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Body composition for paediatricians
Measuring body composition provides clinically useful information for many paediatric conditions such as cystic fibrosis, cerebral palsy, eating disorders and inflammatory bowel disease. Body composition measurements provide an insight into disease severity, nutritional status and long-term health risks, enabling paediatricians and allied health professionals to plan and deliver more holistic care. Waist circumference measurements and assessment of fat mass (FM) and percentage fat using dual-energy X-ray absorptiometry (DEXA) are two examples of methods in clinical use.
Component models of body composition
A variety of techniques exist to measure body composition, ranging in complexity and accuracy, and which have utility across both research and clinical settings (table 1). However, all rely on the same key principles of measuring different chemical constituents of the human body. Measurement of body composition at its simplest quantifies these key constituents into two components: FM and fat-free mass (FFM).
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Methods to measure body composition are therefore often described as component models (figure 1); the simplest being a two-component model which measures FFM from which FM can be derived. More detailed multicomponent methods of body composition measure individual constituents of FFM, such as bone, mineral or water content to form a more comprehensive model.
There are, however, many smaller constituents with different densities which cannot be accurately quantified, and the relative density of measurable components like fat differs between health states, populations and—crucially for paediatrics—by age. All component models therefore make assumptions based on the physical and chemical properties of the constituents of FM and FFM.1 The techniques used to measure the components that underpin composition models can be further classified as direct (eg, imaging or DEXA) or indirect (bioelectrical impedance analysis, skin fold thickness or waist circumference). An overview of the most used body composition measuring techniques is presented in table …
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Contributors EP and CG planned the manuscript. EP wrote the manuscript, supervised by SNU and CG. All authors contributed to the final version of the manuscript.
Funding EP received support from a clinical research training fellowship from the Medical Research Council and Chelsea and Westminster Medical Research Charity. CG received support from the UK Medical Research Council through Clinician Scientist Fellowship and Transition Support awards and from Chiesi Pharmaceuticals to attend an educational conference; in the past 5 years, he has been investigator on received research grants from Medical Research Council, National Institute of Health Research, Canadian Institute of Health Research, Department of Health in England, Mason Medical Research Foundation and Westminster Medical School Research Trust and Chiesi Pharmaceuticals. SNU declares no funding nor conflicts of interest in relation to the work submitted.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.