fat-free mass are based upon the assumption that the chemical composition of these tissue stores remains constant across a broad range of ages and disease states.
One method currently employed to assess body composition based on the three compartment models is dual energy x-ray absorptiometry (DXA). The body composition of children from birth to 16 years of age has been measured using this method (table 1) [1-3]. Fat-free mass and body fat increase with age throughout childhood, but vary at any given age depending on gender and race or ethnicity [1-4]. These estimates provide reference values for healthy children and useful comparative indices to assess nutritional deficits in children who are ill .
●Multicompartment models reduce the errors inherent in the two-compartment model by dividing the body into components based on its atomic, molecular, cellular, or tissue composition (figure 1) . Although these models describe body composition more precisely, the techniques required to measure these components are limited to research settings.
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- THEORETICAL MODELS OF BODY COMPOSITION
- ESTIMATES OF ADIPOSITY
- Body mass index
- Weight for height
- FAT DISTRIBUTION
- Waist-to-hip ratio
- Waist circumference
- Waist-to-height ratio
- MEASURES OF BODY COMPOSITION
- - Skinfold thickness
- - Mid-arm muscle circumference
- Isotope dilution
- Bioelectrical impedance analysis
- Air-displacement plethysmography
- Dual-energy x-ray absorptiometry
- Neutron activation analysis
- Total body potassium
- SUMMARY AND RECOMMENDATIONS