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Background/Objectives: Knowledge of longitudinal body composition development is required to identify the mechanisms behind childhood overweight and obesity and to prevent these conditions. However, accurate data on this development in early childhood are lacking. Our aim was to describe the longitudinal body composition development in healthy young Swedish children. Subjects/Methods: Body size and composition were assessed in 26 children using air-displacement plethysmography (1 and 12 weeks and 4.4 years of age) and isotope dilution (1.5 and 3 years of age) and compared with available reference data. Results: Body fat (%) for boys (n=16) was 12.8[plus or minus]3.9 (1 week), 25.6[plus or minus]4.8 (12 weeks), 28.2[plus or minus]3.8 (1.5 years), 27.3[plus or minus]5.1 (3 years) and 26.1[plus or minus]3.5 (4.4 years). For girls (n=10) these values were 15.3[plus or minus]2.9, 25.7[plus or minus]3.9, 27.9[plus or minus]3.3, 26.3[plus or minus]7.2 and 26.0[plus or minus]5.3, respectively. These values were above the Fomon reference values at 1.5 years of age and later and higher than the Butte reference (P Conclusions: At 4 years of age our children had more body fat than indicated by reference data. This high level may have already been established at 1.5 years of age but our small sample and the lack of appropriate reference data limit the possibility of drawing firm conclusions. Our results demonstrate the limitations of BMI when investigating overweight and obesity in early life and highlight the need for appropriate reference body composition data in infants and young children., Author(s): H Henriksson [sup.1] [sup.2] [sup.3] , B Eriksson [sup.1] , E Forsum [sup.1] , E Flinke [sup.1] , P Henriksson [sup.1] [sup.3] , M Löf [sup.1] [sup.2] Author Affiliations: [...]

Background/Objectives: Easy-to-use and accurate methods to assess free-living activity energy expenditure (AEE) in preschool children are required. The aims of this study in healthy preschool children were to (a) evaluate the ability of the wrist-worn ActiGraph wGT3x-BT to predict free-living AEE and (b) assess wear compliance using a 7-day, 24-h protocol. Subjects/Methods: Participants were 40 Swedish children (5.5[plus or minus]0.2 years) in the Mobile-based intervention intended to stop obesity in preschoolers (MINISTOP) obesity prevention trial. Total energy expenditure (TEE) was assessed using the doubly labeled water method during 14 days. AEE was calculated as (TEEx0.9) minus predicted basal metabolic rate. The ActiGraph accelerometer was worn on the wrist for 7 days and outputs used were mean of the daily and awake filtered vector magnitude (mean VM total and mean VM waking). Results: The ActiGraph was worn for 7 (n=34, 85%), 6 (n=4, 10%), 5 (n=1, 2.5%) and 4 (n=1, 2.5%) days (a valid day was [greater-than or slanted equal to]600 awake minutes). Alone, mean VM total and mean VM waking were able to explain 14% (P=0.009) and 24% (P=0.001) of the variation in AEE, respectively. By incorporating fat and fat-free mass in the models 58% (mean VM total) and 62% (mean VM waking) in the variation of AEE was explained (P Conclusions: The wrist-worn ActiGraph wGT3x-BT in combination with body composition variables explained up to the 62% of the variation in AEE. Given the high wear compliance, the wrist-worn ActiGraph has the potential to provide useful information in studies where physical activity in preschool children is measured., Author(s): C Delisle Nyström [sup.1] , J Pomeroy [sup.2] , P Henriksson [sup.1] [sup.3] , E Forsum [sup.4] , F B Ortega [sup.1] [sup.3] , R Maddison [sup.5] , J [...]

Objective:: To compare body fatness estimated using a skinfold technique and body mass index (BMI) with body fatness estimated using the body water dilution method in healthy Swedish children 9 or 14 months of age. Methods:: Total body fat (TBF) was calculated from total body water, estimated using the doubly labelled water method, and body weight. When expressed in per cent of body weight, these estimates (%TBF-BWD) represented reference values for body fatness. Body fatness was also calculated from skinfold thickness (%TBF-SFT) and as BMI. The children were ranked and grouped into five groups with an increasing level of body fatness using BMI, %TBF-SFT and %TBF-BWD, respectively. Subjects:: A total of 30 infants 9 months of age and 29 children 14 months of age. Results:: On average, the children (n=59) had a BMI=17.5[plus or minus]1.6 kg/m[sup.2] and contained 27.8[plus or minus]3.7 %TBF-SFT and 29.1[plus or minus]4.4 %TBF-BWD. %TBF-BWD minus %TBF-SFT was=1.35[plus or minus]4.06%. By measuring %TBF-SFT or BMI, about 35% of the children could be classified in the correct group with respect to body fatness. Serious misclassification (ie two or more groups too high or too low) was, however, more common for %TBF-SFT (29%) than for BMI (17%). Conclusions:: The capacity of BMI to place children in the correct body fatness group was poor although not quite as poor as the corresponding capacity of the skinfold technique. The latter method produced inaccurate and imprecise estimates of body fatness. European Journal of Clinical Nutrition (2004) 58, 541-547. doi: 10.1038/sj.ejcn.1601842 Keywords: body fat, children, skinfold thickness, body mass index, total body water, Author(s): C Tennefors [1, 2]; E Forsum [2] Introduction Childhood obesity is a serious and growing problem in affluent countries as well as in populations undergoing economic transition (Koletzko et [...]

Objectives:: To measure total energy expenditure (TEE) and total body water (TBW) in healthy Swedish children 9 or 14 months of age. To compare their TEE with current recommendations for energy intake. To define their body composition and relate this to energy expenditure. Design:: Children were investigated at 9 or 14 months. The following variables were measured: TEE and TBW (by the doubly labelled water method), weight and length. Total body fat (TBF), sleeping metabolic rate, activity energy expenditure and physical activity level (PAL) were calculated. Subjects:: Thirty infants 9 months of age and 29 children 14 months of age. Results:: TEE was 323[plus or minus]38, 322[plus or minus]29, 313[plus or minus]23 and 331[plus or minus]28[??]kJ/kg/day in 9-month-old girls, 9-month-old boys, 14-month-old girls and 14-month-old boys, respectively. At 9 months of age girls and boys contained 29.6[plus or minus]4.8 and 29.7[plus or minus]4.5% TBF, respectively. At 14 months the corresponding figures were 29.1[plus or minus]4.3 and 28.2[plus or minus]4.3%. There was a significant negative relationship between PAL and %TBF (r=-0.81, P [less than] 0.001, n=59). Conclusions:: Measured TEE plus calculated energy cost of growth confirm previous estimates that the physiological energy requirements of children 9 and 14 months of age are 15-20% lower than current recommendations for energy intake. One possible interpretation of the relationship between PAL and %TBF is that children with a high TBF content are less physically active than children with less TBF. However, this relationship needs further studies. European Journal of Clinical Nutrition (2003) 57, 647-653. doi: 10.1038/sj.ejcn.1601591 Keywords: body composition, children, doubly labelled water, energy expenditure, physical activity level, Author(s): C Tennefors [1, 2]; W A Coward [3]; O Hernell [4]; A Wright [3]; E Forsum [2] Introduction Knowledge about dietary needs for energy during early life is required [...]

Assessing body composition during infancy requires data for the so-called reference infant. Currently available data for this purpose need to be updated and extended using methods based on principles different from those used previously to define the reference infant. Thus, magnetic resonance imaging was applied to full-term healthy boys (n = 25) and girls (n = 21), 4-131 d old, to estimate adipose tissue volume (ATV) and the amounts of s.c. and non-s.c. adipose tissue (AT). Total body water was estimated using isotope dilution. Total body fat (TBF), fat free weight (FFW) and the degree of hydration in FFW were calculated. Increases in weight, TBF, and FFW with age agreed with current reference data, although when compared with the reference, a slightly more rapid increase in % TBF was observed for boys. The degree of hydration in FFW was 78.9 +/- 4.5% (n = 45). Both sexes showed significant increases with age in s.c. ATV (14.7 and 13.0 mL/d for boys and girls, respectively) and in non-s.c. ATV (1.58 and 1.26 mL/d, respectively). Subcutaneous ATV was 90.5 +/- 1.8% (boys) and 91.1 +/- 1.9% (girls) of total ATV. In conclusion, a pronounced increase with age in the amount of AT was demonstrated involving a considerable gain in s.c. fat during early life. Except for % TBF in boys, changes in body composition with age agreed with current reference data.

Information about body fatness is important during nutritional assessment of infants, but current methods to estimate body composition in vivo are often not applicable in infants. Therefore, a new method based on magnetic resonance imaging (MRI) was developed. This method, which can assess the volume and distribution of adipose tissue (AT) as well as total body fat, was applied in 11 healthy full-term infants. Their total body water was also estimated using the isotope dilution technique. Adipose tissue volume (ATV) was calculated from AT area in 16 images of the body taken by an MRI scanner (1.5 tesla). AT area was assessed using a computer program in which AT criteria was defined by the observer. ATV of the infants was therefore evaluated once by three observers and twice by a fourth observer. The different observers estimated total, s.c., and non-s.c. ATV with a precision that varied between 1.9 and 7.2%, 2.0 and 4.8%, and 4.2 and 40.7%, respectively. Variations during AT area calculations accounted for a large part of the imprecision when assessing total and s.c. ATV. The linear relationship between percent total body water and total ATV in relation to body weight was significant in all evaluations. Although average total ATV varied when estimated by the four observers, there was, within each evaluation, a fairly constant order between infants with respect to their ATV. It is concluded that the MRI procedure represents a useful possibility to assess body fatness in infants.

Both fetal and neonatal nutrition may influence the body fat content of infants. Epidemiologic field studies would be facilitated by a simple method of measuring total body fat (TBF). The accuracy of a method, based on skinfold measurements, of estimating TBF was evaluated in 22 infants by comparing the results with those obtained by the body water dilution technique. Because the accuracy was poor, a modification was evaluated in 14 of the infants. The measurements were used to calculate the amounts of subcutaneous and nonsubcutaneous body fat. Estimates of the thickness of subcutaneous adipose tissue made with calipers and ultrasonography were compared with each other and with those obtained with Futrex 5000, a device based on the principle of near-infrared interactance. The composition of the adipose tissue in biopsy specimen from 38 infants was analyzed and contained a mean of 0.66 g of fat/cm3. Results obtained by Futrex 5000 correlated with subcutaneous adipose tissue thickness only when the latter was thin. Estimates of adipose tissue thickness by calipers were significantly higher than estimates by ultrasonography at the forearm, thigh, and calf, whereas the opposite was found at the triceps, biceps, umbilicus, and nipple. The amount of nonsubcutaneous fat, in relation to body weight minus subcutaneous fat, increased with age and was higher in girls than in boys. Skinfolds were poor predictors of TBF. However, it may be possible to predict TBF from anthropometric measurements if appropriate knowledge about the growth and development of adipose tissue in infancy are available.