Pediatric Body Composition Reference Charts

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Subject
Measurements
DXA Values

BMC, Lean, & Fat must be entered in order to calculate any Z-score. DXA Z-scores are available only for ages 8 - 20 yrs.

Age-based DXA Reference Charts

BMC vs Age
  1. Z-Score:
  2. Percentile:
Percent Fat vs Age
  1. Z-Score:
  2. Percentile:
BMD vs Age
  1. Z-Score:
  2. Percentile:
FFM/Ht2 vs Age
  1. Z-Score:
  2. Percentile:

Notes on Analysis Versions

IMPORTANT: The DXA calculators work with data acquired by HOLOGIC instruments and can adjust for different analysis versions. Prior to the release of NHANES DXA data,

  • NHANES results for children weighing 40 kg (88 lbs) or less were adjusted leading to changes in BMC, BMD, Fat, and Lean (by using the Auto-WB Analysis Option available on Hologic DXA instruments starting with version 12).
  • NHANES lean soft tissue mass and fat mass were then further adjusted for all subjects. "Lean mass was decreased by 5% and an equivalent kilogram weight added to the fat mass so the total mass did not change." This analysis option (NHANES BCA) appears on Hologic DXA instruments starting with version 13.

Before entering DXA values, you should know whether your results incorporate the 40-kg automatic whole-body corrections (Auto-WB) and/or the 5% Lean-Fat adjustment (NHANES BCA calibration), then choose your SW Version accordingly.

Reference Notes

DXA references come from the National Health and Nutrition Examination Survey (NHANES) - DXA data released in 2008. Correction factors were derived by Kelly et al:

Kelly TL, Wilson KE, Heymsfield SB (2009) Dual Energy X-Ray Absorptiometry Body Composition Reference Values from NHANES. PLoS ONE 4(9): e7038. doi:10.1371/journal.pone.0007038

The DXA graphs dealing with Lean tissue, presented by Kelly et al, actually work with fat-free mass (FFM) although they are labeled as 'Lean', thus the graphs presented here are labeled FFM/Ht2 vs Age, and FFM vs Height. (FFM = Lean + BMC)

Verify that you are entering LEAN values in the form, not FFM values.

Height-based DXA Reference Charts

BMC vs Height
  1. Z-Score:
  2. Percentile:
Fat-Free Mass vs Height
  1. Z-Score:
  2. Percentile:
BMD vs Height
  1. Z-Score:
  2. Percentile:

Notes on Analysis Versions

IMPORTANT: The DXA calculators work with data acquired by HOLOGIC instruments and can adjust for different analysis versions. Prior to the release of NHANES DXA data,

  • NHANES results for children weighing 40 kg (88 lbs) or less were adjusted leading to changes in BMC, BMD, Fat, and Lean (by using the Auto-WB Analysis Option available on Hologic DXA instruments starting with version 12).
  • NHANES lean soft tissue mass and fat mass were then further adjusted for all subjects. "Lean mass was decreased by 5% and an equivalent kilogram weight added to the fat mass so the total mass did not change." This analysis option (NHANES BCA) appears on Hologic DXA instruments starting with version 13.

Before entering DXA values, you should know whether your results incorporate the 40-kg automatic whole-body corrections (Auto-WB) and/or the 5% Lean-Fat adjustment (NHANES BCA calibration), then choose your SW Version accordingly.

Reference Notes

DXA references come from the National Health and Nutrition Examination Survey (NHANES) - DXA data released in 2008. Correction factors were derived by Kelly et al:

Kelly TL, Wilson KE, Heymsfield SB (2009) Dual Energy X-Ray Absorptiometry Body Composition Reference Values from NHANES. PLoS ONE 4(9): e7038. doi:10.1371/journal.pone.0007038

The DXA graphs dealing with Lean tissue, presented by Kelly et al, actually work with fat-free mass (FFM) although they are labeled as 'Lean', thus the graphs presented here are labeled FFM/Ht2 vs Age, and FFM vs Height. (FFM = Lean + BMC)

Verify that you are entering LEAN values in the form, not FFM values.


Return to the CNRC Interactive Calculators

Please note

Individual results, when compared to other children, can be affected by many factors such as the parents' body sizes and the child's level of physical maturity. Thus, this software should not be used for medical diagnostic or treatment purposes. Additionally, the authors and their affiliated institutions are not liable for any damages to users or third parties arising from the use of this software.

This software is protected under international copyright law. Unauthorized duplication or distribution is a violation of copyright. Entering this section of the web site implies acceptance of the conditions stated above.

These tools are created and maintained by the Children's Nutrition Research Center (CNRC) which houses laboratories of varied disciplines, a vast array of state-of-the-art equipment, a greenhouse, observation labs and accommodations for research volunteers, a metabolic kitchen, and an elite group of scientists conducting groundbreaking research. Visit the CNRC.

To cite this source

Shypailo RJ (2020) Age- and Height-based Pediatric DXA Reference Charts. Retrieved from the Baylor College of Medicine, Children's Nutrition Research Center, Body Composition Laboratory Web Site:
http://www.bcm.edu/bodycomplab/DXAapp/DXA-calculator-kids.html

Supporting publications

Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF, Johnson CL. CDC growth charts: United States. Adv Data 2000:1–27.

Flegal KM, Cole TJ. Construction of LMS parameters for the Centers for Disease Control and Prevention 2000 growth chart. National health statistics reports; no 63. Hyattsville, MD: National Center for Health Statistics. 2013.

Flegal KM, Wei R, Ogden CL, Freedman DS, Johnson CL, Curtin LR. Characterizing extreme values of body mass index-for-age by using the 2000 Centers for Disease Control and Prevention growth charts. Am J Clin Nutr 2009;90:1314–20.

Kelly TL, Wilson KE, Heymsfield SB. Dual Energy X-Ray Absorptiometry Body Composition Reference Values from NHANES. PLoS ONE 2009; 4(9): e7038. doi:10.1371/journal.pone.0007038

Shypailo RJ, Butte NF, Ellis KJ. DXA: Can It Be Used as a Criterion Reference for Body Fat Measurements in Children? Obesity (Silver Spring) 2008 Feb; 16(2): 457-62.

Shypailo RJ, Ellis KJ. Bone assessment in children: Comparison of fan-beam DXA analysis. Journal of Clinical Densitometry 2005; 8(4): 445-453.

Ellis KJ, Shypailo RJ, Hardin DS, Perez MD, Motil KJ, Wong WW, Abrams SA. Z score prediction model for assessment of bone mineral content in pediatric diseases. Journal of Bone and Mineral Research 2001; 16(9): 1658-1664


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