Assessing Early Growth and Adiposity: Report from an EarlyNutrition Academy Workshop

Abstract

This report provides a summary of a workshop organised by the European Commission-funded EarlyNutrition Project and the EarlyNutrition Academy. Accurate and reliable methods to assess body composition are needed in research on prenatal and early post-natal influences of nutrition on later health because common surrogate measures of maternal and offspring adiposity (body fat content), such as body mass index (BMI), have relatively poor predictive power for the risk of later disease. The key goals of the workshop were to discuss approaches to assess growth and body composition from pregnancy to adolescence, to summarise conclusions and to prepare a framework for research in the EarlyNutrition Project. The participants concluded that there is a pressing need to harmonise the methodologies for assessing body composition, recognising that each has advantages and limitations. Essential core measurements across studies assessing early growth and body composition were identified, including weight, length, BMI, waist and mid-upper arm circumference, subscapular and triceps skinfold thicknesses, and bioelectrical impedance analysis. In research settings with access to more sophisticated technologies, additional methods could include dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, ultrasound assessment of regional body fat, magnetic resonance imaging (MRI), air displacement plethysmography (ADP), and deuterium dilution. These provide richer data to answer research questions in greater depth but also increase costs. Where overall whole-body composition is the primary outcome measure, ADP or tracer dilution should be used whenever possible. Where regional distribution of body fat is of greater interest, an imaging technique such as MRI is preferred.

How growth due to infant nutrition influences obesity and later disease risk

“…As such, more reliable and accurate methods to assess body composition are essential to determine disease risk in later life due to the relatively poor predictive power of the current common measures of adiposity (body fat content) such as BMI. This issue has been recently acknowledged by an expert group meeting of the Early Nutrition Academy aimed at reconciling a standard methodology for application within the framework of the new European Union (EU)‐funded research Project EarlyNutrition (http://www.project-earlynutrition.eu) . It seems conceivable that, as well as the direct relationships of fat mass, the size and distribution of fat depots are of relevance when it comes to the understanding of the association between maternal and offspring anthropometry or between early postnatal development and later obesity risk .…”

“…This issue has been recently acknowledged by an expert group meeting of the Early Nutrition Academy aimed at reconciling a standard methodology for application within the framework of the new European Union (EU)‐funded research Project EarlyNutrition (http://www.project-earlynutrition.eu) . It seems conceivable that, as well as the direct relationships of fat mass, the size and distribution of fat depots are of relevance when it comes to the understanding of the association between maternal and offspring anthropometry or between early postnatal development and later obesity risk . The expert group identified a number of generally available measurements essential for detailed determination of anthropometry and body composition: weight, length, BMI, waist circumference, mid‐upper arm circumference, subscapular and triceps skinfold thicknesses, and bioelectrical impedance.…”

Length-free near infrared measurement of newborn malnutrition

“…The BF% was determined by placing the naked newborn inside a closed chamber and air displacement was measured using pressure and volume changes. Body density was calculated from measured body mass and the calculated body volume19. Gestational age and length were obtained from the PEA POD database for data analysis.…”

The Power of Programming and the EarlyNutrition Project: Opportunities for Health Promotion by Nutrition during the First Thousand Days of Life and Beyond

“…Given that body composition is a central endpoint of studies across the themes of the project, a workshop was held to review and discuss methods to assess body composition in the target groups of the project [36]. The key goals of the workshop were to discuss approaches for assessment of growth and body composition from pregnancy to adolescence, to summarize conclusions, and to prepare a framework for research in this area in the EarlyNutrition project.…”