Skip to main content
Top
Published in: BMC Pediatrics 1/2019

Open Access 01-12-2019 | Obesity | Research article

Clinically relevant body composition methods for obese pediatric patients

Authors: Alexandra Kreissl, Anselm Jorda, Katharina Truschner, Gabriele Skacel, Susanne Greber-Platzer

Published in: BMC Pediatrics | Issue 1/2019

Login to get access

Abstract

Background

There is no gold standard in body composition measurement in pediatric patients with obesity. Therefore, the aim of this study was to investigate if there are any differences between two bioelectrical impedance analysis techniques performed in children and adolescents with obesity.

Methods

Data were collected at the Department of Pediatrics and Adolescent Medicine in Vienna from September 2015 to May 2017. Body composition measurement was performed with TANITA scale and BIA-BIACORPUS.

Results

In total, 38 children and adolescents (age: 10–18 years, BMI: 25–54 kg/m2) were included. Boys had significantly increased fat free mass (TANITA p = 0.019, BIA p = 0.003), total body water (TANITA p = 0.020, BIA p = 0.005), and basal metabolic rate (TANITA p = 0.002, BIA p = 0.029). Girls had significantly increased body fat percentage with BIA (BIA p = 0.001). No significant gender differences of core abdominal area have been determined. TANITA overestimated body fat percentage (p < 0.001), fat mass (p = 0.002), and basal metabolic rate (p < 0.001) compared to BIA. TANITA underestimated fat free mass (p = 0.002) in comparison to BIA. The Bland Altman plot demonstrated a low agreement between the body composition methods.

Conclusions

Low agreement between TANITA scale and BIA-BIACORPUS has been observed. Body composition measurement should always be performed by the same devices to obtain comparable results. At clinical routine due to its feasibility, safety, and efficiency, bioelectrical impedance analysis is appropriate for obese pediatric patients.

Trial registration

ClinicalTrials NCT02545764. Registered 10 September 2015.
Literature
2.
go back to reference Sharma AM, Chetty VT. Obesity, hypertension and insulin resistance. Acta Diabetol. 2005;42(Suppl 1):3–8.CrossRef Sharma AM, Chetty VT. Obesity, hypertension and insulin resistance. Acta Diabetol. 2005;42(Suppl 1):3–8.CrossRef
3.
go back to reference Kyle UG, Earthman CP, Pichard C, Coss-Bu JA. Body composition during growth in children: limitations and perspectives of bioelectrical impedance analysis. Eur J Clin Nutr. 2015;69:1298–305.CrossRef Kyle UG, Earthman CP, Pichard C, Coss-Bu JA. Body composition during growth in children: limitations and perspectives of bioelectrical impedance analysis. Eur J Clin Nutr. 2015;69:1298–305.CrossRef
4.
go back to reference Fomon SJ, Haschke F, Ziegler EE, Nelson SE. Body composition of reference children from birth to age 10 years. Am J Clin Nutr. 1982;35(Suppl 1):1169–75.CrossRef Fomon SJ, Haschke F, Ziegler EE, Nelson SE. Body composition of reference children from birth to age 10 years. Am J Clin Nutr. 1982;35(Suppl 1):1169–75.CrossRef
5.
go back to reference Talma H, Chinapaw MJ, Bakker B, HiraSing RA, Terwee CB, Altenburg TM. Bioelectrical impedance analysis to estimate body composition in children and adolescents: a systematic review and evidence appraisal of validity, responsiveness, reliability and measurement error. Obes Rev. 2013;14:895–905.CrossRef Talma H, Chinapaw MJ, Bakker B, HiraSing RA, Terwee CB, Altenburg TM. Bioelectrical impedance analysis to estimate body composition in children and adolescents: a systematic review and evidence appraisal of validity, responsiveness, reliability and measurement error. Obes Rev. 2013;14:895–905.CrossRef
6.
go back to reference Ellis KJ, Shypailo RJ, Abrams SA, Wong WW. The reference child and adolescent models of body composition. A contemporary comparison. Ann N Y Acad Sci. 2000;904:374–82.CrossRef Ellis KJ, Shypailo RJ, Abrams SA, Wong WW. The reference child and adolescent models of body composition. A contemporary comparison. Ann N Y Acad Sci. 2000;904:374–82.CrossRef
7.
go back to reference Diaz EO, Villar J, Immink M, Gonzales T. Bioimpedance or anthropometry? Eur J Clin Nutr. 1989;43:129–37.PubMed Diaz EO, Villar J, Immink M, Gonzales T. Bioimpedance or anthropometry? Eur J Clin Nutr. 1989;43:129–37.PubMed
8.
go back to reference Horsak B, Artner D, Baca A, Pobatschnig B, Greber-Platzer S, Nehrer S, et al. The effects of a strength and neuromuscular exercise programme for the lower extremity on knee load, pain and function in obese children and adolescents: study protocol for a randomised controlled trial. Trials. 2015;16:586.CrossRef Horsak B, Artner D, Baca A, Pobatschnig B, Greber-Platzer S, Nehrer S, et al. The effects of a strength and neuromuscular exercise programme for the lower extremity on knee load, pain and function in obese children and adolescents: study protocol for a randomised controlled trial. Trials. 2015;16:586.CrossRef
9.
go back to reference Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, Hesse V, et al. Perzentile für den Body-mass-Index für das Kindes- und Jugend-alter unter Heranziehung verschiedener deutscher Stichproben. Monatsschrift Kinderheilkunde. 2001;149:807–18.CrossRef Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, Hesse V, et al. Perzentile für den Body-mass-Index für das Kindes- und Jugend-alter unter Heranziehung verschiedener deutscher Stichproben. Monatsschrift Kinderheilkunde. 2001;149:807–18.CrossRef
10.
go back to reference WHO. Obesity: preventing and managing the global epidemic. Geneva: Report on a WHO Consultation on Obesity; 2000. WHO. Obesity: preventing and managing the global epidemic. Geneva: Report on a WHO Consultation on Obesity; 2000.
11.
go back to reference Ross R, Berentzen T, Bradshaw AJ, Janssen I, Kahn HS, Katzmarzyk PT, et al. Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference? Obes Rev. 2008;9:312–25.CrossRef Ross R, Berentzen T, Bradshaw AJ, Janssen I, Kahn HS, Katzmarzyk PT, et al. Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference? Obes Rev. 2008;9:312–25.CrossRef
12.
go back to reference WHO. Waist Circumference and Waist-Hip Ratio Report of a WHO Expert Consultation.Geneva; 2008: 47. WHO. Waist Circumference and Waist-Hip Ratio Report of a WHO Expert Consultation.Geneva; 2008: 47.
13.
go back to reference TANITA Corporation. Body composition analyzer BC-418 instructional manual. Tokyo, Japan:1–23. TANITA Corporation. Body composition analyzer BC-418 instructional manual. Tokyo, Japan:1–23.
14.
go back to reference Medical Healthcare GmbH. Bedienungsanleitung Biacorpus RX 4000. Germany: 2013:1–19. Medical Healthcare GmbH. Bedienungsanleitung Biacorpus RX 4000. Germany: 2013:1–19.
15.
go back to reference Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.CrossRef Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.CrossRef
16.
go back to reference Bland JM, Altman DG. Comparing methods of measurement: why plotting difference against standard method is misleading. Lancet. 1995;346:1085–7.CrossRef Bland JM, Altman DG. Comparing methods of measurement: why plotting difference against standard method is misleading. Lancet. 1995;346:1085–7.CrossRef
17.
go back to reference Butte NF, Hopkinson JM, Wong WW, Smith EO, Ellis KJ. Body composition during the first 2 years of life: an updated reference. Pediatr Res. 2000;47:578–85.CrossRef Butte NF, Hopkinson JM, Wong WW, Smith EO, Ellis KJ. Body composition during the first 2 years of life: an updated reference. Pediatr Res. 2000;47:578–85.CrossRef
18.
go back to reference Leonard MB, Elmi A, Mostoufi-Moab S, Shults J, Burnham JM, Thayu M, et al. Effects of sex, race, and puberty on cortical bone and the functional muscle bone unit in children, adolescents, and young adults. J Clin Endocrinol Metab. 2010;95:1681–9.CrossRef Leonard MB, Elmi A, Mostoufi-Moab S, Shults J, Burnham JM, Thayu M, et al. Effects of sex, race, and puberty on cortical bone and the functional muscle bone unit in children, adolescents, and young adults. J Clin Endocrinol Metab. 2010;95:1681–9.CrossRef
19.
go back to reference McCarthy HD, Cole TJ, Fry T, Jebb SA, Prentice AM. Body fat reference curves for children. Int J Obes. 2006;30:598–602.CrossRef McCarthy HD, Cole TJ, Fry T, Jebb SA, Prentice AM. Body fat reference curves for children. Int J Obes. 2006;30:598–602.CrossRef
20.
21.
go back to reference Snijder MB, Visser M, Dekker JM, Goodpaster BH, Harris TB, Kritchevsky SB, et al. Low subcutaneous thigh fat is a risk factor for unfavourable glucose and lipid levels, independently of high abdominal fat. Health ABC Study Diabetologia. 2005;48:301–8.PubMed Snijder MB, Visser M, Dekker JM, Goodpaster BH, Harris TB, Kritchevsky SB, et al. Low subcutaneous thigh fat is a risk factor for unfavourable glucose and lipid levels, independently of high abdominal fat. Health ABC Study Diabetologia. 2005;48:301–8.PubMed
22.
go back to reference Mayer M, Gleiss A, Hausler G, Borkenstein M, Kapelari K, Kostl G, et al. Weight and body mass index (BMI): current data for Austrian boys and girls aged 4 to under 19 years. Ann Hum Biol. 2015;42:45–55.CrossRef Mayer M, Gleiss A, Hausler G, Borkenstein M, Kapelari K, Kostl G, et al. Weight and body mass index (BMI): current data for Austrian boys and girls aged 4 to under 19 years. Ann Hum Biol. 2015;42:45–55.CrossRef
23.
go back to reference Iacopino L, Andreoli A, Innocente I, Minisci C, Di Giorgio G, Anastasi A, et al. Use of foot-to-foot bioelectrical impedance analysis in children. Acta Diabetol. 2003;40(Suppl 1):210–1.CrossRef Iacopino L, Andreoli A, Innocente I, Minisci C, Di Giorgio G, Anastasi A, et al. Use of foot-to-foot bioelectrical impedance analysis in children. Acta Diabetol. 2003;40(Suppl 1):210–1.CrossRef
24.
go back to reference Sung RY, Lau P, Yu CW, Lam PK, Nelson EA. Measurement of body fat using leg to leg bioimpedance. Arch Dis Child. 2001;85:263–7.CrossRef Sung RY, Lau P, Yu CW, Lam PK, Nelson EA. Measurement of body fat using leg to leg bioimpedance. Arch Dis Child. 2001;85:263–7.CrossRef
25.
go back to reference Lim JS, Hwang JS, Lee JA, Kim DH, Park KD, Jeong JS, et al. Cross-calibration of multi-frequency bioelectrical impedance analysis with eight-point tactile electrodes and dual-energy X-ray absorptiometry for assessment of body composition in healthy children aged 6-18 years. Pediatr Int. 2009;51:263–8.CrossRef Lim JS, Hwang JS, Lee JA, Kim DH, Park KD, Jeong JS, et al. Cross-calibration of multi-frequency bioelectrical impedance analysis with eight-point tactile electrodes and dual-energy X-ray absorptiometry for assessment of body composition in healthy children aged 6-18 years. Pediatr Int. 2009;51:263–8.CrossRef
26.
go back to reference Yu OK, Rhee YK, Park TS, Cha YS. Comparisons of obesity assessments in over-weight elementary students using anthropometry, BIA, CT and DEXA. Nutr Res Pract. 2010;4:128–35.CrossRef Yu OK, Rhee YK, Park TS, Cha YS. Comparisons of obesity assessments in over-weight elementary students using anthropometry, BIA, CT and DEXA. Nutr Res Pract. 2010;4:128–35.CrossRef
27.
go back to reference Azcona C, Koek N, Fruhbeck G. Fat mass by air-displacement plethysmography and impedance in obese/non-obese children and adolescents. Int J Pediatr Obes. 2006;1:176–82.CrossRef Azcona C, Koek N, Fruhbeck G. Fat mass by air-displacement plethysmography and impedance in obese/non-obese children and adolescents. Int J Pediatr Obes. 2006;1:176–82.CrossRef
28.
go back to reference Goldfield GS, Cloutier P, Mallory R, Prud'homme D, Parker T, Doucet E. Validity of foot-to-foot bioelectrical impedance analysis in overweight and obese children and parents. J Sport Med Phys Fit. 2006;46:447–53. Goldfield GS, Cloutier P, Mallory R, Prud'homme D, Parker T, Doucet E. Validity of foot-to-foot bioelectrical impedance analysis in overweight and obese children and parents. J Sport Med Phys Fit. 2006;46:447–53.
29.
go back to reference Lazzer S, Boirie Y, Meyer M, Vermorel M. Evaluation of two foot-to-foot bioelectrical impedance analysers to assess body composition in overweight and obese adolescents. Br J Nutr. 2003;90:987–92.CrossRef Lazzer S, Boirie Y, Meyer M, Vermorel M. Evaluation of two foot-to-foot bioelectrical impedance analysers to assess body composition in overweight and obese adolescents. Br J Nutr. 2003;90:987–92.CrossRef
30.
go back to reference Sluyter JD, Schaaf D, Scragg RK, Plank LD. Prediction of fatness by standing 8-electrode bioimpedance: a multiethnic adolescent population. Obesity. 2010;18:183–9.CrossRef Sluyter JD, Schaaf D, Scragg RK, Plank LD. Prediction of fatness by standing 8-electrode bioimpedance: a multiethnic adolescent population. Obesity. 2010;18:183–9.CrossRef
31.
go back to reference Jebb SA, Elia M. Techniques for the measurement of body composition: a practical guide. Int J Obes Relat Metab Disord. 1993;17:611–21.PubMed Jebb SA, Elia M. Techniques for the measurement of body composition: a practical guide. Int J Obes Relat Metab Disord. 1993;17:611–21.PubMed
Metadata
Title
Clinically relevant body composition methods for obese pediatric patients
Authors
Alexandra Kreissl
Anselm Jorda
Katharina Truschner
Gabriele Skacel
Susanne Greber-Platzer
Publication date
01-12-2019
Publisher
BioMed Central
Keywords
Obesity
Obesity
Published in
BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-019-1454-2

Other articles of this Issue 1/2019

BMC Pediatrics 1/2019 Go to the issue