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Comparison of air displacement plethysmography, dual-energy X-ray absorptiometry, and bioimpedance in 6-week-old and 6-month-old infants

Pediatric Research (2025)Cite this article

Impact

  • Body composition estimates in infancy differ substantially depending on the tool used (ADP, DXA, or BIA) and on within-tool factors (e.g. DXA software version).

  • This study systematically compares three widely used infant body composition tools, demonstrating that the choice of tool and analysis approach can markedly affect the results.

  • These findings underscore the need for caution when comparing infant body composition measurements across studies or over time where a change in tool type has been required.

  • Standardized protocols and transparent reporting will be crucial for improving paediatric nutrition and growth assessments.

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Fig. 1: Bland–Altman plots comparing body composition methods in 6-week-old infants in New Zealand (average weight = 4.8 kg).
Fig. 2: Bland–Altman plots comparing body composition methods in 6-month-old infants in New Zealand (average weight = 7.5 kg).

Data availability

The data described in the manuscript, code book, and analytic code will not be available because the participants did not consent to open access data sharing. This is an ongoing longitudinal study in which further analyses will be conducted.

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Acknowledgement

K.M.G. is supported by the National Institute for Health Research [NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004)], and the European Union (Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP). S.Y.C. is supported by a Singapore NMRC Clinician Scientist Award (NMRC/CSA-INV/0010/2016; MOH-CSAINV19nov-0002). W.S.C. is supported by A Better Start National Science Challenge Research Programme. Funding for aspects of the NiPPeR study has been provided by Société des Produits Nestlé S.A. under a Research Agreement with the University of Southampton, Auckland UniServices Ltd, SICS, National University Hospital Singapore PTE Ltd, and NUS. Public good funding for the investigator-led NiPPeR study is through the UK Medical Research Council (as part of an MRC award to the MRC Lifecourse Epidemiology Unit (MC_UU_12011/4)); the Singapore National Research Foundation, National Medical Research Council (NMRC, NMRC/TCR/012-NUHS/2014); the National University of Singapore (NUS) and the Agency of Science, Technology and Research as part of the Growth, Development and Metabolism Programme of the Singapore Institute for Clinical Sciences (SICS) (H17/01/a0/005); and as part of Gravida, a New Zealand Government Centre of Research Excellence. For the purpose of Open Access, the author has applied a Creative Commons Attribution (CC BY) license to any Author Accepted Manuscript version arising from this submission.

Author information

Author notes

  1. These authors contributed equally: Keith M. Godfrey, Shiao-Yng Chan, Wayne S. Cutfield.

Authors and Affiliations

  1. Liggins Institute, University of Auckland, Auckland, New Zealand

    Jaz Lyons-Reid, Benjamin B. Albert, Timothy Kenealy & Wayne S. Cutfield

  2. Department of Paediatrics: Child and Youth Health, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

    José G. B. Derraik

  3. Environmental-Occupational Health Sciences and Non-communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand

    José G. B. Derraik

  4. Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

    José G. B. Derraik

  5. School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, QLD, Australia

    Leigh C. Ward

  6. Institute for Human Development and Potential, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore

    Mya-Thway Tint & Shiao-Yng Chan

  7. Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Mya-Thway Tint & Shiao-Yng Chan

  8. Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland

    Cathriona R. Monnard & J. Manuel Ramos Nieves

  9. Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand

    Timothy Kenealy

  10. MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom

    Keith M. Godfrey

  11. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Keith M. Godfrey

  12. Department of Obstetrics & Gynaecology, National University of Singapore, Singapore, Singapore

    Shiao-Yng Chan

  13. A Better Start—National Science Challenge, University of Auckland, Auckland, New Zealand

    Wayne S. Cutfield

Authors
  1. Jaz Lyons-Reid
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  2. José G. B. Derraik
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  3. Leigh C. Ward
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  4. Mya-Thway Tint
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  5. Benjamin B. Albert
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  6. Cathriona R. Monnard
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  7. J. Manuel Ramos Nieves
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  8. Timothy Kenealy
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  9. Keith M. Godfrey
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  10. Shiao-Yng Chan
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  11. Wayne S. Cutfield
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Contributions

K.M.G., S.Y.C., and W.S.C. led the NiPPeR trial conception and design, and supervised data collection and assimilation at each of the study sites. J.L., L.C.W., and M.T.T. prepared the body composition data for analysis. W.S.C., T.K., B.B.A., J.G.B.D., C.R.M., J.M.R.N., and J.L. planned the statistical analyses. J.L. compiled the data and carried out the statistical analyses. J.L. wrote the manuscript with critical input from all other authors. All authors have approved the final version of this manuscript and have agreed to be accountable for all aspects of this work.

Corresponding author

Correspondence to Wayne S. Cutfield.

Ethics declarations

Competing interests

L.C.W. provides consultancy services to ImpediMed Ltd (a manufacturer of devices for bioelectrical impedance analysis). ImpediMed Ltd was not involved in the inception and conduct of this research or in writing this manuscript. C.R.M. and J.M.R.N. are employees of Société des Produits Nestlé SA. K.M.G., S.Y.C., and W.S.C. are part of an academic consortium that has received grants from Société des Produits Nestlé S.A. All other authors declare no conflicts of interest.

Consent statement

The study was conducted in accordance with the Declaration of Helsinki and all procedures were approved by the Northern A Health and Disability Ethics Committee New Zealand (15/NTA/21). Written informed consent was obtained from the mothers of the participants.

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Lyons-Reid, J., Derraik, J.G.B., Ward, L.C. et al. Comparison of air displacement plethysmography, dual-energy X-ray absorptiometry, and bioimpedance in 6-week-old and 6-month-old infants. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04597-7

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