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Epidemiology

Longitudinal assessment of body composition in healthy Swedish children from 1 week until 4 years of age

European Journal of Clinical Nutrition volume 71, pages 1345–1352 (2017)Cite this article

Subjects

Abstract

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±3.9 (1 week), 25.6±4.8 (12 weeks), 28.2±3.8 (1.5 years), 27.3±5.1 (3 years) and 26.1±3.5 (4.4 years). For girls (n=10) these values were 15.3±2.9, 25.7±3.9, 27.9±3.3, 26.3±7.2 and 26.0±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<0.05) for boys at 1.5 years of age. At all ages the coefficients of variation were higher for body fat (%) (12–30%) than for BMI (4-11%).

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.

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References

  1. Ahrens W, Pigeot I, Pohlabeln H, De Henauw S, Lissner L, Molnár D et al. Prevalens of overweight and obesity in European children below the age of 10. Int J Obes 2014; 38: S99–S107.

    Article  Google Scholar 

  2. Ogden CL, Carroll MD, Kit BK, Flegal KM . Prevalence of childhood and adult obesity in the United States, 2011-2012. J Am Med Ass 2014; 311: 806–814.

    Article  CAS  Google Scholar 

  3. Singh AS, Mulder C, Twisk JWR, van Mechelen W, Chinapaw MJM . Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev 2008; 9: 474–488.

    Article  CAS  Google Scholar 

  4. World Health Organization Internet. Available online http://www.who.int/dietphysicalactivity/childhood/en/ accessed 19 February 2017.

  5. Blomquist HK, Bergström E . Obesity in 4-year-old children more prevalent in girls and in municipalities with a low socioeconomic level. Acta Paediatr 2007; 96: 113–116.

    Article  CAS  Google Scholar 

  6. Bergström E, Blomquist HK . Is the prevalence of obesity declining among 4-year-old Swedish children? Acta Paediatr 2009; 98: 1956–1958.

    Article  Google Scholar 

  7. Bråbäck L, Bågenholm G, Ekholm L . No further increase of obesity among Swedish 4-year old children. Large regional differences indicate the significance of socioeconomic factors. Läkartidningen 2009; 106: 2758–2761.

    PubMed  Google Scholar 

  8. Forsum E, Flinke Carlsson E, Henriksson H, Henriksson P, Löf M . Total body fat content versus BMI in 4-year-old healthy Swedish children. J Obes 2013; 2013: 206715.

    Article  Google Scholar 

  9. 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: 1169–1175.

    Article  CAS  Google Scholar 

  10. Ruxton CHS, Reilly JJ, Kirk TR . Body composition of healthy 7-and 8-year-old children and a comparison with the 'reference child'. Int J Obes 1999; 23: 1276–1281.

    Article  CAS  Google Scholar 

  11. Sun SS, Deng X, Sabo R, Carrico R, Schubert CM, Wan W et al. Secular trends in body composition for children and young adults: the Fels Longitudinal Study. Am J Hum Biol 2012; 24: 506–514.

    Article  Google Scholar 

  12. Olds TS . One million skinfolds: secular trends in the fatness of young people 1951-2004. Eur J Clin Nutr 2009; 63: 934–946.

    Article  CAS  Google Scholar 

  13. Eriksson B, Löf M, Forsum E . Body composition in full-term healthy infants measured with air displacement plethysmography at 1 and 12 weeks of age. Acta Paediatr 2010; 99: 563–568.

    Article  Google Scholar 

  14. Eriksson B, Henriksson H, Löf M, Hannestad U, Forsum E . Body-composition development during early childhood and energy expenditure in response to physical activity in 1.5-y-old children. Am J Clin Nutr 2012; 96: 567–573.

    Article  CAS  Google Scholar 

  15. Henriksson H, Forsum E, Löf M . Evaluation of Actiheart and a 7 d activity diary for estimating free-living total and activity energy expenditure using criterion methods in 1.5- and 3-year-old children. Br J Nutr 2014; 111: 1830–1840.

    Article  CAS  Google Scholar 

  16. Butte NF, Hopkinson JM, Wong WW, O'Brian Smith E, Ellis KJ . Body composition during the first 2 years of life: an updated reference. Pediatr Res 2000; 47: 578–585.

    Article  CAS  Google Scholar 

  17. Fomon SJ, Nelson SE . Body composition of the male and female reference infants. Ann Rev Nutr 2002; 22: 1–17.

    Article  CAS  Google Scholar 

  18. Albertsson Wikland K, Luo ZC, Niklasson A, Karlberg J . Swedish population-based longitudinal reference values from birth to 18 years of age for height, weight and head circumference. Acta Paediatr 2002; 91: 739–754.

    Article  Google Scholar 

  19. The Public Health Agency of Sweden. Folkhälsan i Sverige 2016. Available online www.folkhalsomyndigheten.se (accessed February 19 2017).

  20. The Swedish National Agency for Education, Fler barn än någonsin i förskolan. Available online www.skolverket.se (accessed February 19 2017).

  21. Henriksson P, Löf M, Söderqvist P, Forsum E . Variation in the fat mass and obesity-related (FTO) genotype is not associated with body fatness in infants, but possibly with their length. Pediatr Obes 2014; 9: e112–e115.

    Article  CAS  Google Scholar 

  22. Leppänen MH, Delisle Nyström C, Henriksson P, Pomeroy J, Ruiz JR, Ortega FB et al. Physical activity intensity, sedentary behaviour, body composition and physical fitness in 4-year-old children: results from the ministop trial. Int J Obes 2016; 40: 1126–1133.

    Article  Google Scholar 

  23. Fields DA, Gilchrist JM, Catalano PM, Gianni ML, Roggero PM, Mosca F . Longitudinal body composition data in exclusively breast-fed infants: a multicenter study. Obesity 2011; 19: 1887–1891.

    Article  Google Scholar 

  24. Going SB . Hydrodensitometry and air displacement plethysmography. In: Heymsfield SB, Lohman TG, Wang Z, Going SB (eds). Human body composition. 2nd edn, Human Kinetics: Champaign, IL, USA, 2005; 17–33.

    Google Scholar 

  25. Schoeller DA. Hydrometry. In: Heymsfield SB, Lohman TG, Wang Z, Going SB (eds). Human body composition.2nd edn, Human Kinetics: Champaign, IL, USA, 2005; 35–49.

    Google Scholar 

  26. Ellis KJ, Yao M, Shypailo RJ, Urlando A, Wong WW, Heird WC . Body-composition assessment in infancy: air-displacement plethysmography compared with a reference 4-compartment model. Am J Clin Nutr 2007; 85: 90–95.

    Article  CAS  Google Scholar 

  27. Fields DA, Allison DB . Air-displacement plethysmography pediatric option in 2-6 years old using the four-compartment model as a criterion method. Obesity 2012; 20: 1732–1737.

    Article  Google Scholar 

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

    Article  Google Scholar 

  29. Ma G, Yao M, Liu Y, Lin A, Zou H, Urlando A et al. Validation of a new pediatric air-displacement plethysmograph for assessing body composition in infants. Am J Clin Nutr 2004; 79: 653–660.

    Article  CAS  Google Scholar 

  30. Wells JCK, Williams JE, Chomtho S, Darch T, Grijalva-Eternod C, Kennedy K et al. Body-composition reference data for simple and reference techniques and a 4-component model: a new UK reference child. Am J Clin Nutr 2012; 96: 1316–1326.

    Article  CAS  Google Scholar 

  31. Wang Y, Lobstein T . Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006; 1: 11–25.

    Article  Google Scholar 

  32. Karlberg P, Taranger J, Engström I, Lichtenstein H, Svennberg-Redegren I . The somatic development of children in a Swedish urban community. Acta Paediatr Scand 1976; 258: 1–148.

    Google Scholar 

  33. Carberry A, Colditz PB, Lingwood BE . Body composition from birth to 4.5 months in infants born to non-obese women. Pediatr Res 2010; 68: 84–88.

    Article  Google Scholar 

  34. Kizirian NV, Kong Y, Muirhead R, Brodie S, Garnett SP, Petocz P et al. Effects of a low-glycemic index diet during pregnancy on offspring growth, body composition, and vascular health: a pilot randomized controlled trial. Am J Clin Nutr 2016; 103: 1073–1082.

    Article  CAS  Google Scholar 

  35. Tennefors C, Coward WA, Hernell O, Wright A, Forsum E . Total energy expenditure and physical activity level in healthy young Swedish children 9 or 14 months of age. Eur J Clin Nutr 2003; 57: 647–653.

    Article  CAS  Google Scholar 

  36. Andres A, Hull HR, Shankar K, Casey PH, Cleves MA, Badger TM . Longitudinal body composition of children born to mothers with normal weight, overweight, and obesity. Obesity 2015; 23: 1252–1258.

    Article  Google Scholar 

  37. Freedman DS, Wang J, Maynard LM, Thornton JC, Mei Z, Pierson RN et al. Relation of BMI to fat and fat-free mass among children and adolescents. Int J Obes 2005; 29: 1–8.

    Article  CAS  Google Scholar 

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Acknowledgements

We thank all participating parents and children. Supported by grants from the Swedish Research Council project no. 15402; AFA Insurance; the Medical Faculty, Linköping University; the County Council of Östergötland, Sweden; the Medical Research Council of Southeast Sweden and the Swedish Society of Medicine.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    H Henriksson, B Eriksson, E Forsum, E Flinke, P Henriksson & M Löf

  2. Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden

    H Henriksson & M Löf

  3. Department of Physical Education and Sports, PROFITH ‘PROmoting FITness and Health through physical activity’ Research Group, Faculty of Sport Sciences, University of Granada, Granada, Spain

    H Henriksson & P Henriksson

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  1. H Henriksson
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Correspondence to E Forsum.

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Henriksson, H., Eriksson, B., Forsum, E. et al. Longitudinal assessment of body composition in healthy Swedish children from 1 week until 4 years of age. Eur J Clin Nutr 71, 1345–1352 (2017). https://doi.org/10.1038/ejcn.2017.125

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