Research Research and Professional Briefs| Volume 112, ISSUE 12, P1993-1998, December 2012

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Air Displacement Plethysmography, Dual-Energy X-ray Absorptiometry, and Total Body Water to Evaluate Body Composition in Preschool-Age Children

Published:November 20, 2012DOI:


      Anthropometrics and body mass index are only proxies in the evaluation of adiposity in the pediatric population. Air displacement plethysmography technology was not available for children aged 6 months to 9 years until recently. Our study was designed to test the precision of air displacement plethysmography (ADP) in measuring body fat mass in children at ages 3 to 5 years compared with a criterion method, deuterium oxide dilution (D2O), which estimates total body water and a commonly used methodology, dual-energy x-ray absorptiometry (DXA). A prospective, cross-sectional cohort of 66 healthy children (35 girls) was recruited in the central Arkansas region between 2007 and 2009. Weight and height were obtained using standardized procedures. Fat mass (%) was measured using ADP, DXA, and D2O. Concordance correlation coefficient and Bland-Altman plots were used to investigate the precision of the ADP techniques against D2O and DXA in children at ages 3 to 5 years. ADP concordance correlation coefficient for fat mass was weak (0.179) when compared with D2O. Bland-Altman plots revealed a low accuracy and large scatter of ADP fat mass (%) results (mean=−2.5, 95% CI −20.3 to 15.4) compared with D2O. DXA fat mass (%) results were more consistent although DXA systematically overestimated fat mass by 4% to 5% compared with D2O. Compared with D2O, ADP does not accurately assess percent fat mass in children aged 3 to 5 years. Thus, D2O, DXA, or quantitative nuclear magnetic resonance may be considered better options for assessing fat mass in young children.


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      T. A. Crook is an assistant professor, Department of Dietetics and Nutrition, University of Arkansas for Medical Sciences, Little Rock.


      N. Armbya is a biostatician, Arkansas Children's Nutrition Center, Little Rock, and with the Department of Physiology and Biophysics, University of Arkansas for Medical Sciences, Little Rock.


      M. A. Cleves is a professor, Arkansas Children's Nutrition Center, Little Rock, and Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.


      A. Andres is an assistant professor, Arkansas Children's Nutrition Center, Little Rock, and Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.


      T. M. Badger is a professor, Arkansas Children's Nutrition Center, Little Rock, and Department of Pediatrics and Department of Physiology and Biophysics, University of Arkansas for Medical Sciences, Little Rock.