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Body composition in childhood: effects of normal growth and disease

Published online by Cambridge University Press:  08 December 2008

J. C. K. Wells
J. C. K. Wells*
Affiliation:
MRC Childhood Nutrition Research Centre, Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
*
Corresponding author: Dr J. C. K. Wells, fax +44 20 7831 9903, J.Wells@ich.ucl.ac.uk
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Abstract

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Body composition in children is of increasing interest within the contexts of childhood obesity, clinical management of patients and nutritional programming as a pathway to adult disease. Energy imbalance appears to be common in many disease states; however, body composition is not routinely measured in patients. Traditionally, clinical interest has focused on growth or nutritional status, whereas more recent studies have quantified fat mass and lean mass. The human body changes in proportions and chemical composition during childhood and adolescence. Most of the weight gain comprises lean mass rather than fat. In general, interest has focused on percentage fat, and less attention has been paid to the way in which lean mass varies within and between individuals. In the general population secular trends in BMI have been widely reported, indicating increasing levels of childhood obesity, which have been linked to reduced physical activity. However, lower activity levels may potentially lead not only to increased fatness, but also to reduced lean mass. This issue merits further investigation. Diseases have multiple effects on body composition and may influence fat-free mass and/or fat mass. In some diseases both components change in the same direction, whereas in other diseases, the changes are contradictory and may be concealed by relatively normal weight. Improved techniques are required for clinical evaluations. Both higher fatness and reduced lean mass may represent pathways to an increased risk of adult disease.

Keywords

Body composition in childhoodFat massLean massChildhood diseaseNutritional programming
Type
Clinical Nutrition and Metabolism Group Symposium on ‘Control of energy balance in health and disease’
Information
Proceedings of the Nutrition Society , Volume 62 , Issue 2 , May 2003 , pp. 521 - 528
Copyright
Copyright © The Nutrition Society 2003

References

Barker, DJP (1998) In utero programming of chronic disease. Clinical Science 95, 115–128CrossRefGoogle ScholarPubMed
Bogin, B (1996) Human growth and development from an evolutionary perspective. In Long-term Consequences of Early Environment: Growth, Development and the Lifespan Developmental Perspective, pp. 7–24 [Henry, CJK and Ulijaszek, SJ, editors]. Cambridge: Cambridge University Press.Google Scholar
Brambilla, P, Bricalli, D, Sala, N, Renzetti, F, Manzoni, P, Vanzulli, A, Chiumello, G, di, Natale, B Vigano, A (2001) Highly active antiretroviral-treated HIV-infected children show fat distribution changes even in absence of lipodystrophy. AIDS 15, 2415–2422Google Scholar
Bundred, P, Kitchiner, D & Buchan, I (2001) Prevalence of over-weight and obese children between 1989 and 1998: population based series of cross sectional studies. British Medical Journal 322, 326–328CrossRefGoogle ScholarPubMed
Chinn, S & Rona, RJ (2001) Prevalence and trends in overweight and obesity in three cross sectional studies of British children, 1974–94. British Medical Journal 322, 24–26Google Scholar
De, Palo, T, Messina, G, Edefonti, A, Perfumo, F, Pisanello, L, Peruzzi, L, Di, lorio, B, Mignozzi, M, Vienna, A, Conti, G, Penza, R & Piccoli, A (2000) Normal values of the bioelectrical impedance vector in childhood and puberty. Nutrition 16, 417–424Google Scholar
Deurenberg-Yap, M, Schmidt, G, van-Staveren, WA & Deurenberg, P (2000) The paradox of low body mass index and high body fat percentage among Chinese, Malays and Indians in Singapore. International Journal of Obesity 24, 1011–1017CrossRefGoogle ScholarPubMed
Fewtrell, MS, Doherty, C, Cole, TJ, Stafford, M, Hales, CN & Lucas, A (2000) Effects of size at birth, gestational age and early growth in preterm infants on glucose and insulin concentrations at 9–12 years. Diabetologia 43, 714–717Google Scholar
Flegal, KM (1993) Defining obesity in children and adolescents: epidemiologic approaches. Critical Reviews in Food and Science Nutrition 33, 307–312CrossRefGoogle ScholarPubMed
Fomon, SJ, Haschke, F, Ziegler, EE & Nelson, SE (1982) Body composition of reference children from birth to age 10 years. American Journal of Clinical Nutrition 35, 1169–1175Google Scholar
Frisch, RE (1984) Body fat, puberty and fertility. Biological Reviews of Cambridge Philosophical Society 59, 161–188Google Scholar
Fuller, NJ, Fewtrell, MS, Dewit, O, Elia, M & Wells, JCK (2002) Segmental bioelectrical impedance analysis in children aged 8–12 y: 2. The assessment of regional body composition and muscle mass. International Journal of Obesity 26, 692–700CrossRefGoogle ScholarPubMed
Fuller, NJ, Jebb, SA, Laskey, MA, Coward, WA & Elia, M (1992) Four-component model for the assessment of body composition in humans: comparison with alternative methods, and evaluation of the density and hydration of fat-free mass. Clinical Science 82, 687–693Google Scholar
Haschke, F (1983a) Body composition of adolescent males. I. Total body water in normal adolescent males. Acta Paediatrica Scandinavia 307, 1–12 Suppl.Google ScholarPubMed
Haschke, F (1983b) Body composition of adolescent males. II. Body composition of the male reference adolescent. Acta Paediatrica Scandinavia 307, 13–23 Suppl.Google ScholarPubMed
Hattori, K, Tatsumi, N & Tanaka, S (1997) Assessment of body composition by using a new chart method. American Journal of Human Biology 9, 573–5783.0.CO;2-V>CrossRefGoogle ScholarPubMed
Iketani, T, Kiriike, N, Nagata, T & Yamagami, S (1999) Altered body fat distribution after recovery of weight in patients with anorexia nervosa. International Journal of Eating Disorders 26, 275–2823.0.CO;2-I>CrossRefGoogle ScholarPubMed
Karlberg, J, Engström, I, Karlberg, P & Fryer, J (1987) Analysis of linear growth using a mathematical model 1 from birth to 3 years. Acta Paediatrica 76, 478–488Google Scholar
Kelly, DA (1997) Nutritional factors affecting growth before and after liver transplantation. Pediatric Transplantation 1, 80–84Google ScholarPubMed
Lohman, TG (1989) Assessment of body composition in children. Pediatric Exercise Science 1, 19–30Google Scholar
Lucas, A, Fewtrell, MS & Cole, TJ (1999) Fetal origins of adult disease–the hypothesis revisited. British Medical Journal 319, 245–249Google Scholar
Maynard, LM, Wisemandle, W, Roche, AF, Chumlea, WC, Guo, SS & Siervogel, RM (2001) Childhood body composition in relation to body mass index. Pediatrics 107, 344–350CrossRefGoogle ScholarPubMed
Metcalfe, NB & Monaghan, P (2001) Compensation for a bad start: grow now, pay later?. Trends in Ecology and Evolution 16, 254–259Google Scholar
Miller, TL, Awnetwant, EL, Evans, S, Morris, VM, Vazquez, IM & Mclntosh, K (1995) Gastrostomy tube supplementation for HIV-infected children. Pediatrics 96, 696–702CrossRefGoogle ScholarPubMed
Moreno, LA, Fleta, J, Sarria, A, Rodriguez, G, Gil, C & Bueno, M (2001) Secular changes in body fat patterning in children and adolescents of Zaragoza (Spain), 1980–1995. International Journal of Obesity 25, 1656–1660Google Scholar
Nicholls, D, Wells, JCK, Stanhope, R, Singhal, A & Lask, B (2002) Body composition in children with eating disorders. European Journal of Clinical Nutrition 56, 857–865CrossRefGoogle ScholarPubMed
Norgan, NG (2000) Long-term physiological and economic consequences of growth retardation in children and adolescents. Proceedings of the Nutrition Society 29, 245–256Google Scholar
Oguz, A, Karadeniz, C, Pelit, M & Hasanoglu, A (1999) Arm anthropometry in evaluation of malnutrition in children with cancer. Pediatric Hepatology and Oncology 16, 35–41CrossRefGoogle ScholarPubMed
Pietrobelli, A, Faith, MS, Allison, DB, Gallagher, D, Chiumello, G & Heymsfield, SB (1998) Body mass index as a measure of adiposity among children and adolescents: a validation study. Journal of Pediatrics 132, 204–210CrossRefGoogle ScholarPubMed
Reilly, JJ (2002) The role of energy balance research in under-standing the malnutrition of chronic disease in childhood and old age. Proceedings of the Nutrition Society 61, 321–327Google Scholar
Reilly, JJ, Edwards, CA & Weaver, LT (1997) Malnutrition in children with cystic fibrosis: the energy-balance equation. Journal of Pediatric Gastroenterology and Nutrition 25, 127–136Google Scholar
Reilly, JJ, Wilson, J & Durnin, JVGA (1995) Determination of body composition from skinfold thickness: a validation study. Archives of Disease in Childhood 73, 305–310CrossRefGoogle ScholarPubMed
Rolland-Cachera, M-F, Deheeger, M, Bellisle, F, Sempé, M, Guilloud-Bataille, M & Patois, E (1984) Adiposity rebound in children: a simple indicator for predicting obesity. American Journal of Clinical Nutrition 39, 129–135CrossRefGoogle ScholarPubMed
Russell, JD, Mira, M, Allen, BJ, Stewart, PM, Vizzard, J, Arthur, B & Beumont, PJ (1994) Protein repletion and treatment in anorexia nervosa. American Journal of Clinical Nutrition 59, 98–102Google Scholar
Ruxton, CH, Reilly, JJ & Kirk, TR (1999) Body composition of healthy 7- and 8-year-old children and a comparison with the ‘reference child’. International Journal of Obesity 23, 1276–1281Google Scholar
Schoeller, DA (1996) Hydrometry. In Human Body Composition, pp. 25–43 [Roche, AF Heymsfield, SB and Lohman, TG, editors]. Champaign, IL: Human Kinetics.Google Scholar
Torun, B & Viteri, FE (1994) Influence of exercise on linear growth. European Journal of Clinical Nutrition 48, S186–S189 Suppl. 1Google ScholarPubMed
Van, Itallie, TB, Yang, M, Heymsfield, SB, Funk, RC, Boileau RA (1990) Height-normalised indices of the body's fat-free and fat mass: potentially useful indicators of nutritional status. American Journal of Clinical Nutrition 52, 953–959Google Scholar
Wang, Y & Wang, JQ (2002) A comparison of international references for the assessment of child and adolescent overweight and obesity in different populations. European Journal of Clinical Nutrition 56, 973–982Google Scholar
Wells, JCK (2000) A Hattori chart analysis of body mass index in infants and children. International Journal of Obesity 24, 325–329Google Scholar
Wells, JCK (2001) A critique of the expression of paediatric body composition data. Archives of Disease in Childhood 85, 67–72Google Scholar
Wells, JCK, Cole, TJ ALSPAC Study Team (2002a) Adjustment of fat-free mass and fat mass for height in children aged 8 years. International Journal of Obesity 26, 947–952CrossRefGoogle Scholar
Wells, JCK, Coward, WA, Cole, TJ & Davies, PSW (2002b) The contribution of fat and fat-free tissue to body mass index in contemporary children and the reference child. International Journal of Obesity 26, 1323–1328Google Scholar
Wells, JCK, Douros, I, Fuller, NJ, Elia, M & Dekker, L (2000) Assessment of body volume using a near infra-red 3-dimensional photographic scanner. Annals of the New York Academy of Sciences 904, 247–254Google Scholar
Wells, JCK, Fuller, NJ, Dewit, O, Fewtrell, MS, Elia, M & Cole, TJ (1999) Four-component model of body composition in children: density and hydration of fat free mass and comparison with simpler models. American Journal of Clinical Nutrition 69, 904–912CrossRefGoogle ScholarPubMed
Wells, JCK, Mok, Q & Johnson, AW (2001) Nutritional status in children. Lancet 357 1293CrossRefGoogle ScholarPubMed
Wells, JCK, Mok, Q, Johnson, AW, Lanigan, JA & Fewtrell, MS (2002c) Energy requirements and body composition in paediatric intensive care patients receiving ventilatory support. Food and Nutrition Bulletin 23, 95–98 Suppl. 3CrossRefGoogle ScholarPubMed
Wells, JCK & Nicholls, D (2001) The relationship between body size and body composition in women of different nutritional status. European Eating Disorders Review 9, 416–426Google Scholar
Werkman, A, Deurenberg-Yap, M, Schmidt, G & Deurenberg, PA (2000) Comparison between composition and density of the fat-free mass of young adult Singaporean Chinese and Dutch Caucasians. Annals of Nutrition and Metabolism 44, 235–242Google Scholar
Widdowson, EM (1950) Chemical composition of newly born mammals. Nature 166, 626–628Google Scholar
Wright, CM, Parker, L, Lamont, D & Craft, AW (2001) Implications of childhood obesity for adult health: findings from thousand families cohort study. British Medical Journal 323, 1280–1284CrossRefGoogle ScholarPubMed
Yajnik, CS (2001) Fetal origins of adult disease: where do we stand?. International Journal of Diabetes in Developing Countries 21, 42–50Google Scholar