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Wong Ramsey KN, Davis JD, Tanaka JS, Kuo S. Infant Body Composition in an Asian Pacific Islander Population. J Racial Ethn Health Disparities 2023; 10:2663-2669. [PMID: 36357640 DOI: 10.1007/s40615-022-01444-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/29/2022] [Accepted: 11/01/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Normative infant body composition data using air displacement plethysmography (ADP) are from primarily Caucasian populations. Racial differences may exist. OBJECTIVES To describe body composition in Asian and Pacific Islander infants and compare them to previously published data on Caucasian infants. DESIGN Body composition was measured using ADP with the PEA POD® Infant Body Composition System in 249 healthy full-term newborns in a predominately Asian and Pacific Islander population in Hawaii within the first 3 days of life and compared to published data on Caucasian infants with multiple t-tests adjusted for false discovery rate. RESULTS There were no differences in percent body fat between Asian, Pacific Islander, or mixed race Asian Pacific Islander infants. Both Asian and Pacific Islander infants had significantly higher percent body fat than Caucasians from Italy in Europe (13.2% and 11.8% vs 8.9%, p < 0.01 among males, 15.3% and 15.6% vs 8.7%, p < 0.01 among females) but not when compared to Caucasians from New York. CONCLUSIONS Racial and geographical differences in body composition exist at birth between Asian and Pacific Islanders and other Caucasian cohorts. Previously published ADP nomograms must be interpreted with caution. Future studies are needed to investigate the impact of environmental, perinatal, and genetic factors on infant body composition and its relationship to future cardiometabolic morbidity. Efforts to address racial disparities in cardiometabolic disease measures must also address pre-conceptual maternal health, which may have long-term implications on future body composition in offspring.
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Affiliation(s)
- Kara N Wong Ramsey
- University of Hawaii Department of Pediatrics, John A Burns School of Medicine and Kapiolani Medical Center for Women and Children, 1319 Punahou St, Honolulu, HI, 96826, USA.
| | - James D Davis
- University of Hawaii Department of Biostatistics, John A Burns School of Medicine, Honolulu, HI, USA
| | - John S Tanaka
- Hawaii Pacific Health Summer Student Research Program, Honolulu, Hawaii and Duke University Hospital Department of Internal Medicine, Durham, NC, USA
| | - Sheree Kuo
- University of Hawaii Department of Pediatrics, John A Burns School of Medicine and Kapiolani Medical Center for Women and Children, 1319 Punahou St, Honolulu, HI, 96826, USA
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Kuriyan R, Hills AP, Murphy-Alford A, Padmanabha R, Nyati LH, Byrne NM, Kurpad AV, Norris S. Body composition of infants at 6 months of age using a 3-compartment model. Eur J Clin Nutr 2023:10.1038/s41430-023-01351-2. [PMID: 37833566 DOI: 10.1038/s41430-023-01351-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 09/16/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND/OBJECTIVES Two compartment (2 C) models of body composition, including Air Displacement Plethysmography (ADP) and Deuterium Dilution (DD), assume constant composition of fat-free mass (FFM), while 3-compartment (3 C) model overcomes some of these assumptions; studies are limited in infants. The objective of the present study is to compare 3 C estimates of body composition in 6-mo. old infants from Australia, India, and South Africa, including FFM density and hydration, compare with published literature and to evaluate agreement of body composition estimates from ADP and DD. METHODS Body volume and water were measured in 176 healthy infants using ADP and DD. 3C-model estimates of fat mass (FM), FFM and its composition were calculated, compared between countries (age and sex adjusted) and with published literature. Agreement between estimates from ADP and DD were compared by Bland-Altman and correlation analyses. RESULTS South African infants had significantly higher % FM (11.5%) and density of FFM compared to Australian infants. Australian infants had significantly higher % FFM (74.7 ± 4.4%) compared to South African infants (71.4 ± 5.0) and higher FFMI (12.7 ± 0.8 kg/m2) compared to South African (12.3 ± 1.2 kg/m2) and Indian infants (11.9 ± 1.0 kg/m2). FFM composition of present study differed significantly from literature. Pooled three country estimates of FM and FFM were comparable between ADP and DD; mean difference of -0.05 (95% CI: -0.64, +0.55) kg and +0.05 (95% CI: -0.55, +0.64) kg. CONCLUSIONS 3C-model estimates of body composition in infants differed between countries; future studies are needed to confirm these findings and investigate causes for the differences.
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Affiliation(s)
| | | | | | | | | | | | | | - Shane Norris
- University of Witwatersrand, Johannesburg, South Africa
- University of Southampton, Southampton, UK
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Sridharan K, Al Jufairi M, Al Ansari E, Alsadah L, Wasel H. Is fat-free mass-based gentamicin dosing regimen preferable than whole-body weight in neonates? Pediatr Investig 2023; 7:86-94. [PMID: 37324598 PMCID: PMC10262884 DOI: 10.1002/ped4.12386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 02/08/2023] [Indexed: 06/17/2023] Open
Abstract
Importance Body fluid dynamics and renal maturation status vary during the neonatal period. We hypothesized that differences in peak and trough gentamicin concentrations could be expected. Objective To predict the peak and trough gentamicin concentrations in critically ill neonates and to predict the changes in the predicted peak plasma concentrations of gentamicin following fat-free mass dosing. Methods Critically ill neonates that received gentamicin and have gentamicin concentration measured were recruited. Fat mass was estimated using skinfold thicknesses. Changes in the peak plasma concentrations (Cmax) using whole-body weight (estimated using the current dosing regimen) and predicted concentrations following the fat-free mass-based dosing were the outcome measures. Results Eighty-nine critically ill neonates were recruited. Sub-therapeutic Cmax was estimated using the current dosing regimen in 32.6%, and 22.5% neonates following the first and second doses of gentamicin. Preterm neonates had significantly higher fat mass compared to term neonates. All except one had Cmax above 12 μg/ml after the first dose and all had after the second gentamicin dose following the predicted fat-free mass-based gentamicin dosing. The recommended doses are as follows: extreme preterm: 7.95 mg/kg every 48 h; very preterm: 7.30 mg/kg every 36-48 h; late preterm: 5.90 mg/kg every 36-48 h; and term neonates at 5.10 mg/kg every 24 h. Interpretation Fat-free mass dosing may be considered for obtaining optimal therapeutic effects in the neonatal population.
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Affiliation(s)
- Kannan Sridharan
- Department of Pharmacology and TherapeuticsCollege of Medicine and Medical SciencesArabian Gulf UniversityManamaKingdom of Bahrain
| | - Muna Al Jufairi
- Neonatal Intensive Care UnitSalmaniya Medical ComplexMinistry of HealthManamaKingdom of Bahrain
- Department of PediatricsCollege of Medicine and Medical SciencesArabian Gulf UniversityManamaKingdom of Bahrain
| | - Eman Al Ansari
- Neonatal Intensive Care UnitSalmaniya Medical ComplexMinistry of HealthManamaKingdom of Bahrain
| | - Lulwa Alsadah
- College of Medicine and Medical SciencesArabian Gulf UniversityManamaKingdom of Bahrain
| | - Howra Wasel
- College of Medicine and Medical SciencesArabian Gulf UniversityManamaKingdom of Bahrain
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Zemel BS. Some caveats about using body composition reference charts for infants from birth to 24 months. Am J Clin Nutr 2023:S0002-9165(23)46270-3. [PMID: 36940801 DOI: 10.1016/j.ajcnut.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 03/09/2023] [Indexed: 03/23/2023] Open
Affiliation(s)
- Babette S Zemel
- Division of GI, Hepatology and Nutrition. The Children's Hospital of Philadelphia. Department of Pediatrics. The University of Pennsylvania Perelman School of Medicine. 2716 South Street. Philadelphia, PA 19146.
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Yousuf EI, Rochow N, Li J, Simioni J, Gunn E, Hutton EK, Morrison KM. Growth and body composition trajectories in infants meeting the WHO growth standards study requirements. Pediatr Res 2022; 92:1640-7. [PMID: 35296784 DOI: 10.1038/s41390-022-02005-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND While the World Health Organization (WHO) developed postnatal growth standards for infants, corresponding body composition data remains scarce. This study explores growth and body composition trajectories in infants meeting the WHO Multicentre Growth Reference Study (MGRS) eligibility criteria. STUDY DESIGN Infants enrolled in this longitudinal cohort underwent anthropometric and body composition measurement by air displacement plethysmography (ADP) at 6 weeks, 12 weeks, and 5 months postnatally. Age and sex-specific growth and body composition percentiles were generated using GAMLSS, with extrapolated data at 5 months for those exceeding ADP weight limits. We evaluated which anthropometric measure (body mass index (BMI), weight for length or mid upper arm circumference) was most closely related to adiposity. RESULTS Of the 225 infants with body composition measures, 187 met the WHO MGRS criteria. Their length and weight curves were comparable with WHO growth curves. Trajectory curves for fat and fat-free mass were developed. Of the anthropometric measures, BMI z score was most closely related to fat mass index z score at all timepoints. CONCLUSION This study presents body composition trajectories for infants meeting the WHO growth standard criteria. BMI z score is the best anthropometric metric to estimate adiposity in infants. IMPACT While postnatal growth standards derived from the WHO Multicentre Growth Reference Study (MGRS) exist for the routine clinical assessment of infant growth, this study fills the previous gap in the availability of corresponding body composition data for term-born, healthy, breastfed infants meeting the MGRS criteria. Extrapolation was used to obtain body composition values for infants exceeding the weight limit of the ADP device, to avoid construction of biased body composition curves. Sex-specific growth curves for fat mass, fat-free mass, fat mass index, and fat-free mass index are presented for a population meeting the World Health Organization growth standard criteria.
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Chen F, Wang J, Liu J, Huang G, Hou D, Liao Z, Zhang T, Liu G, Xie X, Tai J. Characteristics of Body Composition Estimated by Air-Displacement Plethysmography in Chinese Preschool Children. Front Public Health 2022; 10:926819. [PMID: 35719642 PMCID: PMC9204163 DOI: 10.3389/fpubh.2022.926819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo describe the characteristics of body composition by air-displacement plethysmography (ADP) among Chinese preschool children.MethodsPreschool children were recruited from three kindergartens. Adiposity indices were evaluated using the ADP method. BMI, fat mass index (FMI), fat-free mass index (FFMI) and waist-to-height ratio (WHtR) were calculated. Overweight and obesity were diagnosed using the WHO reference. Analyses were executed by SPSS and MedCalc software. Smoothed curves were constructed using the lambda-mu-sigma (LMS) method.ResultsThis study evaluated the growth trend for body composition of ADP-based body fat indices based on a relatively large sample of preschool children, the first ever reported in China. A total of 1,011 children aged 3–5 years comprised our study population. BMI and FFMI increased with age, but the slope (P = 0.710) and y intercept (P = 0.132) in the BMI trend analysis demonstrated no differences between boys and girls. For the FFMI trend lines, the slope was significantly higher for boys than for girls (P = 0.013). The percentage of fat mass (FM%), FMI, and WHtR were negatively correlated with age for both sexes, except for FMI in girls (P = 0.094). The 95% CI regression lines for FM% according to different weight statuses intersected.ConclusionsADP is applicable to estimating body composition among Chinese preschool children. Misclassifications might occur when overweight/obese status is defined based on surrogate indices.
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Affiliation(s)
- Fangfang Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
- *Correspondence: Fangfang Chen
| | - Jing Wang
- Research Project Group, Tianjin Women's and Children's Health Center, Tianjin, China
| | - Junting Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Guimin Huang
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Dongqing Hou
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Zijun Liao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Ting Zhang
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Gongshu Liu
- Research Project Group, Tianjin Women's and Children's Health Center, Tianjin, China
| | - Xianghui Xie
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
- Xianghui Xie
| | - Jun Tai
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
- Jun Tai
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Gopalakrishnamoorthy M, Whyte K, Horowitz M, Widen E, Toro-Ramos T, Johnson J, Gidwani S, Paley C, Rosenn B, Lin S, Thornton J, Pi-Sunyer X, Gallagher D. Anthropometric models to estimate fat mass at 3 days, 15 and 54 weeks. Pediatr Obes 2022; 17:e12855. [PMID: 34558804 PMCID: PMC8821135 DOI: 10.1111/ijpo.12855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/19/2021] [Accepted: 09/01/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Currently available infant body composition measurement methods are impractical for routine clinical use. The study developed anthropometric equations (AEs) to estimate fat mass (FM, kg) during the first year using air displacement plethysmography (PEA POD® Infant Body Composition System) and Infant quantitative magnetic resonance (Infant-QMR) as criterion methods. METHODS Multi-ethnic full-term infants (n = 191) were measured at 3 days, 15 and 54 weeks. Sex, race/ethnicity, gestational age, age (days), weight-kg (W), length-cm (L), head circumferences-cm (HC), skinfold thicknesses mm [triceps (TRI), thigh (THI), subscapular (SCP), and iliac (IL)], and FM by PEA POD® and Infant-QMR were collected. Stepwise linear regression determined the model that best predicted FM. RESULTS Weight, length, head circumference, and skinfolds of triceps, thigh, and subscapular, but not iliac, significantly predicted FM throughout infancy in both the Infant-QMR and PEA POD models. Sex had an interaction effect at 3 days and 15 weeks for both the models. The coefficient of determination [R2 ] and root mean square error were 0.87 (66 g) at 3 days, 0.92 (153 g) at 15 weeks, and 0.82 (278 g) at 54 weeks for the Infant-QMR models; 0.77 (80 g) at 3 days and 0.82 (195 g) at 15 weeks for the PEA POD models respectively. CONCLUSIONS Both PEA POD and Infant-QMR derived models predict FM using skinfolds, weight, head circumference, and length with acceptable R2 and residual patterns.
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Affiliation(s)
| | - Kathryn Whyte
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center
| | - Michelle Horowitz
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center
| | - Elizabeth Widen
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center,Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University,Department of Nutritional Sciences, The University of Texas at Austin
| | - Tatiana Toro-Ramos
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York
| | - Jill Johnson
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York
| | - Sonia Gidwani
- Department Pediatrics, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine
| | - Charles Paley
- Department Pediatrics, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine
| | - Barak Rosenn
- Department of Obstetrics and Gynecology, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine
| | - Susan Lin
- Center for Family and Community Medicine, Columbia University
| | | | - Xavier Pi-Sunyer
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center,Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University
| | - Dympna Gallagher
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center,Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University
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Lutz TL, Burton AE, Hyett JA, McGeechan K, Gordon A. A hospital-based cohort study of gender and gestational age-specific body fat percentage at birth. Pediatr Res 2021; 89:231-7. [PMID: 32289811 DOI: 10.1038/s41390-020-0879-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/05/2020] [Accepted: 03/13/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Birthweight is the most commonly used proxy marker but does not adequately define true nutritional status. Modalities like DXA (dual energy x-ray absorptiometry) and TOtal Body Electric Conductivity (TOBEC) have been validated to assess body composition but their accuracy in neonates has not been established. The PEAPOD (COSMED, Rome Italy) has been validated as an accurate tool for measuring percentage body fat (%BF) in newborns. The study aim was to determine the gender-specific %BF percentiles at different gestations (35-41 weeks) for a healthy population of newborn infants. A secondary aim was to determine whether there is any relationship between %BF and neonatal condition at birth (cord gas measurement). METHODS %BF was measured using air displacement plethysmography (PEAPOD) within 6 h of birth. RESULTS There is an increase in the mean %BF with increasing gestation for female and males from 36 weeks' gestation in the 7667 infants who underwent assessment. Females have a higher %BF than their male equivalents. There was no correlation between %BF and cord pH. CONCLUSION Gender and gestation are both important in determining the quantiles and mean %BF at birth. There was no correlation between low cord pH and %BF. IMPACT Measuring the percentage body fat (PEAPOD) at birth is a useful marker of an infant's nutritional status. This is the largest hospital-based cohort of gestational age and gender-specific %BF in healthy newborns. The normative graphs from this study will help to accurately determine high-risk infants with low %BF so they can be monitored appropriately.
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Abstract
Obesity-associated metabolic illnesses are increasing at an alarming rate in Asian countries. A common feature observed in the Asian population is a higher incidence of abdominal obesity-the "skinny-fat" Asian syndrome. In this review, we critically evaluate the relative roles of genetics and environmental factors on fat distribution in Asian populations. While there is an upward trend in obesity among most Asian countries, it appears particularly conspicuous in Malaysia. We propose a novel theory, the Malaysian gene-environment multiplier hypothesis, which explains how ancestral variations in feast-and-famine cycles contribute to inherited genetic predispositions that, when acted on by modern-day stressors-most notably, urbanization, westernization, lifestyle changes, dietary transitions, cultural pressures, and stress-contribute to increased visceral adiposity in Asian populations. At present, the major determinants contributing to visceral adiposity in Asians are far from conclusive, but we seek to highlight critical areas for further research.
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Affiliation(s)
- Rachel Williams
- Department of Internal Medicine, University of Central Florida (UCF) College of Medicine, Burnett School of Biomedical Sciences, Orlando, FL, USA
| | - Muthu Periasamy
- Department of Internal Medicine, University of Central Florida (UCF) College of Medicine, Burnett School of Biomedical Sciences, Orlando, FL, USA
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Marano D, Oliveira ECD, Amaral YNDVD, Silva LMLD, Moreira MEL. Evaluation of anthropometric equations developed to estimate neonates' body composition: a systematic review. Cien Saude Colet 2020; 25:2711-2720. [PMID: 32667553 DOI: 10.1590/1413-81232020257.26982018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 10/06/2018] [Indexed: 11/22/2022] Open
Abstract
This article aims to evaluate the anthropometric equations developed by selected studies in order to estimate the body composition of neonates. The systematic review consisted in the research of published articles in the following databases: PubMed, Brazilian Virtual Health Library, Embase and ScienceDirect by utilizing the following descriptors: "fat mass, fat free mass, anthropometry, air displacement plethysmography, validation, neonate". For doing so, the PRISMA protocol has been utilized. The bibliographical research resulted in 181 articles. However, only eight were selected for the present review because repetition in different databases and having been performed in adults, during pregnancy, in athletes, in preterm and children. There was discrepancy in terms of study method, mainly over the variables of the anthropometric equations, age and ethnicity of the neonates. All studies used the plethysmography method as a reference apart from one study. Only four studies had their equations validated. The studies that developed anthropometric models for estimating the body composition of neonates are scarce, and the use of these equations needs to be conducted carefully in order to avoid errors in nutritional diagnosis.
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Affiliation(s)
- Daniele Marano
- Unidade de Pesquisa Clínica, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF). Fundação Oswaldo Cruz (Fiocruz). Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | - Elissa Costa de Oliveira
- Programa Institucional de Bolsa de Iniciação Científica (PIBIC). Fiocruz. Rio de Janeiro RJ Brasil
| | | | - Leila Maria Lopes da Silva
- Unidade de Pesquisa Clínica, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF). Fundação Oswaldo Cruz (Fiocruz). Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | - Maria Elisabeth Lopes Moreira
- Unidade de Pesquisa Clínica, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF). Fundação Oswaldo Cruz (Fiocruz). Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
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Wiechers C, Kirchhof S, Balles L, Avelina V, Weber R, Maas C, Pauluschke-Fröhlich J, Hallschmid M, Preißl H, Fritsche A, Poets CF, Franz AR. Neonatal body composition: crossectional study in healthy term singletons in Germany. BMC Pediatr 2019; 19:488. [PMID: 31830928 PMCID: PMC6907196 DOI: 10.1186/s12887-019-1837-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/15/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND During pregnancy, a variety of factors can influence fetal growth and development. Intrauterine growth may impact on later life and health. Neonatal body composition may be a more sensitive marker for the intrauterine environment than established anthropometric parameters at birth. METHODS To study neonatal body composition determined by air displacement plethysmography in healthy, term singletons as national reference data, and to establish factors impacting on neonatal body composition in this population. This prospective cross-sectional observational study included 271 healthy, full-term, singletons born between June 2014 and July 2015. Body composition was measured within 96 h of birth using air displacement plethysmography. RESULTS Median (Q1, Q2) fat mass / total body mass (BF%) in German singletons was 10.8% (7.7-13.4) and fat free mass (FFM) 2843 g (2606-3099). Female infants had significantly increased BF% compared to male infants (11.2% (8.7-14.0) vs. 9.6% (7.2-12.1)). On multiple regression analysis, BF% and fat mass increased with female gender, maternal pre-pregnancy body mass index, non-smoking mother and parity, whereas FFM increased with male gender and increasing gestational age at birth. Gestational weight gain category, birth mode, and postnatal age at measurement were not associated with BF%, FFM or fat mass. CONCLUSIONS We generated BF% and FFM centiles for healthy, term, singletons born in Germany; these are similar to those found in other European countries. Infant body composition at birth was associated with modifiable (pre-pregnancy body mass index, smoking), and given factors (gender, gestational age at birth, parity).
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Affiliation(s)
- Cornelia Wiechers
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Sara Kirchhof
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Lena Balles
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Vanessa Avelina
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Romy Weber
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Christoph Maas
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Jan Pauluschke-Fröhlich
- Department of Obstetrics and Gynecology, University Hospital, Eberhard Karls University, Tuebingen, Germany
| | - Manfred Hallschmid
- Institute for Medical Psychology and Behavioural Neurobiology, Eberhard Karls University, Tuebingen, Germany
- German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany
| | - Hubert Preißl
- German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany
- Department of Internal Medicine IV, Eberhard Karls University, Tuebingen, Germany
| | - Andreas Fritsche
- German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany
- Department of Internal Medicine IV, Eberhard Karls University, Tuebingen, Germany
| | - Christian F. Poets
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Axel R. Franz
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
- Center for Pediatric Clinical Studies, University Children’s Hospital, Eberhard Karls University, Tuebingen, Germany
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Wiechers C, Kirchhof S, Maas C, Poets CF, Franz AR. Neonatal body composition by air displacement plethysmography in healthy term singletons: a systematic review. BMC Pediatr 2019; 19:489. [PMID: 31830946 PMCID: PMC6907141 DOI: 10.1186/s12887-019-1867-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 12/02/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND There is increasing evidence that intrauterine environment and, consequently, growth in utero have both immediate and far-reaching consequences for health. Neonatal body composition might be a more sensitive marker of intrauterine environment and neonatal adiposity than birth weight and could serve as a predictor for non-communicable diseases later in life. METHODS To perform a systematic literature review on neonatal body composition determined by air displacement plethysmography in healthy infants. The systematic review was performed using the search terms "air displacement plethysmography", "infant" and "newborn" in Pubmed. Data are displayed as mean (Standard deviation). RESULTS Fourteen studies (including n = 6231 infants) using air displacement plethysmography fulfilled inclusion criteria for meta-analysis. In these, weighted mean body fat percentage was 10.0 (4.1) % and weighted mean fat free mass was 2883 (356) g in healthy term infants. Female infants had a higher body fat percentage (11.1 (4.1) % vs. 9.6 (4.0) %) and lower fat free mass (2827 (316) g vs. 2979 (344) g). In the Caucasian subpopulation (n = 2202 infants) mean body fat percentage was 10.8 (4.1), whereas data for reference values of other ethnic groups are still sparse. CONCLUSIONS Body composition varies depending on gender and ethnicity. These aggregated data may serve as reference for body composition in healthy, term, singletons at least for the Caucasian subpopulation.
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Affiliation(s)
- Cornelia Wiechers
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Sara Kirchhof
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Christoph Maas
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Christian F. Poets
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Axel R. Franz
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
- Center for Pediatric Clinical Studies, University Children’s Hospital, Eberhard Karls University, Tuebingen, Germany
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13
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Abreu LRS, Shirley MK, Castro NP, Euclydes VV, Bergamaschi DP, Luzia LA, Cruz AM, Rondó PHC. Gestational diabetes mellitus, pre-pregnancy body mass index, and gestational weight gain as risk factors for increased fat mass in Brazilian newborns. PLoS One 2019; 14:e0221971. [PMID: 31465493 PMCID: PMC6715169 DOI: 10.1371/journal.pone.0221971] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/15/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It may predispose offspring to increased fat mass (FM) and the development of obesity, however few data from Latin America exist. OBJECTIVE To investigate the influence of GDM on newborn FM in mother-newborn pairs recruited from a public maternity care center in São Paulo, Brazil. METHODS Data were collected cross-sectionally in 2013-2014 from 72 mothers diagnosed with GDM, and 211 mothers with normal glucose tolerance (NGT). Newborn FM was evaluated by air-displacement plethysmography (PEA POD), and relevant demographic and obstetric data were collected from hospital records. Associations between maternal GDM status and newborn FM were investigated by multiple linear regression analysis, with adjustment for maternal age, pre-pregnancy BMI, gestational weight gain, type of delivery, sex of the child, and gestational age. RESULTS FM was greater in GDM versus NGT newborns in a bivariable model (Median (IQR), GDM: 0.35 (0.3) kg vs. NGT: 0.27 (0.2) kg, p = 0.02), however GDM status was not a significant predictor of FM with adjustment for other variables. Rather, pre-pregnancy BMI (coefficient (β) 1.46; 95% confidence interval (CI) 0.66, 2.27), gestational weight gain (β 1.32; 95% CI 0.49, 2.15), and male sex (β -17.8; 95% CI -27.2, -8.29) predicted newborn FM. Analyzing GDM and NGT groups separately, pre-pregnancy BMI (β 6.75; 95% CI 2.36, 11.1) and gestational weight gain (β 5.64; 95% CI 1.16, 10.1) predicted FM in the GDM group, while male sex alone predicted FM in the NGT group (β -12.3; 95% CI -18.3, -6.34). CONCLUSIONS Combined model results suggest that in our cohort, pre-pregnancy BMI and gestational weight gain are more important risk factors for increased neonatal FM than GDM. However, group-specific model results suggest that GDM status may contribute to variation in the relationship between maternal/offspring factors and FM. Our use of a binary GDM variable in the combined model may have precluded clearer results on this point. Prospective cohort studies including data on maternal pre-pregnancy BMI, GWG, and glycemic profile are needed to better understand associations among these variables and their relative influence on offspring FM.
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Affiliation(s)
- Laísa R. S. Abreu
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Meghan K. Shirley
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
- * E-mail:
| | - Natália P. Castro
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Verônica V. Euclydes
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Denise P. Bergamaschi
- Epidemiology Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Liania A. Luzia
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Ana M. Cruz
- Geraldo de Paula Souza Health Center, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Patrícia H. C. Rondó
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
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14
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Longmore DK, Barr ELM, Lee IL, Barzi F, Kirkwood M, Whitbread C, Hampton V, Graham S, Van Dokkum P, Connors C, Boyle JA, Catalano P, Brown ADH, O'Dea K, Oats J, McIntyre HD, Shaw JE, Maple-Brown LJ. Maternal body mass index, excess gestational weight gain, and diabetes are positively associated with neonatal adiposity in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study. Pediatr Obes 2019; 14:e12490. [PMID: 30650263 DOI: 10.1111/ijpo.12490] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 09/27/2018] [Accepted: 10/03/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND In-utero exposures likely influence the onset and severity of obesity in youth. With increasing rates of type 2 diabetes mellitus (T2DM) and maternal adiposity in pregnancy globally, it is important to assess the impact of these factors on neonatal adipose measures. OBJECTIVES To evaluate the contribution of maternal ethnicity, body mass index (BMI), gestational weight gain, and hyperglycaemia to neonatal adiposity. METHODS Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) is a longitudinal cohort study of Australian mother and neonate pairs. In this analysis, Indigenous (n = 519) and Europid (n = 358) women were included, of whom 644 had hyperglycaemia (type 2 diabetes [T2DM], diabetes in pregnancy [DIP], or gestational diabetes [GDM]). Associations between maternal ethnicity, hyperglycaemia, BMI and gestational weight gain, and the neonatal outcomes of length, head circumference, sum of skinfolds, total body fat, and percentage body fat were examined. Models were adjusted for maternal age, smoking status, parity, education, neonatal gender, and gestational age. RESULTS Among those with hyperglycaemia in pregnancy, Indigenous women had a higher proportion of T2DM and DIP (36%, 13%) compared with Europid women (4%, 3%). In multivariate analysis, maternal T2DM (compared with no hyperglycaemia), BMI during pregnancy, and excess compared with appropriate gestational weight gain, were significantly associated with greater neonatal measures. DIP was associated with greater sum of skinfolds, total body fat, and percentage body fat. Indigenous ethnicity was associated with greater sum of skinfolds. CONCLUSIONS Maternal BMI, excess gestational weight gain, and hyperglycaemia operated as independent factors influencing neonatal adiposity. Interventions addressing these factors are needed to reduce neonatal adiposity.
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Affiliation(s)
- Danielle K Longmore
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia.,Department of Paediatrics, Western Health, Melbourne, Australia
| | - Elizabeth L M Barr
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia
| | - I-Lynn Lee
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
| | - Federica Barzi
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
| | - Marie Kirkwood
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
| | - Cherie Whitbread
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia.,Division of Medicine, Royal Darwin Hospital, Darwin, Australia
| | - Vanya Hampton
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
| | - Sian Graham
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
| | - Paula Van Dokkum
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia.,Baker Heart and Diabetes Institute, Alice Springs, Australia
| | | | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Alex D H Brown
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Kerin O'Dea
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
| | - Jeremy Oats
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - H David McIntyre
- Mater Medical Research Institute, University of Queensland, Brisbane, Australia
| | | | - Louise J Maple-Brown
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia.,Division of Medicine, Royal Darwin Hospital, Darwin, Australia
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15
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Wilkes M, Thornton J, Horlick M, Sopher A, Wang J, Widen EM, Pierson R, Gallagher D. Relationship of BMI z score to fat percent and fat mass in multiethnic prepubertal children. Pediatr Obes 2019; 14:10.1111/ijpo.12463. [PMID: 30117308 PMCID: PMC6309265 DOI: 10.1111/ijpo.12463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 06/06/2018] [Accepted: 06/29/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The objective of the study is to examine the validity of body mass index z score (zBMI) as a measure of percent body fat in prepubertal children. METHODS One hundred eleven multiethnic, healthy, Tanner 1 children aged 6-12 years had fat percent and fat mass measured by the four-compartment method as part of the Paediatric Rosetta Body Composition Cohort. Multiple regression models were developed with fat percent as the dependent variable and zBMI, age, sex and ethnicity as independent variables. RESULTS Body mass index z score predicted fat percent, adjusted for age in both girls (P < 0.001, RMSE 5.67 and R2 0.54) and boys (P < 0.001, RMSE 4.71, R2 0.69). The average model percent error was 20.3% in girls and 21.6% in boys. zBMI2 predicted fat mass when adjusted for age and zBMI in both girls (P < 0.001, RMSE 2.27 and R2 0.82) and boys (P < 0.001, RMSE 2.08 and R2 0.81). The average percent error was 7.2% in girls and 8.7% in boys. Age was associated with percentage body fat (P < 0.01), while ethnicity was not (P > 0.05). CONCLUSIONS Given the relatively large error in the models, zBMI are not a useful indicator of fat mass in healthy, Tanner 1 children. zBMI2 scores are associated with significantly lower absolute percent errors in girls and boys.
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Affiliation(s)
- Meredith Wilkes
- New York Obesity Research Center, Dept. of Medicine,
College of Physicians and Surgeons, Columbia University,Department of Pediatrics, Icahn School of Medicine at Mount
Sinai,Department Pediatrics, College of Physicians and Surgeons,
Columbia University
| | - John Thornton
- Consultant,Previous member of the Body Composition Unit, St.
Luke’s-Roosevelt Hospital where data were collected
| | - Mary Horlick
- Previous member of the Body Composition Unit, St.
Luke’s-Roosevelt Hospital where data were collected
| | - Aviva Sopher
- Department Pediatrics, College of Physicians and Surgeons,
Columbia University
| | - Jack Wang
- Previous member of the Body Composition Unit, St.
Luke’s-Roosevelt Hospital where data were collected
| | - Elizabeth M. Widen
- New York Obesity Research Center, Dept. of Medicine,
College of Physicians and Surgeons, Columbia University,Department of Nutritional Sciences, University of Texas at
Austin
| | - Richard Pierson
- Previous member of the Body Composition Unit, St.
Luke’s-Roosevelt Hospital where data were collected
| | - Dympna Gallagher
- New York Obesity Research Center, Dept. of Medicine,
College of Physicians and Surgeons, Columbia University,Previous member of the Body Composition Unit, St.
Luke’s-Roosevelt Hospital where data were collected,Institute of Human Nutrition, College of Physicians and
Surgeons, Columbia University
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16
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Chen LW, Tint MT, Fortier MV, Aris IM, Shek LPC, Tan KH, Rajadurai VS, Gluckman PD, Chong YS, Godfrey KM, Kramer MS, Henry JK, Yap F, Lee YS. Body composition measurement in young children using quantitative magnetic resonance: a comparison with air displacement plethysmography. Pediatr Obes 2018; 13:365-373. [PMID: 29024557 PMCID: PMC5805128 DOI: 10.1111/ijpo.12250] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 08/23/2017] [Accepted: 09/18/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Quantitative magnetic resonance (QMR) has been increasingly used to measure human body composition, but its use and validation in children is limited. OBJECTIVE We compared body composition measurement by QMR and air displacement plethysmography (ADP) in preschool children from Singapore's multi-ethnic Asian population (n = 152; mean ± SD age: 5.0 ± 0.1 years). METHODS Agreements between QMR-based and ADP-based fat mass and fat mass index (FMI) were assessed using intraclass correlation coefficient (ICC), reduced major axis regression and Bland-Altman plot analyses. Analyses were stratified for the child's sex. RESULTS Substantial agreement was observed between QMR-based and ADP-based fat mass (ICC: 0.85) and FMI (ICC: 0.82). Reduced major axis regression analysis suggested that QMR measurements were generally lower than ADP measurements. Bland-Altman analysis similarly revealed that QMR-based fat mass were (mean difference [95% limits of agreement]) -0.5 (-2.1 to +1.1) kg lower than ADP-based fat mass and QMR-based FMI were -0.4 (-1.8 to +0.9) kg/m2 lower than ADP-based FMI. Stratification by offspring sex revealed better agreement of QMR and ADP measurements in girls than in boys. CONCLUSIONS QMR-based fat mass and FMI showed substantial agreement with, but was generally lower than, ADP-based measures in young Asian children.
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Affiliation(s)
- Ling-Wei Chen
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mya-Thway Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore,Duke-National University of Singapore Graduate Medical School, Singapore
| | | | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore,Liggins Institute, University of Auckland, New Zealand
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, UK
| | - Michael S Kramer
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Canada
| | - Jeya K Henry
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore
| | - Fabian Yap
- Duke-National University of Singapore Graduate Medical School, Singapore,Department of Pediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore,Address correspondence and requests for reprints to: Yung Seng Lee (to whom the proofs should be sent), Department of Paediatrics, Yong Loo Lin School of Medicine, NUHS Tower Block, Level 12, 1E Kent Ridge Road, Singapore 119228; Phone: (65) 67724420; Fax: (65) 67797486; ; Fabian Yap, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore Children’s Tower Level 3, 100 Bukit Timah Road, S229899; Phone: (65) 6394 8841 Fax: (65) 6394 1700;
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore,Khoo Teck Puat- National University Children’s Medical Institute, National University Health System, Singapore,Address correspondence and requests for reprints to: Yung Seng Lee (to whom the proofs should be sent), Department of Paediatrics, Yong Loo Lin School of Medicine, NUHS Tower Block, Level 12, 1E Kent Ridge Road, Singapore 119228; Phone: (65) 67724420; Fax: (65) 67797486; ; Fabian Yap, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore Children’s Tower Level 3, 100 Bukit Timah Road, S229899; Phone: (65) 6394 8841 Fax: (65) 6394 1700;
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17
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Admassu B, Ritz C, Wells JCK, Girma T, Andersen GS, Belachew T, Owino V, Michaelsen KF, Abera M, Wibaek R, Friis H, Kæstel P. Accretion of Fat-Free Mass Rather Than Fat Mass in Infancy Is Positively Associated with Linear Growth in Childhood. J Nutr 2018; 148:607-615. [PMID: 29659955 DOI: 10.1093/jn/nxy003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 01/03/2018] [Indexed: 12/16/2022] Open
Abstract
Background We have previously shown that fat-free mass (FFM) at birth is associated with height at 2 y of age in Ethiopian children. However, to our knowledge, the relation between changes in body composition during early infancy and later linear growth has not been studied. Objective This study examined the associations of early infancy fat mass (FM) and FFM accretion with linear growth from 1 to 5 y of age in Ethiopian children. Methods In the infant Anthropometry and Body Composition (iABC) study, a prospective cohort study was carried out in children in Jimma, Ethiopia, followed from birth to 5 y of age. FM and FFM were measured ≤6 times from birth to 6 mo by using air-displacement plethysmography. Linear mixed-effects models were used to identify associations between standardized FM and FFM accretion rates during early infancy and linear growth from 1 to 5 y of age. Standardized accretion rates were obtained by dividing FM and FFM accretion by their respective SD. Results FFM accretion from 0 to 6 mo of age was positively associated with length at 1 y (β = 0.64; 95% CI: 0.19, 1.09; P = 0.005) and linear growth from 1 to 5 y (β = 0.63; 95% CI: 0.19, 1.07; P = 0.005). The strongest association with FFM accretion was observed at 1 y. The association with linear growth from 1 to 5 y was mainly engendered by the 1-y association. FM accretion from 0 to 4 mo was positively associated with linear growth from 1 to 5 y (β = 0.45; 95% CI: 0.02, 0.88; P = 0.038) in the fully adjusted model. Conclusions In Ethiopian children, FFM accretion was associated with linear growth at 1 y and no clear additional longitudinal effect from 1 to 5 y was observed. FM accretion showed a weak association from 1 to 5 y. This trial was registered at www.controlled-trials.com as ISRCTN46718296.
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Affiliation(s)
- Bitiya Admassu
- Department of Population and Family Health, Faculty of Public Health, Department of Pediatrics and Child Health, Faculty of Medical Sciences.,Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jonathan C K Wells
- Childhood Nutrition Research Center, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Tsinuel Girma
- Department of Pediatrics and Child Health, Faculty of Medical Sciences
| | | | - Tefera Belachew
- Department of Population and Family Health, Faculty of Public Health, Department of Pediatrics and Child Health, Faculty of Medical Sciences
| | - Victor Owino
- International Atomic Energy Agency, Vienna, Austria
| | - Kim F Michaelsen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Mubarek Abera
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia.,Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus Wibaek
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Kæstel
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
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18
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Huvanandana J, Carberry AE, Turner RM, Bek EJ, Raynes-Greenow CH, McEwan AL, Jeffery HE. An anthropometric approach to characterising neonatal morbidity and body composition, using air displacement plethysmography as a criterion method. PLoS One 2018; 13:e0195193. [PMID: 29601596 PMCID: PMC5877876 DOI: 10.1371/journal.pone.0195193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 03/14/2018] [Indexed: 11/18/2022] Open
Abstract
Background With the greatest burden of infant undernutrition and morbidity in low and middle income countries (LMICs), there is a need for suitable approaches to monitor infants in a simple, low-cost and effective manner. Anthropometry continues to play a major role in characterising growth and nutritional status. Methods We developed a range of models to aid in identifying neonates at risk of malnutrition. We first adopted a logistic regression approach to screen for a composite neonatal morbidity, low and high body fat (BF%) infants. We then developed linear regression models for the estimation of neonatal fat mass as an assessment of body composition and nutritional status. Results We fitted logistic regression models combining up to four anthropometric variables to predict composite morbidity and low and high BF% neonates. The greatest area under receiver-operator characteristic curves (AUC with 95% confidence intervals (CI)) for identifying composite morbidity was 0.740 (0.63, 0.85), resulting from the combination of birthweight, length, chest and mid-thigh circumferences. The AUCs (95% CI) for identifying low and high BF% were 0.827 (0.78, 0.88) and 0.834 (0.79, 0.88), respectively. For identifying composite morbidity, BF% as measured via air displacement plethysmography showed strong predictive ability (AUC 0.786 (0.70, 0.88)), while birthweight percentiles had a lower AUC (0.695 (0.57, 0.82)). Birthweight percentiles could also identify low and high BF% neonates with AUCs of 0.792 (0.74, 0.85) and 0.834 (0.79, 0.88). We applied a sex-specific approach to anthropometric estimation of neonatal fat mass, demonstrating the influence of the testing sample size on the final model performance. Conclusions These models display potential for further development and evaluation in LMICs to detect infants in need of further nutritional management, especially where traditional methods of risk management such as birthweight for gestational age percentiles may be variable or non-existent, or unable to detect appropriately grown, low fat newborns.
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Affiliation(s)
- Jacqueline Huvanandana
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
- * E-mail:
| | - Angela E. Carberry
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Robin M. Turner
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Emily J. Bek
- Sydney Medical School, University of Sydney, Sydney, Australia
| | | | - Alistair L. McEwan
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Heather E. Jeffery
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
- Sydney School of Public Health, University of Sydney, Sydney, Australia
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19
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Ikenoue S, Waffarn F, Sumiyoshi K, Ohashi M, Ikenoue C, Buss C, Gillen DL, Simhan HN, Entringer S, Wadhwa PD. Association of ultrasound-based measures of fetal body composition with newborn adiposity. Pediatr Obes 2017; 12 Suppl 1:86-93. [PMID: 27900852 PMCID: PMC5526753 DOI: 10.1111/ijpo.12198] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 09/22/2016] [Accepted: 10/17/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Newborns exhibit substantial variation in gestational age-adjusted and sex-adjusted fat mass proportion. The antecedent characteristics of fetal body composition that are associated with newborn fat mass proportion are poorly understood. OBJECTIVE The aim of this study was to determine whether a composite measure of fetal fat mass is prospectively associated with newborn adiposity. METHODS In a longitudinal study of 109 low-risk pregnancies, fetal ultrasonography was performed at approximately 12, 20 and 30 weeks gestation. Estimated fetal adiposity (EFA) was derived by integrating cross-sectional arm and thigh per cent fat area and anterior abdominal wall thickness. Newborn per cent body fat was quantified by Dual Energy X-Ray Absorptiometry. The association between EFA and newborn per cent body fat was determined by multiple linear regression. RESULTS After controlling for confounding factors, EFA at 30 weeks was significantly associated with newborn per cent body fat (standardized β = 0.41, p < 0.001) and explained 24.0% of its variance, which was substantially higher than that explained by estimated fetal weight (8.1%). The observed effect was driven primarily by arm per cent fat area. CONCLUSIONS A composite measure of fetal adiposity at 30 weeks gestation may constitute a better predictor of newborn per cent body fat than estimated fetal weight by conventional fetal biometry. Fetal arm fat deposition may represent an early indicator of newborn adiposity. After replication, these findings may provide a basis for an improved understanding of the ontogeny of fetal fat deposition, thereby contributing to a better understanding of its intrauterine determinants and the development of potential interventions.
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Affiliation(s)
- Satoru Ikenoue
- Department of Pediatrics, University of California, Irvine, Irvine, California,Development, Health and Disease Research Program, University of California, Irvine, Irvine, California,Department of Obstetrics and Gynecology, Keio University Graduate School of Medicine, Shinjuku, Tokyo, Japan
| | - Feizal Waffarn
- Department of Pediatrics, University of California, Irvine, Irvine, California,Development, Health and Disease Research Program, University of California, Irvine, Irvine, California
| | - Kaeko Sumiyoshi
- Department of Pediatrics, University of California, Irvine, Irvine, California,Development, Health and Disease Research Program, University of California, Irvine, Irvine, California,Department of Obstetrics and Gynecology, University of Miyazaki, Miyazaki, Japan
| | - Masanao Ohashi
- Department of Pediatrics, University of California, Irvine, Irvine, California,Development, Health and Disease Research Program, University of California, Irvine, Irvine, California,Department of Obstetrics and Gynecology, University of Miyazaki, Miyazaki, Japan
| | - Chigusa Ikenoue
- Department of Pediatrics, University of California, Irvine, Irvine, California,Development, Health and Disease Research Program, University of California, Irvine, Irvine, California
| | - Claudia Buss
- Department of Pediatrics, University of California, Irvine, Irvine, California,Development, Health and Disease Research Program, University of California, Irvine, Irvine, California,Institute of Medical Psychology, Charité University Medicine Berlin, Germany
| | - Daniel L. Gillen
- Department of Statistics, University of California, Irvine, Irvine, California
| | - Hyagriv N. Simhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sonja Entringer
- Department of Pediatrics, University of California, Irvine, Irvine, California,Development, Health and Disease Research Program, University of California, Irvine, Irvine, California,Institute of Medical Psychology, Charité University Medicine Berlin, Germany
| | - Pathik D. Wadhwa
- Department of Pediatrics, University of California, Irvine, Irvine, California,Department of Obstetrics and Gynecology, University of California, Irvine, Irvine, California,Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California,Department of Epidemiology, University of California, Irvine, Irvine, California,Development, Health and Disease Research Program, University of California, Irvine, Irvine, California
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Abstract
BACKGROUND In newborns and children, body fat estimation equations are often used at different ages than the age used to develop the equations. Limited validation studies exist for newborn body fat estimation equations at birth or later in infancy. The study purpose was to validate 4 newborn fat mass (FM) estimation equations in comparison to FM measured by air displacement plethysmography (ADP; the Pea Pod) at birth and 3 months. METHODS Ninety-five newborns (1-3 days) had their body composition measured by ADP and anthropometrics assessed by skinfolds. Sixty-three infants had repeat measures taken (3 months). FM measured by ADP was compared to FM from the skinfold estimation equations (Deierlein, Catalano, Lingwood, and Aris). Paired t-tests assessed mean differences, linear regression assessed accuracy, precision was assessed by R2 and standard error of the estimate (SEE), and bias was assessed by Bland-Altman plots. RESULTS At birth, FM measured by ADP differed from FM estimated by Deierlein, Lingwood and Aris equations, but did not differ from the Catalano equation. At 3 months, FM measured by ADP was different from all equations. At both time points, poor precision and accuracy was detected. Bias was detected in most all equations. CONCLUSIONS Poor agreement, precision, and accuracy were found between prediction equations and the criterion at birth and 3 months.
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Affiliation(s)
- Jennifer S Cauble
- Department of Dietetics and Nutrition, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow BLVD, Mail Stop 4013, Kansas City, KS, 66160, USA
| | - Mira Dewi
- Department of Dietetics and Nutrition, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow BLVD, Mail Stop 4013, Kansas City, KS, 66160, USA
| | - Holly R Hull
- Department of Dietetics and Nutrition, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow BLVD, Mail Stop 4013, Kansas City, KS, 66160, USA.
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21
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Yang C, Wang L. Comparisons of Waist Circumference Measurements at Five Different Anatomical Sites in Chinese Children. Biomed Res Int 2017; 2017:7678613. [PMID: 28261614 DOI: 10.1155/2017/7678613] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 12/24/2016] [Accepted: 01/16/2017] [Indexed: 11/18/2022]
Abstract
This study compared the waist circumference (WC) measurements of Chinese children at different sites to determine the relationship between WC measurements and body fat. WC was measured at five sites in 255 subjects aged 9-19 years: immediately below the lowest rib (WC1), at the narrowest waist (WC2), the midpoint between the lowest rib and the iliac crest (WC3), 1 cm above the umbilicus (WC4), and immediately above the iliac crest (WC5). Body fat mass (FM), body fat percentage (% BF), body fat mass in the trunk (FM in the trunk), and fat percentage in the trunk (% BF in the trunk) were determined by dual-energy X-ray absorptiometry. The WCs were then compared through ANOVA with repeated measurement. The relationship of WC of each site with FM, % BF, FM in the trunk, and % BF in the trunk was examined through partial correlation. The WCs exhibited the following pattern: WC2 < WC1 < WC3 < WC4 < WC5 (p < 0.001) in males and WC2 < WC1 < WC4, WC3 < WC5 (p < 0.001) in females. The measured WCs were strongly correlated with FM, % BF, FM in the trunk, and % BF in the trunk. The WC measurements at five commonly used sites among Chinese children are different from one another. Results indicate that standardizing the anatomic point for the WC measurements is necessary.
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Boone-Heinonen J, Messer L, Andrade K, Takemoto E. Connecting the Dots in Childhood Obesity Disparities: A Review of Growth Patterns from Birth to Pre-Adolescence. CURR EPIDEMIOL REP 2016; 3:113-124. [PMID: 27172171 DOI: 10.1007/s40471-016-0065-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In this review, we considered how disparities in obesity emerge between birth, when socially disadvantaged infants tend to be small, and later in childhood, when socially disadvantaged groups have high risk of obesity. We reviewed epidemiologic evidence of socioeconomic and racial/ethnic differences in growth from infancy to pre-adolescence. Minority race/ethnicity and lower socioeconomic status was associated with rapid weight gain in infancy but not in older age groups, and social differences in linear growth and relative weight were unclear. Infant feeding practices was the most consistent mediator of social disparities in growth, but mediation analysis was uncommon and other factors have only begun to be explored. Complex life course processes challenge the field of social epidemiology to develop innovative study designs and analytic techniques with which to pose and test challenging yet impactful research questions about how obesity disparities evolve throughout childhood.
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Affiliation(s)
- Janne Boone-Heinonen
- Oregon Health & Science University, OHSU-PSU School of Public Health 3181 SW Sam Jackson Park Road, CB669 Portland, OR 97239-3098
| | - Lynne Messer
- Portland State University; OHSU-PSU School of Public Health 470H Urban Center; 506 SW Mill St. Portland, OR 37201 (P) 503.725.5182 (F) 503.725.5100
| | - Kate Andrade
- University of Minnesota, Division of Epidemiology & Community Health 1300 S 2 St, Ste 300 Minneapolis, MN 55454
| | - Erin Takemoto
- Oregon Health & Science University, OHSU-PSU School of Public Health 3181 SW Sam Jackson Park Road, CB669 Portland, OR 97239-3098 (P) 503-418-9810
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