Deuterium dilution technique for body composition assessment: resolving methodological issues in children with moderate acute malnutrition

<p>Childhood malnutrition is highly prevalent and associated with high mortality risk. In observational and interventional studies among malnourished children, body composition is increasingly recognised as a key outcome. The deuterium dilution technique has generated high-quality data on body composition in studies of infants and young children in several settings, but its feasibility and accuracy in children suffering from moderate acute malnutrition requires further study. Prior to a large nutritional intervention trial among children with moderate acute malnutrition, we conducted pilot work to develop and adapt the deuterium dilution technique. We refined procedures for administration of isotope doses and collection of saliva. Furthermore, we established that equilibration time in local context is 3 h. These findings and the resulting standard operating procedures are important to improve data quality when using the deuterium dilution technique in malnutrition studies in field conditions, and may encourage a wider use of isotope techniques.</p

Spearman correlation coefficients between total energy expenditure (TEE) and physical activity energy expenditure (PAEE) by doubly labeled water and physical activity by accelerometry and questionnaire.

<p>Spearman's rank coefficients (Rho) are based on kilocalories per day of Total Energy Expenditure (TEE) and Physical Activity Energy Expenditure (PAEE).</p

Total energy expenditure (TEE) by doubly labeled water (kcal/day) and accelerometry-based physical activity (counts).

<p>The regression equation is TEE  = 1221+ (0.0033 * counts), adjusted r² = 0.31, p-value for accelerometry-based physical activity 0.002.</p

Physical activity energy expenditure (PAEE) by doubly labeled water (kcal/day) and accelerometry-based physical activity (counts).

<p>The regression equation is PAEE  = −286+ (0.0027 * counts), adjusted r² = 0.34, p-value for MVPA 0.002.</p

Description of the sample in terms of body composition, energy expenditure and physical activity.

<p>Values are means +/− standard deviations (SD).</p

Physical activity energy expenditure (PAEE) by doubly labeled water (kcal/day) and minutes per week spent on physical activity by questionnaire.

<p>The regression equation is PAEE  = 637+ (0.39 * minutes per week of physical activity), adjusted r² = 0.16, p-value for physical activity 0.03.</p

Mean scores for the three dimensions of infant temperament at age 3 months, by mode of infant feeding at age 3 months.

<p>P-values are shown for tests of heterogeneity between all groups, adjusted for age.</p

Infant temperament at age three months according to gender.

<p>Data are means (±SD).</p><p>Main infant temperament dimensions are shown in bold and subscales in italics.</p

Characteristics of the study population, according to the mode of infant feeding at age 3 months.

<p>Data are mean (SD) or n (%).</p><p>*35 mothers did not complete the relevant prenatal questionnaire and 145 did not complete this question.</p

Mode of feeding and infant temperament, assessed at age three months (n = 316).

<p>Data are estimated marginal means (95% CI), adjusted for infant's age and index of multiple deprivation.</p><p>Main infant temperament dimensions are shown in bold.</p><p>*P<0.05 versus the Formula-fed group.</p