Air displacement plethysmography (pea pod) in full-term and pre-term infants: a comprehensive review of accuracy, reproducibility, and practical challenges

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Abstract

Air displacement plethysmography (ADP) has been widely utilised to track body composition because it is considered to be practical, reliable, and valid. Pea Pod is the infant version of ADP that accommodates infants up to the age of 6 months and has been widely utilised to assess the body composition of full-term infants, and more recently pre-term infants. The primary goal of this comprehensive review is to 1) discuss the accuracy/reproducibility of Pea Pod in both full- and pre-term infants, 2) highlight and discuss practical challenges and potential sources of measurement errors in relation to Pea Pod operating principles, and 3) make suggestions for future research direction to overcome the identified limitations.

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Most cited references 104

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How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups?

D. Gallagher, M. Visser, D. Sepulveda … (1996)

This study tested the hypothesis that body mass index (BMI) is representative of body fatness independent of age, sex, and ethnicity. Between 1986 and 1992, the authors studied a total of 202 black and 504 white men and women who resided in or near New York City, were ages 20-94 years, and had BMIs of 18-35 kg/m2. Total body fat, expressed as a percentage of body weight (BF%), was assessed using a four-compartment body composition model that does not rely on assumptions known to be age, sex, or ethnicity dependent. Statistically significant age dependencies were observed in the BF%-BMI relations in all four sex and ethnic groups (p values < 0.05-0.001) with older persons showing a higher BF% compared with younger persons with comparable BMIs. Statistically significant sex effects were also observed in BF%-BMI relations within each ethnic group (p values < 0.001) after controlling first for age. For an equivalent BMI, women have significantly greater amounts of total body fat than do men throughout the entire adult life span. Ethnicity did not significantly influence the BF%-BMI relation after controlling first for age and sex even though both black women and men had longer appendicular bone lengths relative to stature (p values < 0.001 and 0.02, respectively) compared with white women and men. Body mass index alone accounted for 25% of between-individual differences in body fat percentage for the 706 total subjects; adding age and sex as independent variables to the regression model increased the variance (r2) to 67%. These results suggest that BMI is age and sex dependent when used as an indicator of body fatness, but that it is ethnicity independent in black and white adults.

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Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality.

Abel Romero-Corral, Virend K Somers, Justo Sierra-Johnson … (2010)

We hypothesized that subjects with a normal body mass index (BMI), but high body fat (BF) content [normal weight obesity (NWO)], have a higher prevalence of cardiometabolic dysregulation and are at higher risk for cardiovascular (CV) mortality. We analysed 6171 subjects >20 years of age from the Third National Health and Nutrition Examination Survey (NHANES III) and the NHANES III mortality study, whose BMI was within the normal range (18.5-24.9 kg/m(2)), and who underwent a complete evaluation that included body composition assessment, blood measurements, and assessment of CV risk factors. Survival information was available for >99% of the subjects after a median follow-up of 8.8 years. We divided our sample using sex-specific tertiles of BF%. The highest tertile of BF (>23.1% in men and >33.3% in women) was labelled as NWO. When compared with the low BF group, the prevalence of metabolic syndrome in subjects with NWO was four-fold higher (16.6 vs. 4.8%, P < 0.0001). Subjects with NWO also had higher prevalence of dyslipidaemia, hypertension (men), and CV disease (women). After adjustment, women with NWO showed a significant 2.2-fold increased risk for CV mortality (HR = 2.2; 95% CI, 1.03-4.67) in comparison to the low BF group. Normal weight obesity, defined as the combination of normal BMI and high BF content, is associated with a high prevalence of cardiometabolic dysregulation, metabolic syndrome, and CV risk factors. In women, NWO is independently associated with increased risk for CV mortality.

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Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: a systematic review and meta-analysis.

Abrar A. Javed, M F Jumean, M Murad … (2015)

The ideal means of identifying obesity in children and adolescents has not been determined although body mass index (BMI) is the most widely used screening tool.

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Author and article information

Contributors

Hajar Mazahery: h.mazahery@massey.ac.nz

Pamela R. von Hurst: p.r.vonhurst@massey.ac.nz

Christopher J. D. McKinlay: c.mckinlay@auckland.ac.nz

Barbara E. Cormack: bcormack@adhb.govt.nz

Cathryn A. Conlon: +64-9-414-0800 , c.conlon@massey.ac.nz

Journal

Journal ID (nlm-ta): Matern Health Neonatol Perinatol

Journal ID (iso-abbrev): Matern Health Neonatol Perinatol

Title: Maternal Health, Neonatology and Perinatology

Publisher: BioMed Central (London )

ISSN (Electronic): 2054-958X

Publication date (Electronic): 20 June 2018

Publication date PMC-release: 20 June 2018

Publication date Collection: 2018

Volume: 4

Electronic Location Identifier: 12

Affiliations

[1 ]GRID grid.148374.d, College of Health, , Massey University, ; Auckland, 0745 New Zealand

[2 ]Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand

[3 ]ISNI 0000 0004 0372 3343, GRID grid.9654.e, Liggins Institute and Department of Paediatrics: Child and Youth Health, , University of Auckland, ; Auckland, New Zealand

[4 ]Starship Children’s Hospital, Auckland District Health Board, Auckland, New Zealand

Article

Publisher ID: 79

DOI: 10.1186/s40748-018-0079-z

PMC ID: 6011189

PubMed ID: 29951209

SO-VID: 82812eb9-84ce-4ccf-a15b-84d8427a3cd8

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 13 November 2017

Date accepted : 20 March 2018

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Keywords: air displacement plethysmography,adp,pea pod,infant,pre-term,full-term,body composition

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Keywords: air displacement plethysmography, adp, pea pod, infant, pre-term, full-term, body composition

Air displacement plethysmography (pea pod) in full-term and pre-term infants: a comprehensive review of accuracy, reproducibility, and practical challenges

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Most cited references 104

How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups?

Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality.

Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: a systematic review and meta-analysis.

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