Doctoral CRP on Longitudinal Measures of Body Composition of Healthy Infants and Young Children up to 2 Years of Age Using Stable Isotope Techniques

Closed for proposals

Project Type

Coordinated Research Project

Project Code

E43028

CRP

1964

Approved Date

17 September 2012

Status

Closed

Start Date

4 July 2013

Expected End Date

4 July 2020

Completed Date

4 July 2021

Participating Countries

Australia
India
United Kingdom of Great Britain and Northern Ireland

Description

Body composition (the proportion of fat and lean tissue) in early life is associated with risk of non-communicable diseases in later life. Body composition in infants can be assessed using stable isotope techniques.

Objectives

The overall objective of the CRP is to assess longitudinal changes in body composition (fat mass and fat free mass) of healthy infants and young children during the first 2 years of life.

Specific objectives

To assess longitudinally body composition of healthy young children by stable isotope techniques at 3, 6, 9, 12, 18 and 24 months of age;

To contribute to capacity building in nutrition by supporting PhD students

Impact

Body composition assessment in the first 2 y of life provides important insights into child nutrition and health. The application and interpretation of body composition data in infants and young children have been challenged by a lack of global reference data.
We developed body composition reference charts of infants aged 0–6 mo based on air displacement plethysmography (ADP) and those aged 3–24 mo based on total body water (TBW) by deuterium dilution (DD). Body composition was assessed by ADP in infants aged 0–6 mo from Australia, India, and South Africa. TBW using DD was assessed for infants aged 3–24 mo from Brazil, Pakistan, South Africa, and Sri Lanka. Reference charts and centiles were constructed for body composition using the lambda–mu–sigma method.
Sex-specific reference charts were produced for FM index (FMI), FFM index (FFMI), and percent FM (%FM) for infants aged 0–6 mo (n = 470 infants; 1899 observations) and 3–24 mo (n = 1026 infants; 3690 observations). When compared with other available references, there were observable differences but similar patterns in the trajectories of FMI, FFMI, and %FM. These reference charts will strengthen the interpretation and understanding of body composition in infants across the first 24 mo of life. The pooled CRP results also showed that birth weight and breastfeeding are independent predictors of body composition in early life, irrespective of sex. These are important considerations when interpreting data and planning global programs to improve early life nutrition.

This CRP brought together scientist from 6 countries who collaborated and exchanged knowledge to generate important new information on the body composition of infants and generate new tools for clinicians to use in the evaluation of infant health. These results have already been widely disseminated through more than 15 peer reviewed publications and international presentations. This CRP inspired a regional Asian project (RAS6092) and a regional Latin American and Caribbean project (RAS6079) which collected cross sectional infant data to understand regional difference and influences in infant body composition. These 2 regional TC projects are using the CRP developed body composition references curves to evaluate the data from their regions. This CRP has also influenced the IAEA recommended protocol for assessing body composition by deuterium dilution in infants which is now being disseminated through the TC projects.

Relevance

The double burden of malnutrition presents a significant global health concern, especially in low- and middle-income countries where high levels of undernutrition remain in addition to increasing obesity levels. The first years of life are recognized as a priority in establishing strong nutrition foundations to ensure optimal growth and functional development, as well as long-term health. Policies and programs to improve feeding practices and food quality in early life are essential for preventing malnutrition across the life course. Infant and young child feeding interventions must be informed by accurate, informative, and relevant data. To promote effective early-life interventions and understand the associations between early-life nutrition and later health, it is important to capture the nutritional status of infants through the collection of body composition data [1]. Although length and weight are core components of early childhood global nutrition surveillance, these measurements (and derivatives, such as BMI) do not provide information on FM and FFM. Body composition has important implications for energy metabolism and long-term health. The literature has highlighted the need for the assessment of body composition in infants [1,2] and assessment techniques have become more accessible; however, the lack of available reference body composition data has been a key barrier to the implementation of these techniques in public health or clinical settings. Body composition can be challenging to assess in infants and young children, although several techniques are available, which have been shown to be feasible and accurate in children aged <2 y. The “PEA POD” uses air displacement plethysmography (ADP) to assess body composition from birth up to 6 mo of age, and is a simple, noninvasive, and quick technique that can be used in public health and clinical settings. Deuterium dilution (DD) can be used to accurately determine total body water (TBW) in the field, which makes it a feasible technique with wide applicability for assessing the body composition of infants. To ensure that body composition data from these techniques are valuable for public health guidance as well as clinical evaluation, reference data are needed. We developed body composition reference curves between birth and 24 mo, which will allow the body composition to be evaluated over the first 2 y of life. We combined longitudinal data from 4 regions (Africa, Asia, Oceania, and South America) and collected data matching the MGRS eligibility criteria and harmonized protocols across all countries. The longitudinal data collected on healthy infants with >5500 measurements represent the most diverse collection available of body composition data across the first 24 mo. Now with the reference data available, clinicians and researchers have the tools to evaluate and interpret body composition measurements to inform and evaluate interventions to combat the double burden of malnutrition and setup healthier childhood trajectories.

CRP Publications

Type

Peer reviewed publication

Year

2023

Publication URL

https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04155-2

Description

The association of intrauterine and postnatal growth patterns and nutritional status with toddler body composition. Masiakwala E, Nyati LH, Norris SA. BMC Pediatr. 2023 Jul 6;23(1):342. doi: 10.1186/s12887-023-04155-2.

Country/Organization

South Africa

Type

Peer reviewed publication

Year

2023

Publication URL

https://www.nature.com/articles/s41430-023-01351-2

Description

Body composition of infants at 6 months of age using a 3-compartment model. Kuriyan R, Hills AP, Murphy-Alford A, Padmanabha R, Nyati LH, Byrne NM, Kurpad AV, Norris S; Multi-Center Infant Body Composition Reference Study (MIBCRS). Eur J Clin Nutr. 2023 Oct 13. doi: 10.1038/s41430-023-01351-2. Online ahead of print.

Country/Organization

IAEA

Type

Peer reviewed publication

Year

2020

Publication URL

http://scielo.iec.gov.br/pdf/ess/v29n1/en_2237-9622-ess-29-01-e2019219.pdf

Description

Maternal intention to breastfeed, duration of breastfeeding and reasons for weaning: a cohort study, Pelotas, RS, Brazil, 2014. Amaral SAD, Bielemann RM, Del-Ponte B, Valle NCJ, Costa CDS, Oliveira MDS, Santos IS. Epidemiol Serv Saude. 2020;29(1):e2019219. doi: 10.5123/s1679-49742020000100024. Epub 2020 Apr 6.

Country/Organization

Brazil

Type

Peer reviewed publication

Year

2023

Publication URL

https://www.sciencedirect.com/science/article/pii/S0002916523076876?via%3Dihub

Description

Murphy-Alford AJ, Johnson W, Nyati LH, Santos IS, Hills AP, Ariff S, Wickramasinghe VP, Kuriyan R, Lucas MN, Costa CS, Slater C, Ahmad T, Byrne NM, Divya PJ, Kurpad AV, Cheikh Ismail LI, Loechl CU, Norris SA; Multicenter Infant Body Composition Reference Study (MIBCRS). Body composition reference charts for infants from birth to 24 months: Multicenter Infant Body Composition Reference Study. Am J Clin Nutr. 2023 Jun;117(6):1262-1269. 10.1016/j.ajcnut.2023.02.012

Country/Organization

IAEA

Type

Peer reviewed publication

Year

2021

Publication URL

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073882/

Description

Determinants of Infant Adiposity across the First 6 Months of Life: Evidence from the Baby-bod study. Herath MP, Ahuja KDK, Beckett JM, Jayasinghe S, Byrne NM, Hills AP. J Clin Med. 2021 Apr 19;10(8):1770. doi: 10.3390/jcm10081770.

Country/Organization

Australia

Type

Peer reviewed publication

Year

2023

Publication URL

https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajhb.23914

Description

Infection, nutritional status, and body composition: Associations at birth and 6 months postnatally in Soweto, South Africa. Momberg, D. J., Bell, R., Norris, S. A., Ngandu, C. B., Richter, L. M., Murphy-Alford, A. J., & Said-Mohamed, R. (2023). American Journal of Human Biology, 35(9), e23914. https://doi.org/10.1002/ajhb.23914

Country/Organization

South Africa

Type

Peer reviewed publication

Year

2022

Publication URL

https://apjcn.nhri.org.tw/server/APJCN/31/2/264.pdf

Description

Is abdominal adiposity in healthy Sri Lankan neonates different from the rest of the world? Lucas MN, Lanerolle P, Senarath U, Hills AP, Wickramasinghe VP. Asia Pac J Clin Nutr. 2022;31(2):264-274. doi: 10.6133/apjcn.202206_31(2).0012.

Country/Organization

Sri Lanka

Type

Peer reviewed publication

Year

2021

Publication URL

https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13…

Description

Exclusivity of breastfeeding and body composition: learnings from the Baby-bod study. Jayasinghe S, Herath MP, Beckett JM, Ahuja KDK, Byrne NM, Hills AP. Int Breastfeed J. 2021 May 19;16(1):41. doi: 10.1186/s13006-021-00389-x.

Country/Organization

Australia

Type

Peer reviewed publication

Year

2021

Publication URL

https://bmjpaedsopen.bmj.com/content/5/1/e001123

Description

WHO Child Growth Standards in context: The Baby-bod Project - Observational study in Tasmania. Jayasinghe S, Herath MP, Beckett JM, Ahuja KDK, Byrne NM, Hills AP. BMJ Paediatr Open. 2021 Jun 16;5(1):e001123. doi: 10.1136/bmjpo-2021-001123. eCollection 2021.

Country/Organization

Australia

Type

Peer reviewed publication

Year

2021

Publication URL

https://www.nature.com/articles/s41430-020-00768-3

Description

Anthropometry-based prediction of body fat in infants from birth to 6 months: the Baby-bod study. Jayasinghe S, Herath MP, Beckett JM, Ahuja KDK, Byrne NM, Hills AP. Eur J Clin Nutr. 2021 Apr;75(4):715-723. doi: 10.1038/s41430-020-00768-3. Epub 2020 Oct 14.

Country/Organization

Australia

Type

Peer reviewed publication

Year

2020

Publication URL

https://www.sciencedirect.com/science/article/pii/S0022316622021150?via%3Dihub

Description

The Thin But Fat Phenotype is Uncommon at Birth in Indian Babies. Kuriyan R, Naqvi S, Bhat KG, Ghosh S, Rao S, Preston T, Sachdev HS, Kurpad AV. J Nutr. 2020 Apr 1;150(4):826-832. doi: 10.1093/jn/nxz305.

Country/Organization

India

Type

Peer reviewed publication

Year

2023

Description

Infant growth and body composition from birth to 24 months: Are infants developing the same? Accepted to EJCN

Country/Organization

IAEA

Type

Peer reviewed publication

Year

2020

Publication URL

https://apjcn.nhri.org.tw/server/APJCN/29/4/795.pdf

Description

Birth anthropometry from a tertiary care hospital in Sri Lanka: Differs from the WHO growth standards. Lucas MN, Lanerolle P, Senarath U, Hills AP, Wickramasinghe VP. Asia Pac J Clin Nutr. 2020;29(4):795-802. doi: 10.6133/apjcn.202012_29(4).0015

Country/Organization

Sri Lanka

Type

Peer reviewed publication

Year

2023

Publication URL

https://www.nature.com/articles/s41430-023-01322-7

Description

Hills AP, Norris SA, Byrne NM, Jayasinghe S, Murphy-Alford AJ, Loechl CU, Ismail LIC, Kurpad AV, Kuriyan R, Nyati LH, Santos IS, Costa CS, Wickramasinghe VP, Lucas MN, Slater C, Yameen A, Ariff S; Multi-center Infant Body Composition Reference Study (MIBCRS). Body composition from birth to 2?years. Eur J Clin Nutr. 2023 Aug 10. doi: 10.1038/s41430-023-01322-7. Epub ahead of print. PMID: 37563231.

Country/Organization

IAEA

Type

Peer reviewed publication

Year

2020

Publication URL

https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-020-00401-3

Description

Determinants of infant and young complementary feeding practices among children 6-23?months of age in urban Pakistan: a multicenter longitudinal study. Ariff S, Saddiq K, Khalid J, Sikanderali L, Tariq B, Shaheen F, Nawaz G, Habib A, Soofi SB. BMC Nutr. 2020 Dec 16;6(1):75. doi: 10.1186/s40795-020-00401-3.

Country/Organization

Pakistan

Type

Peer reviewed publication

Year

2023

Publication URL

https://www.nature.com/articles/s41430-023-01321-8

Description

Infant body composition at 6 and 24 months: what are the driving factors? Santos IS, Costa CS, Hills AP, Ariff S, Wickramasinghe VP, Norris S, Murphy-Alford AJ, Slater C, Lucas N, Nyati LH, Kurpad AV, Ahuja KDK, Kuriyan R; Multi-center Infant Body Composition Reference Study- MIBCRS. Eur J Clin Nutr. 2023 Aug 10. doi: 10.1038/s41430-023-01321-8. Online ahead of print.

Country/Organization

IAEA

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