Report of a Meeting: An Expert Consultation on Body Composition and Adiposity for Children and Adolescents in All Their Diversity

We convened experts to discuss methods for measuring body composition and diagnosing obesity among infants, children, and adolescents aged 0–19 y. The motivation for this meeting was to inform critical decisions for a systematic review protocol to assess the diagnostic test accuracy (DTA) of body ma...

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Main Authors: Lauren E O’Connor, Lucero Lopez-Perez, Ricardo X Martinez, Maureen K Spill, Juan Pablo Peña-Rosas, Amanda J MacFarlane
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Current Developments in Nutrition
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Online Access:http://www.sciencedirect.com/science/article/pii/S2475299125029361
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author Lauren E O’Connor
Lucero Lopez-Perez
Ricardo X Martinez
Maureen K Spill
Juan Pablo Peña-Rosas
Amanda J MacFarlane
author_facet Lauren E O’Connor
Lucero Lopez-Perez
Ricardo X Martinez
Maureen K Spill
Juan Pablo Peña-Rosas
Amanda J MacFarlane
author_sort Lauren E O’Connor
collection DOAJ
description We convened experts to discuss methods for measuring body composition and diagnosing obesity among infants, children, and adolescents aged 0–19 y. The motivation for this meeting was to inform critical decisions for a systematic review protocol to assess the diagnostic test accuracy (DTA) of body mass index (BMI)-for-age and sex for diagnosing infants, children, and adolescents with excessive adiposity that can impair health. Thirty-nine clinicians and researchers from 23 countries provided written responses and/or attended 1 of 2 virtual meetings held in January 2024. Experts were asked to share their perspectives about methods and clinical tests used to measure body composition, including thresholds and adiposity types (i.e., total or central), for diagnosing obesity for infants, children, and adolescents. Experts suggested that deuterium oxide dilution, magnetic resonance imaging, dual energy X-ray absorptiometry, air displacement plethysmography, hydrostatic weighing, and multicompartmental models were acceptable to measure body composition, with the 4-compartmental model preferred. Waist circumference and bioelectrical impedance were preferred clinical tests to use either alone or in combination with BMI for diagnosing obesity; preferential use was country specific. Most experts preferred fat mass index (fat mass/height2) to % body fat as the metric, because it is more sensitive to changes over time and depends on age and height, similar to BMI. Experts agreed that total and regional adiposity are important for determining metabolic risk related to obesity, but using central adiposity for diagnosing obesity is challenging due to variations in body type. All agreed that age, race, ethnicity, and puberty stage should be considered when defining thresholds of obesity. This input from experts informed the systematic review protocol for an assessment of the DTA of BMI to support the World Health Organization’s guideline development for the integrated management of children and adolescents with obesity in all their diversity.
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spelling doaj-art-cda233f930684ba9bc3fc56d5e03517c2025-08-20T03:08:55ZengElsevierCurrent Developments in Nutrition2475-29912025-07-019710747510.1016/j.cdnut.2025.107475Report of a Meeting: An Expert Consultation on Body Composition and Adiposity for Children and Adolescents in All Their DiversityLauren E O’Connor0Lucero Lopez-Perez1Ricardo X Martinez2Maureen K Spill3Juan Pablo Peña-Rosas4Amanda J MacFarlane5Texas A&M Agriculture, Food, and Nutrition Evidence Center, Fort Worth, TX, United StatesTexas A&M Agriculture, Food, and Nutrition Evidence Center, Fort Worth, TX, United StatesTexas A&M Agriculture, Food, and Nutrition Evidence Center, Fort Worth, TX, United StatesTexas A&M Agriculture, Food, and Nutrition Evidence Center, Fort Worth, TX, United States; Corresponding author.Nutrition and Food Safety, Division of Healthier Populations, World Health Organization, Geneva, SwitzerlandTexas A&M Agriculture, Food, and Nutrition Evidence Center, Fort Worth, TX, United States; Nutrition Research Division, Health Canada, Ottawa, ON, Canada; Corresponding author.We convened experts to discuss methods for measuring body composition and diagnosing obesity among infants, children, and adolescents aged 0–19 y. The motivation for this meeting was to inform critical decisions for a systematic review protocol to assess the diagnostic test accuracy (DTA) of body mass index (BMI)-for-age and sex for diagnosing infants, children, and adolescents with excessive adiposity that can impair health. Thirty-nine clinicians and researchers from 23 countries provided written responses and/or attended 1 of 2 virtual meetings held in January 2024. Experts were asked to share their perspectives about methods and clinical tests used to measure body composition, including thresholds and adiposity types (i.e., total or central), for diagnosing obesity for infants, children, and adolescents. Experts suggested that deuterium oxide dilution, magnetic resonance imaging, dual energy X-ray absorptiometry, air displacement plethysmography, hydrostatic weighing, and multicompartmental models were acceptable to measure body composition, with the 4-compartmental model preferred. Waist circumference and bioelectrical impedance were preferred clinical tests to use either alone or in combination with BMI for diagnosing obesity; preferential use was country specific. Most experts preferred fat mass index (fat mass/height2) to % body fat as the metric, because it is more sensitive to changes over time and depends on age and height, similar to BMI. Experts agreed that total and regional adiposity are important for determining metabolic risk related to obesity, but using central adiposity for diagnosing obesity is challenging due to variations in body type. All agreed that age, race, ethnicity, and puberty stage should be considered when defining thresholds of obesity. This input from experts informed the systematic review protocol for an assessment of the DTA of BMI to support the World Health Organization’s guideline development for the integrated management of children and adolescents with obesity in all their diversity.http://www.sciencedirect.com/science/article/pii/S2475299125029361obesityoverweightbody compositiondiagnosticsanthropometrychildren
spellingShingle Lauren E O’Connor
Lucero Lopez-Perez
Ricardo X Martinez
Maureen K Spill
Juan Pablo Peña-Rosas
Amanda J MacFarlane
Report of a Meeting: An Expert Consultation on Body Composition and Adiposity for Children and Adolescents in All Their Diversity
Current Developments in Nutrition
obesity
overweight
body composition
diagnostics
anthropometry
children
title Report of a Meeting: An Expert Consultation on Body Composition and Adiposity for Children and Adolescents in All Their Diversity
title_full Report of a Meeting: An Expert Consultation on Body Composition and Adiposity for Children and Adolescents in All Their Diversity
title_fullStr Report of a Meeting: An Expert Consultation on Body Composition and Adiposity for Children and Adolescents in All Their Diversity
title_full_unstemmed Report of a Meeting: An Expert Consultation on Body Composition and Adiposity for Children and Adolescents in All Their Diversity
title_short Report of a Meeting: An Expert Consultation on Body Composition and Adiposity for Children and Adolescents in All Their Diversity
title_sort report of a meeting an expert consultation on body composition and adiposity for children and adolescents in all their diversity
topic obesity
overweight
body composition
diagnostics
anthropometry
children
url http://www.sciencedirect.com/science/article/pii/S2475299125029361
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