Copyright 2011 by ESPGHAN and NASPGHAN. Unauthorized reproduction of this article is prohibited. Decrease of Total Subcutaneous Adipose Tissue From Infancy to Childhood  Petra S. Kaimbacher,  Marguerite Dunitz-Scheer, y Sandra J. Wallner-Liebmann,  Peter J.Z. Scheer, z Karl Sudi, § Wolfgang J. Schnedl, and jj Erwin Tafeit ABSTRACT Objectives: The observation and research of body composition is a topic of present interest. For the assessment of health and variables influencing growth and nutrition, it is of utmost interest to focus on the population of young children. Subjects and Methods: The measurements of subcutaneous body fat distribution in a sample of clinically healthy children ages 0 to 7 years were examined. The optical device LIPOMETER was applied to measure the thickness of subcutaneous adipose tissue layers (in millimeters) at 15 well-defined body sites. This set of measurement points defines the sub- cutaneous adipose tissue topography. In the present study, subcutaneous adipose tissue topography was determined in 275 healthy children (128 girls and 147 boys) divided into 3 age groups. Results: The results of the measurements are presented in 3 levels: total sub- cutaneous adipose tissue, 4 body regions, and 15 body sites. Our results show a clear physiological decrease in subcutaneous body fat in boys (43.8%) and girls (39.8%). One interesting finding was that the decrease occurs mainly in the trunk, abdomen, and lower extremities, whereas the body fat distribution of the upper extremities did not differ. Furthermore, slight subcutaneous adipose tissue topography differences between both sexes were found. Conclusions: The present study provides basic documentation of subcutaneous adipose tissue topography in healthy children ages 0 to 7 years. An accurate description of subcutaneous adipose tissue topo- graphy in healthy subjects could help to characterize various diseases in relation to overnutrition and malnutrition throughout childhood. Key Words: body composition, body fat distribution, LIPOMETER, subcutaneous adipose tissue topography, subcutaneous body fat distribution (JPGN 2011;53: 553–560) T he pattern of subcutaneous fat in children is of growing interest in the field of pediatric body composition. A better understanding of subcutaneous body fat distribution and body composition in children may influence the prognosis of adult health conditions and support the development of effective preventive strategies for reducing risk factors of diseases (1 – 3) such as obesity (2–8); metabolic syndrome (3,5–8); cardiovascular disease (3–8), including hyperinsulinemia (3,5–9); increased blood pressure; and atherogenic levels of blood lipids (4–8). Various methods exist to evaluate body composition in children. Because of the necessary technical equipment, some of these methods are expensive, impractical, and inappropriate for use in field studies. The optical device LIPOMETER (EU Pat. No. 0516251) was developed to generate noninvasive, quick, accurate, and safe measurements of a monolayer of subcutaneous adipose tissue at any given site on the human body. Its technical features and validation results are based on computed tomography as a reference system and have been presented previously (10,11). The LIP- OMETER allows the measurement of subcutaneous fat distribution and the determination of the so-called subcutaneous adipose tissue topography (12). Previous results (13–16) using the LIPOMETER to determine the subcutaneous adipose tissue topography emphasize the importance of describing subcutaneous adipose tissue in adult obesity and metabolic syndrome and during childhood and adoles- cence (17,18). A subcutaneous adipose tissue topography descrip- tion of schoolchildren and children older than 7 years (17,18) has already been presented. Furthermore, a relation among subcu- taneous adipose tissue layers, fat mass, and leptin in obese children and adolescents has been found (19,20). The present study is the first to investigate and highlight subcutaneous adipose tissue topography in healthy infants (younger than 12 months) and children ages 1 to 7 years. The aim of the present study was to provide basic documentation of subcutaneous adipose tissue topography as a reference for characterizing devi- ations of subcutaneous adipose tissue in clinical samples. An accurate description of subcutaneous adipose tissue topography in healthy children may help describe various diseases, such as obesity, failure to thrive, and feeding and eating disorders, in relation to over- and malnutrition throughout childhood. In this basic documentation of subcutaneous adipose tissue topography, we focus on the description of healthy subjects during infancy and childhood analyzing the following: 1. The subcutaneous adipose tissue topography deviations in different age groups 2. The difference between female and male subcutaneous adipose tissue patterns for each age group Previous findings for children older than 7 years (17,18) showed subcutaneous adipose tissue topography differences between different age groups. Because of these results, we inves- tigated the hypothesis of subcutaneous adipose tissue topography differences between different age groups in our sample. In the previous studies (17,18), no sex differences in subcutaneous adipose tissue patterns in 7- to 11-year-olds were found. Sex Received October 4, 2010; accepted June 1, 2011. From the  Department of General Pediatrics, University Clinic of Pediatrics and Adolescence Medicine, the y Institute of Pathophysiology, Center for Molecular Medicine, Medical University Graz, the z Institute for Sport Sciences, Karl-Franzens University Graz, Graz, the § Practice for General Internal Medicine, Bruck/Mur, and the jj Institute of Physiological Chemistry, Center for Physiological Medicine, Medical University Graz, Graz, Austria. Address correspondence and reprint requests to Petra S. Kaimbacher, Department of General Pediatrics, University Clinic of Pediatrics and Adolescence Medicine, Medical University Graz, Auenbruggerplatz 30/ 4, A-8036 Graz, Austria (e-mail: petra.kaimbacher@stud.medunigraz.at). The authors report no conflicts of interest. Copyright # 2011 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition DOI: 10.1097/MPG.0b013e318228d7bb ORIGINAL ARTICLE:HEPATOLOGY AND NUTRITION JPGN  Volume 53, Number 5, November 2011 553