Body composition assessment in a sample of eight-year-old children

doi:10.1016/j.nut.2009.01.016

Nutrition

Volume 25, Issue 10, October 2009, Pages 1020-1028

https://doi.org/10.1016/j.nut.2009.01.016 Get rights and content

Abstract

Objective

We assessed the body composition of 8-y-old children living in Livorno through the integration of bioelectrical and anthropometric evaluations.

Methods

The study, conducted during December 2005, involved 8-y-old third graders of Livorno, Italy. We collected for each subject (449 children, 210 female and 239 male) anthropometric parameters and carried out bioelectrical impedance test with a STA/BIA Soft Tissue Analyzer. Data were processed with SPSS 14.0.

Results

According to anthropometric parameters, a statistically significant difference between genders was found only for height. Percentages of overweight and obese children by gender were 13.9 and 2.4 for girls and 21.3 and 2.1 for boys (P < 0.05). No significant differences were observed for weight, height, and body mass index percentiles from national reference values, whereras significant differences were found in mid-upper arm circumference between our sample and—lacking national data—the reference (U.S.) population for age and gender. With regard to bioelectrical impedance analysis, a common trend of distribution was observed in both genders toward the left and the area above the spatial ellipses and a statistically significant difference between genders for all parameters with the exception of phase angle. A gradual mean impedance shortening vector was observed with an increase of body mass index or mid-upper arm circumference. The comparison of the two techniques showed a good relation between anthropometric and bioelectrical parameters.

Conclusion

An integrated interpretation of bioelectrical impedance analysis and anthropometry, demonstrated by the correlation of many parameters between the two techniques, seems to emerge as a good indication of nutritional status for most children of both genders.

Introduction

Obesity has reached epidemic proportions globally, with more than 1 billion adults overweight and at least 300 million clinically obese, providing a major contribution to the global burden of chronic diseases and disability.

In many countries in the European region over half the adult population has passed the threshold of being overweight and 20–30% of adults are categorized as clinically obese. For example, one in five adults is obese in Finland, Germany, and the United Kingdom. In addition, an alarming concern is represented by the increasing incidence of childhood obesity [1], [2].

Because obesity has become a major public health problem, especially in children, the importance of methodologies for the assessment of body composition is assuming a greater relevance as a tool that permits interventions of evaluation and possible containment and/or prevention of this condition.

During the past two decades, many investigators have used different methodologies for the assessment of body composition in adults and children, each one responding to a precise aim [3], [4], [5], [6]. For instance, the more accurate the evaluation, the greater the difficulty in applying it to a large number of subjects simultaneously; for clinical and individual purposes, two of the most recognized techniques are dual-energy x-ray absorptiometry and nuclear magnetic resonance, but these are not affordable for numerous subjects, a situation in which public health interventions usually occur. In contrast, bioelectrical impedance analysis (BIA) is a low-cost technique that is implemented especially because of its simplicity of use, scarce variability in inter- and intraoperators, portability, quickness in execution, and the possibility of following subjects through repeated examinations in brief intervals. Of course, this method has also many limits, among which is the assumption of a constant hydration factor in calculating the parameters of conventional BIA. Therefore, the regression equations are validated only for healthy adults. Age-specific equations are lacking for children, so bioelectrical impedance vector analysis (BIVA) could be more useful in this population [7], [8].

Anthropometric measurements are widely used as indicators of nutritional status for the low cost and simplicity in execution, although these are imperfect proxies for obesity owing to their individual variability in relation to body composition. Furthermore, the detection of variation in growth through anthropometric parameters does not allow timely nutritional interventions.

Due to the limitations of BIA (conventional and vectorial) and anthropometry, the combined use of both techniques could be helpful in producing a more accurate estimate of body composition in populations for public health purposes.

The aim of this study was the description of body composition (proxy of nutritional status) of 8-y-old children living in Livorno, Italy, through an integration of bioelectrical and anthropometric evaluations.

Section snippets

Subjects

This research was conducted in the municipality of Livorno, a city of 160 534 inhabitants (as of December 2005), located on the west coast of central Italy, which had promoted the study.

The study, conducted during December 2005, involved all 8-y-old children (boys and girls) attending third grade (520 subjects) in the 14 public primary schools in Livorno. We selected this group because the differences due to gender, in this age class, could be considered minor with regard to anthropometric

Anthropometric measurements

Anthropometric parameters (weight, height, and BMI) for 210 female and 239 male subjects are listed in Table 1. A statistically significant difference between genders was found only for height (P < 0.05, Student's t test).

After comparing our percentiles for weight, height, and BMI (P3, P50, P97) with national reference values to identify children at risk, we observed no significant differences (Table 2).

In comparison with national references, BMI determinations over cutoff values for overweight

Discussion

In current clinical practice, the most frequently used parameter to define nutritional status is BMI, but with regard to children the cutoff points of overweight and obesity are still unclear. To partly solve this uncertainty, we decided to adopted and compare different techniques to evaluate body composition, anthropometric measurements and BIA, to produce a comprehensive framework of evaluation.

The prevalence of overweight and obesity in our sample is lower than that in Tuscany (a Tuscan

Conclusions

The description of body composition in the sample of children from Livorno seems to be positively assessed by different techniques, such as those used in this study. In addition, through an integrated interpretation of BIA and anthropometry, demonstrated by the correlation of many parameters between the two techniques, a good nutritional status for the majority of children of both genders seems to emerge.

Acknowledgments

The role of the teachers was crucial to ensure the participation of the children and to obtain the informed consent by their parents; this is an obvious, but important, consideration, because it could decisively influence the compliance of the sample.

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Children aged 6–9 years were recruited from four public schools in Natal, Brazil. Anthropometric measurements and bioelectrical impedance (BIA) were performed. The values of age, weight (kg), height (cm), resistance (Ω), and reactance (Ω) were measured. Only eutrophic children were included according to body mass index (BMI)-for-age Z-score. BIVA 2002 software was used for the construction of BIVA plots. A P-value < 0.05 was accepted as statistically significant.
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The PhA values and the new tolerance ellipses provided by our data reflect the normal growth and development of the prepubertal children studied. These reference values have significant clinical utility since they can point out altered body composition in other children due to pathophysiological conditions. Verifying changes in nutritional prognosis and hydration status allow early clinical and nutritional interventions.
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Applied nutritional investigationBody composition assessment in a sample of eight-year-old children

Abstract

Objective

Methods

Results

Conclusion

Introduction

Section snippets

Subjects

Anthropometric measurements

Discussion

Conclusions

Acknowledgments

Am J Clin Nutr

J Pediatr Surg

J Nutr

J Nutr

Nutrition

Clin Nutr

Nutrition

The European health report

Assessing body composition among 3- to 8-year-old children: anthropometry, BIA, and DXA

Obes Res

Body composition by simple anthropometry, bioimpedance and DXA in preschool children: interrelationships among methods

Arch Argent Pediatr

Comparison of field methods to estimate fat mass in children

Ann Hum Biol

Electrical maturation trajectory of human tissues identified by bioelectrical impedance vector analysis

Nutrition

Anthropometric standardization reference manual

Applied nutritional investigation
Body composition assessment in a sample of eight-year-old children