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Body composition in childhood: effects of normal growth and disease

Published online by Cambridge University Press:  08 December 2008

J. C. K. Wells*
MRC Childhood Nutrition Research Centre, Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
Corresponding author: Dr J. C. K. Wells, fax +44 20 7831 9903,
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Body composition in children is of increasing interest within the contexts of childhood obesity, clinical management of patients and nutritional programming as a pathway to adult disease. Energy imbalance appears to be common in many disease states; however, body composition is not routinely measured in patients. Traditionally, clinical interest has focused on growth or nutritional status, whereas more recent studies have quantified fat mass and lean mass. The human body changes in proportions and chemical composition during childhood and adolescence. Most of the weight gain comprises lean mass rather than fat. In general, interest has focused on percentage fat, and less attention has been paid to the way in which lean mass varies within and between individuals. In the general population secular trends in BMI have been widely reported, indicating increasing levels of childhood obesity, which have been linked to reduced physical activity. However, lower activity levels may potentially lead not only to increased fatness, but also to reduced lean mass. This issue merits further investigation. Diseases have multiple effects on body composition and may influence fat-free mass and/or fat mass. In some diseases both components change in the same direction, whereas in other diseases, the changes are contradictory and may be concealed by relatively normal weight. Improved techniques are required for clinical evaluations. Both higher fatness and reduced lean mass may represent pathways to an increased risk of adult disease.

Clinical Nutrition and Metabolism Group Symposium on ‘Control of energy balance in health and disease’
Copyright © The Nutrition Society 2003


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