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Pediatr Obes. 2014 Aug;9(4):249-59. doi: 10.1111/j.2047-6310.2013.00168.x. Epub 2013 Jun 18.

Skeletal muscle mass reference curves for children and adolescents.

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School of Human Sciences, London Metropolitan University, London, UK.



Skeletal muscle is key to motor development and represents a major metabolic end organ that aids glycaemic regulation.


To create gender-specific reference curves for fat-free mass (FFM) and appendicular (limb) skeletal muscle mass (SMMa) in children and adolescents. To examine the muscle-to-fat ratio in relation to body mass index (BMI) for age and gender.


Body composition was measured by segmental bioelectrical impedance (BIA, Tanita BC418) in 1985 Caucasian children aged 5-18.8 years. Skeletal muscle mass data from the four limbs were used to derive smoothed centile curves and the muscle-to-fat ratio.


The centile curves illustrate the developmental patterns of %FFM and SMMa. While the %FFM curves differ markedly between boys and girls, the SMMa (kg), %SMMa and %SMMa/FFM show some similarities in shape and variance, together with some gender-specific characteristics. Existing BMI curves do not reveal these gender differences. Muscle-to-fat ratio showed a very wide range with means differing between boys and girls and across fifths of BMI z-score.


BIA assessment of %FFM and SMMa represents a significant advance in nutritional assessment since these body composition components are associated with metabolic health. Muscle-to-fat ratio has the potential to provide a better index of future metabolic health.


Bioelectrical impedance; centiles; fat-free mass; skeletal muscle mass

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