Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Composition of the fat-free mass in obese and nonobese children: matched case–control analyses

International Journal of Obesity volume 29, pages 29–36 (2005)Cite this article

Abstract

OBJECTIVE:

Most body composition techniques assume constant properties of the fat-free mass (FFM), such as hydration, density and mineralisation. Previous studies suggested that FFM composition may change in childhood obesity; however, this issue has not been investigated in detail.

AIM:

To compare FFM composition in obese and nonobese children.

DESIGN:

Observational matched case–control analyses.

SUBJECTS:

A total of 28 obese children (13 boys, 15 girls) and 22 nonobese children (10 boys, 12 girls) aged 7–14 y. Obesity was defined as body mass index centile >95.

METHODS:

Measurements were made of weight, height, total body water, and body volume. Bone mineral content was estimated in a subsample. Body composition was calculated using three- and four-component models.

RESULTS:

According to the three-component model (n=22 matched pairs), obese children had greater hydration (P<0.05), and reduced density (P=0.057) of FFM. According to the four component model (n=11 pairs), obese children had greater hydration (P<0.01) and reduced density (P<0.002) of FFM. The mineralisation of FFM was increased, but not significantly so.

CONCLUSION:

The greater hydration and reduced density of FFM of obese children should be taken into account if body composition is to be measured with optimum accuracy during treatment programmes. These differences may be addressed by using multicomponent rather than two-component models of body composition. Although the greater mineralisation of FFM in obese children was not significant in the present study, the four-component model is best able to address the combined differences in hydration and mineralisation that occur in childhood obesity.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Bennett N, Dott T, Flatley J, Freeth S, Bolling K . Health survey for England 1993. London, HMSO, 1995.

  2. Reilly JJ, Dorosty AR . Epidemic of obesity in UK children. Lancet 1999; 354: 1874–1875.

    Article  CAS  PubMed  Google Scholar 

  3. Cole, TJ, Freeman JV, Preece MA . Body mass index reference curves for the UK, 1990. Arch Dis Child 1995; 73: 25–29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Wells JCK . A Hattori chart analysis of body mass index in infants and children. Int J Obes Relat Metab Disord 2000; 24: 325–329.

    Article  CAS  PubMed  Google Scholar 

  6. Wells JCK, Coward WA, Cole TJ, Davies PSW . The contribution of fat and fat-free tissue to body mass index in contemporary children and the reference child. Int J Obes Relat Metab Disord 2002; 26: 1323–1328.

    Article  CAS  PubMed  Google Scholar 

  7. Reilly JJ, Savage SAH, Ruxton CHS, Kirk TR . Assessment of obesity in a community sample of prepubertal children. Int J Obes Relat Metab Disord 1999; 23: 217–219.

    Article  CAS  PubMed  Google Scholar 

  8. Maynard LM, Wisemandle W, Roche AF, Chumlea WC, Guo SS, Siervogel RM . Childhood body composition in relation to body mass index. Pediatrics 2001; 107: 344–350.

    Article  CAS  PubMed  Google Scholar 

  9. Nielsen DH, Cassady SL, Janz KF, Cook JS, Hansen JR Wu YW . Criterion methods of body composition analysis for children and adolescents. Am J Hum Biol 1993; 5: 211–223.

    Article  PubMed  Google Scholar 

  10. Hewitt MJ, Going SB, Williams DB, Lohman TG . Hydration of the fat-free mass in children and adults: implications for body composition assessment. Am J Phys 1993; 265: E88–E95.

    CAS  Google Scholar 

  11. Wells JCK, Fuller NJ, Dewit O, Fewtrell MS, Elia M, Cole TJ . Four-component model of body composition in children: density and hydration of fat free mass and comparison with simpler models. Am J Clin Nutr 1999; 69: 904–912.

    Article  CAS  PubMed  Google Scholar 

  12. Fomon S, Haschke F, Ziegler EE, Nelson SE . Body composition of reference children from birth to age 10 years. Am J Clin Nutr 1982; 35: 1169–1175.

    Article  CAS  PubMed  Google Scholar 

  13. Haschke F . Body composition during adolescence. In: 98th Ross conference on pediatric research, ‘Body composition in infants and children’. Ross Laboratories: Columbus, OH; 1989. pp 76–83.

    Google Scholar 

  14. Fuller NJ, Jebb SA, Laskey MA, Coward WA, Elia M . Four-component model for the assessment of body composition in humans: comparison with alternative methods, and evaluation of the density and hydration of fat-free mass. Clin Sci 1992; 82: 687–693.

    Article  CAS  Google Scholar 

  15. Bray GA, DeLany JP, Harsha DW, Volaufova J, Champagne CC . Body composition of African American and white children: a 2 year follow-up of the BAROC study. Obes Res 2001; 9: 605–621.

    Article  CAS  PubMed  Google Scholar 

  16. Goulding A, Taylor RW, Jones IE, McAuley KA, Manning PJ, Williams SM . Overweight and obese children have low bone mass and area for their weight. Int J Obes Relat Metab Disord 2000; 24: 627–632.

    Article  CAS  PubMed  Google Scholar 

  17. Fischer S, Milinarsky A, Giadrosich V, Dib G, Arriagada M, Arinoviche R . X-ray absorptiometry of bone in obese and eutrophic children from Valparaiso, Chile. J Rheumatol 2000; 27: 1294–1296.

    CAS  PubMed  Google Scholar 

  18. Freeman JV, Cole TJ, Chinn S, Jones PRM, White EM, Preece MA . Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 1995; 73: 17–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Wells JCK, Fuller NJ, Wright A, Fewtrell MS, Cole TJ . Evaluation of air-displacement plethysmography in children aged 5–7 years using a three-component model of body composition. Br J Nutr 2003; 90: 699–707.

    Article  CAS  PubMed  Google Scholar 

  20. Wells JCK, Fuller NJ . Precision of measurement and body size in whole-body air-displacement plethysmography. Int J Obes Relat Metab Disord 2001; 25: 1161–1167.

    Article  CAS  PubMed  Google Scholar 

  21. Siri WE . The gross composition of the body. Adv Biol Med Phys 1956; 4: 239–280.

    Article  CAS  PubMed  Google Scholar 

  22. Lohman TG . Assessment of body composition in children. Ped Exerc Sci 1989; 1: 19–30.

    Article  Google Scholar 

  23. Brozek J, Grande F, Anderson JT, Keys A . A densitometric analysis body composition: revision of some quantitative assumptions. Ann NY Acad Sci 1963; 110: 113–140.

    Article  CAS  PubMed  Google Scholar 

  24. Wong WW, Hergenroeder AC, Stuff JE, Butte NF, Smith EO, Ellis KJ . Evaluation body fat in girls and female adolescents: advantages and disadvantages of dual-energy X-ray absortiometry. Am J Clin Nutr 2002; 76: 384–389.

    Article  CAS  PubMed  Google Scholar 

  25. Moreno LA, Fleta J, Sarria A, Rodriguez G, Bueno M . Secular increases in body fat percentage in male children of Zaragoza, Spain, 1980–1995. Prev Med 2001; 33: 357–363.

    Article  CAS  PubMed  Google Scholar 

  26. Owens S, Gutin B, Allison J, Riggs S, Ferguson M, Litaker M, Thompson W . Effect of physical training on total and visceral fat in obese children. Med Sci Sports Exerc 1999; 31: 143–148.

    Article  CAS  PubMed  Google Scholar 

  27. Waki M, Kral JG, Mazariegos M, Wang J, Pierson RN, Heymsfield SB . Relative expansion of extracellular fluid in obese vs nonobese women. Am J Physiol 1991; 261: E199–E203.

    CAS  PubMed  Google Scholar 

  28. Van Marken Lichtenbelt WD, Fogelholm M . Increased extracellular water compartment, relative to intracellular water compartment, after weight reduction. J Appl Physiol 1999; 87: 294–298.

    Article  Google Scholar 

  29. Battistini N, Virgili F, Severi S, Brambilla P, Manzoni P, Beccaria L, Chiumello G . Relative expansion of extracellular water in obese vs normal children. J Appl Physiol 1995; 79: 94–96.

    Article  CAS  PubMed  Google Scholar 

  30. Leone PA, Gallagher D, Wang J, Heymsfield SB . Relative overhydration of fat-free mass in postobese vs never-obese subjects. Ann NY Acad Sci 2000; 904: 514–519.

    Article  CAS  PubMed  Google Scholar 

  31. Van Lenthe FJ, Kemper CG, van Mechelen W . Rapid maturation in adolescence results in greater obesity in adulthood: the Amsterdam Growth and Health Study. Am J Clin Nutr 1996; 64: 18–24.

    Article  CAS  PubMed  Google Scholar 

  32. Whiting SJ . Obesity is not protective for bones in childhood and adolescence. Nutr Rev 2002; 60: 27–30.

    Article  PubMed  Google Scholar 

  33. Kain J, Albala C, Garcia F, Andrade M . Obesity in Chilean preschool children: anthropometric evolution and socioeconomic determinants. Rev Med Chil 1998; 126: 271–278.

    CAS  PubMed  Google Scholar 

  34. Skaggs DL, Loro ML, Pitukcheewanont P, Tolo V, Gilsanz V . Increased body weight and decreased radial cross-sectional dimensions in girls with forearm fractures. J Bone Miner Res 2001; 16: 1337–1342.

    Article  CAS  PubMed  Google Scholar 

  35. Goulding A, Jones IE, Taylor RW, Williams SM, Manning PJ . Bone mineral density and body composition in boys with distal forearm fractures: a dual-energy x-ray absorptiometry study. J Pediatr 2001; 139: 509–515.

    Article  CAS  PubMed  Google Scholar 

  36. Goulding A, Cannan R, Williams SM, Gold EJ, Taylor RW, Lewis-Barned NJ . Bone mineral density in girls with forearm fractures. J Bone Miner Res 1998; 13: 143–148.

    Article  CAS  PubMed  Google Scholar 

  37. Barbeau P, Gutin B, Litaker M, Owens S, Riggs S, Okuyama T . Correlates of individual differences in body-composition changes resulting from physical training in obese children. Am J Clin Nutr 1999; 69: 705–711.

    Article  CAS  PubMed  Google Scholar 

  38. Tothill P, Avenell A, Reid DM . Precision and accuracy of measurements of whole-body bone mineral: comparisons between Hologic, Lunar and Norland dual-energy X-ray absorptiometers. Br J Radiol 1994; 67: 1210–1217.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We are very grateful to Dr Dasha Nicholls of Great Ormond Street Hospital, Paul Sacher of the MEND clinic, and Professor David Candy and Heidi Bennet of the Leaf Clinic, Chichester, for assistance with recruitment of patients.

Author information

Authors and Affiliations

  1. MRC Childhood Nutrition Research Centre, Institute of Child Health, London, UK

    D Haroun, J C K Wells, J E Williams, N J Fuller, M S Fewtrell & M S Lawson

Authors
  1. D Haroun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J C K Wells
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J E Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N J Fuller
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M S Fewtrell
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M S Lawson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J C K Wells.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Haroun, D., Wells, J., Williams, J. et al. Composition of the fat-free mass in obese and nonobese children: matched case–control analyses. Int J Obes 29, 29–36 (2005). https://doi.org/10.1038/sj.ijo.0802834

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802834

Keywords

This article is cited by

Search

Advanced search

Quick links