Location: Arkansas Children's Nutrition CenterTitle: Air displacement plethysmography, dual-energy x-ray absorptiometry, and total body water to evaluate body composition in preschool-age children) Author
Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/13/2012
Publication Date: 12/15/2012
Citation: Crook, T., Armbya, N., Cleves, M., Badger, T.M., Andres, A. 2012. Air displacement plethysmography, dual-energy x-ray absorptiometry, and total body water to evaluate body composition in preschool-age children. Journal of the Academy of Nutrition and Dietetics. 112(12):1993-1998. Interpretive Summary: This study determined the accuracy of air displacement plethysmography (ADP) in measuring body fat mass in 66 healthy children at ages 3-5 years. Compared to the criterion method (deuterium dilution), ADP did not accurately assess body fat mass in children age 3-5 years. Thus, at this time, the criterion method, dual energy X-ray absorptiometry, or quantitative nuclear magnetic resonance may be considered as better options for assessing body composition in young children.
Technical Abstract: Anthropometrics and body mass index are only proxies in the evaluation of adiposity in the pediatric population. Air displacement plethysmography technology was not available for children aged 6 months to 9 years until recently. Our study was designed to test the precision of air displacement plethysmography (ADP) in measuring body fat mass in children at ages 3 to 5 years compared with a criterion method, deuterium oxide dilution (D(2)O), which estimates total body water, and a commonly used methodology, dual-energy x-ray absorptiometry (DXA). A prospective, cross-sectional cohort of 66 healthy children (35 girls) was recruited in the central Arkansas region between 2007 and 2009. Weight and height were obtained using standardized procedures. Fat mass (%) was measured using ADP, DXA, and D(2)O. Concordance correlation coefficient and Bland-Altman plots were used to investigate the precision of the ADP techniques against D(2)O and DXA in children at ages 3 to 5 years. ADP concordance correlation coefficient for fat mass was weak (0.179) when compared with D(2)O. Bland-Altman plots revealed a low accuracy and large scatter of ADP fat mass (%) results (mean=-2.5, 95% CI -20.3 to 15.4) compared with D(2)O. DXA fat mass (%) results were more consistent although DXA systematically overestimated fat mass by 4% to 5% compared with D(2)O. Compared with D(2)O, ADP does not accurately assess percent fat mass in children aged 3 to 5 years. Thus, D(2)O, DXA, or quantitative nuclear magnetic resonance may be considered better options for assessing fat mass in young children.