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Body composition by 2H dilution in Gambian infants: comparison with UK infants and evaluation of simple prediction
Jonathan C K Wells1, Kate Hawton, Tegan Darch
1Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK. J.Wells@ich.ucl.ac.uk
Insights
Gambian infants exhibit growth faltering with reduced lean mass (LM) and fat mass. Body composition analysis revealed age-related increases in LM deficits and central adiposity, necessitating a new bioelectrical impedance analysis (BIA) equation for accurate LM estimation.
Area of Science:
- Pediatric Nutrition
- Human Physiology
- Body Composition Analysis
Background:
- Infants in Gambia experience growth faltering, but their body composition remains poorly understood.
- Existing methods for assessing infant body composition require validation in diverse populations.
Purpose of the Study:
- To compare body composition between Gambian and UK infants.
- To evaluate the accuracy of bioelectrical impedance analysis (BIA) and creatinine excretion for estimating lean mass (LM), using deuterium (2H) dilution as the reference method.
Main Methods:
- Body composition was measured in 30 Gambian infants (3-18 months) using anthropometry, 2H dilution, BIA (Fjeld equation), and urinary creatinine excretion.
- Data were compared with UK reference data.
Main Results:
- Gambian infants were lighter, shorter, and had reduced BMI and skinfolds compared to UK infants.
- Both lean mass (LM) and fat mass were reduced in Gambian infants; LM deficits increased with age, while fat mass differences decreased.
- Creatinine excretion estimates showed unacceptable individual error; BIA overestimated LM, leading to the development of a new, more accurate BIA equation (SE=0.47 kg LM).
Conclusions:
- Gambian infants with growth faltering have age-dependent lean mass deficits and increased central adiposity.
- Creatinine excretion is not recommended for LM estimation in this population.
- A new BIA equation improves LM prediction accuracy in Gambian infants.
Abstract:
Gambian infants show growth faltering, but the underlying body composition is unknown. The present study aimed to compare body composition in Gambian and UK infants using 2H dilution; and to evaluate accuracy of bioelectrical impedance analysis (BIA) and creatinine excretion for estimating lean mass (LM), using 2H as the reference. Body composition was measured in thirty Gambian infants, aged 3-18 months, using (1) anthropometry, (2) 2H, (3) BIA (equation of Fjeld et al. Pediatr Res (1990), 27, 98-102) and (4) 5 h urinary creatinine excretion. Compared with UK reference data, Gambian infants were light, short and had reduced BMI and skinfolds. The subscapular skinfold standard deviation score (SDS) was greater than the triceps SDS (P < 0.01), indicating central fat preservation. Both LM and fat mass were reduced in Gambian infants, with or without adjustment for length. However, whereas the Gambia-UK difference in LM increased with age, that in fat mass decreased. Average creatinine excretion was similar to that expected (95.5 (sd 23.2) % recovery), but LM estimates showed unacceptable error in individuals. BIA using Fjeld's equation overestimated total body water and LM (P < 0.001), hence a new equation was developed, with standard error of 0.47 kg LM. In conclusion, Gambian infants characterised by growth faltering had LM deficits that increased with age. However, adiposity increased with age, and showed indications of a more central distribution than in the reference infants. A new BIA equation for LM prediction is presented; however, creatinine excretion is not recommended for LM estimation in this population.
