Report of a Meeting: An Expert Consultation on Body Composition and Adiposity for Children and Adolescents in All Their Diversity
Bibliographic record
Abstract
We convened experts to discuss methods for measuring body composition and diagnosing excessive adiposity among infants, children, and adolescents aged 0-19 years. The motivation for this meeting was to inform critical decisions for a systematic review protocol to assess the diagnostic test accuracy (DTA) of BMI-for-age and sex (BMI) for diagnosing infants, children, and adolescents with obesity. Thirty-nine experts, including clinicians and researchers from 23 countries, provided written responses and/or attended one of two virtual meetings held in January 2024. Experts were asked to share their perspectives about methods and clinical tests used to measure body composition, including thresholds and adiposity types (i.e., total vs central), for diagnosing obesity for infants, children, and adolescents. Experts suggested that deuterium oxide dilution, MRI, DXA, air displacement plethysmography, hydrostatic weighing, and multicompartmental models were acceptable to measure body composition, with the 4-compartmental model preferred. Waist circumference and bioelectrical impedance were preferred clinical tests to use either alone or in combination with BMI for diagnosing obesity; preferential use was country specific. Most experts preferred fat mass index (fat mass/height 2 ) to % body fat as the metric, because it is more sensitive to changes over time and depends on age and height, similar to BMI. Experts agreed that total and regional adiposity are important for determining metabolic risk related to obesity, but using central adiposity for diagnosing obesity is challenging due to variations in body type. All agreed that age, race, ethnicity, and puberty stage should be considered when defining thresholds of obesity. This input from experts informed the systematic review protocol for an assessment of the diagnostic test accuracy of BMI to support the World Health Organization's guideline development for the integrated management of children and adolescents with obesity in all their diversity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.040 | 0.103 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.004 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.003 | 0.010 |
| Research integrity | 0.017 | 0.013 |
| Insufficient payload (model declined to judge) | 0.031 | 0.009 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".