Abstract
There has been increasing interest in understanding body composition in early life and factors that may influence its evolution. While several technologies exist to measure body composition in infancy, the equipment is typically large, and thus not readily portable, is expensive, and requires a qualified operator. Bioelectrical impedance analysis shows promise as an inexpensive, portable, and easy to use tool. Despite the technique being widely used to assess body composition for over 35 years, it has been seldom used in infancy. This may be related to the evolving nature of the fat-free mass compartment during this period. Nonetheless, a number of factors have been identified that may influence bioelectrical impedance measurements, which, when controlled for, may result in more accurate measurements. Despite this, questions remain in infants regarding the optimal size and placement of electrodes, the standardization of normal hydration, and the influence of body position on the distribution of water throughout the body. The technology requires further evaluation before being considered as a suitable tool to assess body composition in infancy.
Highlights
80% to 60% across the first year of life. This decrease in total body water is accompanied by changes in the proportion of intra- and extracellular water, alongside increases in osseous mineral [2,3]; meaning that while adults maintain a constant hydration of fat-free mass (73%) [12], this varies during infancy
While the predicted values from bioelectrical impedance spectroscopy correlated well with those from the criterion methods, when internally validated there were small biases but large limits of agreement (total body water (TBW): −0.6% (36% to −37%); extracellular fluid (ECF): −4.0% (32% to −39%)), suggesting the technique may not be suitable at the individual level in this age group
In a climate that is increasingly focused on the development of fat mass and evolving obesity, there is a need for an inexpensive, portable, and easy to use tool to assess body composition in infancy
Summary
In 1858, Albert von Bezold first chemically analysed a stillborn infant [1]. Since there has been great interest in understanding how an infant’s body composition evolves as it grows. While a healthy infant is born with 10–15% body fat, this percentage doubles by six months of age, and slowly decreases thereafter until adiposity rebounds, typically around age six years [2,3,4]. This is highly variable, with a number of early life factors influencing adiposity [5,6,7,8,9,10,11]. This is important, as techniques that assess body composition in infancy rely on reference data to inform prediction rather than directly measure body composition
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