Development of Criteria for Assessing Nutritional Status in Moscow Children and Adolescents Using Bioimpedance Analysis Data

Background. Body composition assessment plays an important role in characterizing physical development, monitoring health status, diagnosing nutritional disorders, and assessing disease risks.

Objective. To develop the criteria for assessing nutritional status in Moscow children and adolescents using bioimpedance analysis data.

Materials and methods. The research used data from a non-clinical, cross-sectional, observational study on the body composition of children and adolescents aged 5–17 in Moscow health centers from 2010 to 2019 by the method of bioimpedance analysis. A total of 115,200 persons were assessed, including 61,430 boys and 53,770 girls. Bioimpedance measurements were taken using bioimpedance analyzers according to a standard four-electrode assessment scheme in the supine position with disposable bioadhesive ECG-electrodes placed on the patient’s wrists and ankles. The relative fat mass (RFM) was assessed using the percentage of fat mass (%FM) and the fat mass index (FMI). The criteria for assessing RFM were the cut-offs of %FM and FMI calculated based on the centiles of BMI thresholds according to the IOTF ageand sex-specific criteria. Polynomial smoothing was then applied. In the same way, the criteria for assessing the relative fat-free mass (RFFM) were derived based on the cut-offs of the fat-free mass index (FFMI).

Findings. Diagnostic tables were designed to determine the RFM and RFFM in Moscow children and adolescents. The prevalence of normal weight obesity was assessed.

Conclusion. The study results can be used in clinical, preventive, or sports medicine to diagnose and correct nutritional status disorders as well as to monitor physical development.

1. Toomey CM, Cremona A, Hughes K, Norton K, Jakeman P. A review of body composition measurement in the assessment of health. Topics Clin. Nutr. 2015; 30(1): 16-32. DOI: 10.1097/TIN.0000000000000017

2. Holmes CJ, Racette SB. The utility of body composition assessment in nutrition and clinical practice: an overview of current methodology. Nutrients. 2021; 13(8): 2493. DOI: 10.3390/nu13082493

3. Dai H, Alsalhe TA, Chalghaf N, Riccò M et al. The global burden of disease attributable to high body mass index in 195 countries and territories, 1990–2017: An analysis of the Global Burden of Disease Study. PLoS Medicine. 2020; 17(7): e1003198. DOI: 10.1371/journal.pmed.1003198

4. Chong B, Jayabaskaran J, Kong G, Chan YH et al. Trends and predictions of malnutrition and obesity in 204 countries and territories: an analysis of the Global Burden of Disease Study 2019. eClinicalMedicine. 2023; 57: 101850. DOI: 10.1016/j.eclinm.2023.101850

5. Gao L, Peng W, Xue H, Wu Y et al. Spatial-temporal trends in global childhood overweight and obesity from 1975 to 2030: a weight mean center and projection analysis of 191 countries. Global Health. 2023; 19(1): 53. DOI: 10.1186/s12992-023-00954-5

6. Thibault R, Genton L, Pichard C. Body composition: why, when and for who? Clin. Nutr. 2012; 31(4): 435-447. DOI: 10.1016/j.clnu.2011.12.011

7. Zamberlan P, Mazzoni BP, Bonfim MAC, Vieira RR et al. Body composition in pediatric patients. Nutr. Clin. Pract. 2023; 38(S2): S84-S102. DOI: 10.1002/ncp.11061

8. Sedlmeier AM, Baumeister SE, Weber A, Fischer B et al. Relation of body fat mass and fat-free mass to total mortality: results from 7 prospective cohort studies. Am. J. Clin. Nutr. 2021; 113(3): 639-646. DOI: 10.1093/ajcn/nqaa339

9. Starodubov VI, Rudnev SG, Nikolaev DV, Korostylev KA. Federal Information Resource of Health Centres: current state and developmental perspectives. Sotsial’nye aspekty zdorov’ya naseleniya. 2015; 5: 1. (In Russ.). URL: http://vestnik.mednet.ru/content/view/706/27/lang,ru/

10. Starunova OA, Rudnev SG, Ivanova AE, Semenova VG, Starodubov VI. Application of Benford’s law for quality assessment of preventive screening data. Math. Biol. Bioinf. 2022; 17(2): 230-249. (In Russ.). DOI: 10.17537/2022.17.230

11. Starunova OA, Rudnev SG, Starodubov VI. HCViewer: a program for automated quality analysis, filtering and processing of mass data of preventive screening in Health Centers. Certificate of state registration of the computer program No. 2020665580 dated 11/27/2020. (In Russ.).

12. Smirnov AV, Kolesnikov VA, Nikolaev DV, Eryukova TA. AVS-01 ‘Medass’: analizator otsenki balansa vodnykh sektorov organizma s programmnym obespecheniem (rukovodstvo pol’zovatelya). Moscow: NTTs Medass; 2009. (In Russ.).

13. Houtkooper LB, Going SB, Lohman TG, Roche AF, Van Loan M. Bioelectrical impedance estimation of fat-free body mass in children and youth: a cross-validation study. J. Appl. Physiol. 1992; 72(1): 366-373. DOI: 10.1152/jappl.1992.72.1.366

14. Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatric Obesity. 2012; 7(4): 284-294. DOI: 10.1111/j.2047-6310.2012.00064.x

15. World Health Organization. 2024. BMI-for-age (5-19 years). Available from: https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age

16. Anisimova AV, Rudnev SG, Godina EZ, Nikolaev DV, Chernykh SP. Sostav tela moskovskikh detey i podrostkov: kharakteristika reprezentativnosti dannykh bioimpedansnogo obsledovaniya v Tsentrakh zdorov’ya. Lechenie i profilaktika. 2014; 1(9): 24-29. (In Russ.).

17. Rudnev SG, Soboleva NP, Sterlikov SA, Nikolaev DV et al. Bioimpedance study of body composition in the Russian population. M.: RIO TSNIIOIZ, 2014. 493 p. (In Russ.).

18. Konovalova MV, Vashura AYu, Godina EZ, Nikolaev DV et al. Osobennosti komponentnogo sostava tela u detei i podrostkov s ostrym limfoblastnym leikozom v sostoyanii remissii. Pediatriya. Zhurnal im G.N. Speranskogo. 2011; 90(4): 31-36. (In Russ.).

19. Bennett JP, Cataldi D, Liu YE, Kelly NN et al. Variations in bioelectrical impedance devices impact raw measures comparisons and subsequent prediction of body composition using recommended estimation equations. Clin. Nutr. ESPEN. 2024; 63: 540-550. DOI: 10.1016/j.clnesp.2024.07.009

20. Sipatrova AG, Godina EZ, Permyakova EYu, Anisimova AV et al. Bioimpedance assessment of body composition using ABC-01 ‘Medas’ and Diamant-AIST instruments: a comparison. Lomonosov Journal of Anthropology [Moscow University Anthropology Bulletin]. 2023; 2: 70-81. (In Russ.). DOI: 10.32521/2074-8132.2023.2.070-081

21. Rudnev SG, Burns JS, Williams PL, Lee MM et al. Comparison of bioimpedance body composition in young adults in the Russian Children’s Study. Clin. Nutr. ESPEN. 2020; 35: 153-161. DOI: 10.1016/j.clnesp.2019.10.007