Assessment of body composition in pediatric overweight and obesity: A systematic review of the reliability and validity of common techniques.

Camila E Orsso, Maria Ines B Silva, Maria Cristina Gonzalez, Daniela A Rubin, Steven B Heymsfield, Carla M Prado, Andrea M Haqq

Journal: Obesity reviews : an official journal of the International Association for the Study of Obesity 2021;21(8):e13041

PMID: 32374499

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Abstract

Accurate measurement of body composition is required to improve health outcomes in children and adolescents with overweight or obesity. This systematic review aimed to summarize the reliability and validity of field and laboratory body composition techniques employed in pediatric obesity studies to facilitate technique selection for research and clinical practice implementation. A systematic search in MEDLINE (via PubMed), EMBASE, CINAHL, and SPORTDiscus from inception up to December 2019 was conducted, using a combination of the following concepts: body composition, pediatric overweight/obesity, and reliability/validity. The search strategy resulted in 66 eligible articles reporting reliability (19.7%), agreement between body composition techniques cross sectionally (80.3%), and/or diagnostic test accuracy (10.6%) in children and adolescents with overweight or obesity (mean age range = 7.0-16.5 years). Skinfolds, air-displacement plethysmography (ADP), dual-energy X-ray absorptiometry (DXA), and ultrasound presented as reliable techniques. DXA, ADP, and isotope dilution showed similar and the best agreement with reference standards. Compared with these laboratory techniques, the validity of estimating body composition by anthropometric equations, skinfolds, and BIA was inferior. In conclusion, the assessment of body composition by laboratory techniques cannot be replaced by field techniques due to introduction of measurement errors, which potentially conceal actual changes in body components.

Address: Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.; Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.; Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.; Department of Applied Nutrition, Nutrition School, Federal University of Rio de Janeiro State, Rio de Janeiro, Brazil.; Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.; Pennington Biomedical Research Center, LSU System, Baton Rouge, Louisiana, USA.; Department of Kinesiology, California State University, Fullerton, California, USA.; Pennington Biomedical Research Center, LSU System, Baton Rouge, Louisiana, USA.; Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.

DOI: 10.1111/obr.13041

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MeSH Terms: Absorptiometry, Photon, Anthropometry, Body Composition, Child, Humans, Pediatric Obesity, Plethysmography, Reproducibility of Results