Irish Journal of Medical Science (1971 -)

, Volume 184, Issue 1, pp 53–68

Methodologies to assess paediatric adiposity

Review Article

Abstract

Introduction

Childhood obesity is associated with increased risk of adult obesity, cardiovascular disease, diabetes and cancer. Appropriate techniques for assessment of childhood adiposity are required to identify children at risk. The aim of this review was to examine core clinical measurements and more technical tools to assess paediatric adiposity.

Methods

The online databases PubMed, CINALH and EMBASE were searched and the abstracts identified were reviewed to determine appropriate studies. Their reference lists were also searched to identify further eligible studies. Publications were included if they described childhood measurement techniques or involved validation.

Results and Discussion

There are many body composition assessment tools available, none of which are direct. Each technique has limitations and a combination of methods may be used. The main clinical techniques are weight, height, body mass index (BMI) and circumferences which provide sufficient information to enable classification of overweight or obesity when growth centile charts and ratios are employed. Further investigation depends on resources available and examiner skill. Skinfold thicknesses are cost-effective but require technical training and only measure subcutaneous fat. Dual energy X-ray absorptiometry (DEXA), air displacement plethysmography (ADP), magnetic resonance imaging (MRI) and computed tomography (CT) are more costly and intensive, requiring the child to remain still for longer periods. DEXA and ADP are capable of accurately measuring adiposity but are unable to distinguish between fat depots. MRI and CT can distinguish intra-abdominal from subcutaneous adiposity and are considered gold standards, but CT is unsuitable for adiposity measurement in children due to high levels of radiation exposure. Ultrasound is a promising technique capable of measuring intra-abdominal adiposity in children but requires further validation.

Conclusion

The core clinical measurements of weight, height, BMI and circumferences are sufficient to enable diagnosis of paediatric overweight and obesity while more technical tools provide further insight.

Keywords

Paediatric anthropometry Skinfold Paediatric obesity Body composition Growth references Growth standards Childhood BMI 

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Copyright information

© Royal Academy of Medicine in Ireland 2014

Authors and Affiliations

  1. 1.University College Dublin Obstetrics and Gynaecology, School of Medicine and Medical ScienceNational Maternity HospitalDublin 2Republic of Ireland
  2. 2.Institute of Food and HealthUniversity College DublinDublin 4Republic of Ireland
  3. 3.Royal College of SurgeonsDublin 2Republic of Ireland

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