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Biomedical subjects

E M Evans

Publications and source records attributed to E M Evans.

At least 19 recordsLinked to original sources

Is the current BMI obesity classification appropriate for black and white postmenopausal women?

OBJECTIVE: To evaluate the relation between body fatness (%Fat) and body mass index (BMI) and to evaluate the validity of the BMI standards for obesity established by the NIH in older black and white postmenopausal women. RESEARCH METHODS: Height, weight, BMI, and %Fat, assessed by DXA, were determined for 296 healthy, independently living women ranging in age from 50 to 80 years (M+/-s.d.; 64.4+/-7.8 years). RESULTS: Per NIH guidelines, 32% were classified as obese (> or = 30 kg/m2, mean BMI = 28.1+/-5.5 kg/m2). In contrast, using the %Fat criterion of 38% advocated by Lohman to define obesity, 47% of our sample was obese (mean %Fat=37.3+/-6.2%). A moderately high curvilinear relation existed between BMI and %Fat (R = 0.82, SEE = 3.57 %Fat, P<0.05). Race added meaningfully to the prediction of %Fat (P<0.05) such that for the same BMI, black women will have 1% lower body fatness than white women. Based on a %Fat > or = 38 as the criterion for obesity, receiver operating characteristic (ROC) analysis, performed separately by race, indicated that the currently accepted BMI cutpoint for obesity produced low sensitivity (69% and 61% for black and white women, respectively). Alternatively, BMI values > or = 28.4 kg/m2 for black women and > or = 26.9 kg/m2 for white women to define obesity maximized classification accuracy. CONCLUSION: We conclude that current BMI categories may not be appropriate for identifying obesity among postmenopausal women. Furthermore, the relation between BMI and %Fat is different in black compared to white women but remains constant from the sixth through the eighth decade of life.

Absorptiometry, Photon↗

Use of packaged entrees as part of a weight-loss diet in overweight men: an 8-week randomized clinical trial.

AIM: This study assessed the efficacy of a weight-loss diet by using packaged portion-controlled entrees vs. a self-selected diet based on the United States Department of Agriculture Food Guide Pyramid (FGP). METHODS: Sixty healthy overweight men (body mass index (BMI) 26-42 kg/m2; aged 24-60 years) were randomized into two groups for an 8-week intervention. Group E consumed two portion-controlled entrees daily, plus recommended servings from the FGP. Group P consumed a self-selected diet consisting of a recommended number of servings from the FGP. Diets were designed to be isocaloric (1700 kcal) and identical in macronutrient composition (55% carbohydrate, 25% protein and 20% fat). Participants were instructed to make no changes in physical activity levels. Each group was blinded to the protocol of the other group, and received separate diet instructions, but no behavioural or diet counselling. Outcomes included weight, BMI, body composition by dual energy X-ray absorptiometry, waist and hip circumference, blood pressure (BP), fasting blood lipids, glucose, insulin and C-reactive protein. RESULTS: Fifty-one men completed the study. The portion-control group E (n = 25) experienced greater decreases in weight (-7.4 +/- 3.1 vs. -5.1 +/- 4.0 kg), BMI (-2.4 +/- 1.0 vs. -1.6 +/- 1.3 kg/m2), fat mass (-3.6 +/- 1.8 vs. -2.5 +/- 1.8 kg), waist circumference (-6.6 +/- 3.3 vs. -4.3 +/- 2.9 cm) and diastolic BP (-6.0 +/- 7.2 vs. + 0.2 +/- 10.1 mmHg) than group P (n = 26) (p < 0.05). Consumption of a packaged entree diet resulted in greater losses of weight and fat mass, and reduced BP. CONCLUSIONS: Use of packaged entrees as part of a weight-loss diet is an effective means of achieving portion control and enhancing losses of weight and fat mass in overweight men.

Adult↗

'Disappearing diabetes'--resolution of apparent Type 1 diabetes in a patient with AIDS and cytomegalovirus (CMV) infection.

A 30-year-old African female with established acquired immunodeficiency syndrome (AIDS) and no history of diabetes, presented in severe diabetic ketoacidosis (DKA). Blood pH was 6.96, serum bicarbonate 5 mmol/l, plasma glucose (PG) 33.0 mmol/l, and urine heavily positive for ketones. She responded to standard treatment and was established on twice-daily subcutaneous insulin. Four months later her insulin was stopped because of hypoglycaemic attacks on small doses. A glucose tolerance test (GTT) at 6 months postdiagnosis was normal (fasting PG 4.4 mmol/l and 2 h PG 7.5 mmol/l), and at 12 months random PG was 4.1 mmol/l and HbA1c 4.3%. The onset of her apparent Type 1 diabetes coincided with an HIV-associated cytomegalovirus (CMV) infection, and a reversible 'CMV insulitis' may be an explanation. Alternatively, the patient may have had what has recently been described as 'atypical diabetes' in African or Afro-Caribbean diabetic patients. Here resolution of diabetes may occur after presentation, though complete return to normoglycaemia after true DKA is very unusual.

AIDS-Related Opportunistic Infections↗

Contributions of total and regional fat mass to risk for cardiovascular disease in older women.

The aim of this study was to determine whether trunk fat mass, measured by dual-energy X-ray absorptiometry (DEXA), is predictive of insulin resistance and dyslipidemia, independently of arm and leg fat mass, in postmenopausal women. Total and regional body composition was measured by DEXA in 166 healthy, postmenopausal women (66 +/- 4 yr). Four primary markers of insulin resistance and dyslipidemia were assessed: 1) area under the curve for the insulin (INS(AUC)) response to an oral glucose tolerance test (OGTT), 2) product of the OGTT glucose and insulin areas (INS(AUC)xGLU(AUC)), 3) serum triglycerides (TG), and 4) high-density lipoprotein (HDL)-cholesterol. Trunk fat mass was the strongest independent predictor of each of the primary dependent variables. In multivariate regression models, trunk fat mass was associated with unfavorable levels of INS(AUC), INS(AUC)xGLU(AUC), TG, and HDL-C, whereas leg fat mass was favorably associated with each of these variables. Thus trunk fat is a strong independent predictor of insulin resistance and dyslipidemia in postmenopausal women, whereas leg fat appears to confer protective effects against metabolic dysfunction.

Abdomen↗

Cognitive and contextual factors in the emergence of diverse belief systems: creation versus evolution.

The emergence and distribution of beliefs about the origins of species is investigated in Christian fundamentalist and nonfundamentalist school communities, with participants matched by age, educational level, and locale. Children (n = 185) and mothers (n = 92) were questioned about animate, inanimate, and artifact origins, and children were asked about their interests and natural-history knowledge. Preadolescents, like their mothers, embraced the dominant beliefs of their community, creationist or evolutionist; 8- to 10-year-olds were exclusively creationist, regardless of community of origin; 5- to 7-year-olds in fundamentalist schools endorsed creationism, whereas nonfundamentalists endorsed mixed creationist and spontaneous generationist beliefs. Children's natural-history knowledge and religious interest predicted their evolutionist and creationist beliefs, respectively, independently of parent beliefs. It is argued that this divergent developmental pattern is optimally explained with a model of constructive interactionism: Children generate intuitive beliefs about origins, both natural and intentional, while communities privilege certain beliefs and inhibit others, thus engendering diverse belief systems.

Adolescent↗

Waist circumference vs body mass index for prediction of disease risk in postmenopausal women.

OBJECTIVE: To test the sensitivity of waist circumference (central adiposity) as an index of disease risk in postmenopausal women. DESIGN: Retrospective analysis of postmenopausal women tested at Washington University School of Medicine. SUBJECTS: A total of 323 healthy postmenopausal (66+/-5 y; mean+/-s.d.) women not using any hormone replacement. MEASUREMENTS: Body composition, hyperinsulinemia (insulin area), triglycerides and HDL-cholesterol. RESULTS: Excess waist size had a stronger association with hyperinsulinemia and hypertriglyceridemia than body mass index (BMI; kg/m(2)) in otherwise healthy, postmenopausal women. After adjusting for BMI, a strong relation existed between waist circumference and insulin area, HDL-cholesterol and triglycerides (P<0.01). Conversely, after adjusting for waist circumference, no relation was apparent between BMI and the dependent variables of interest. The strength of the association between waist circumference and disease risk became most apparent when analyses were restricted to normal-weight women (BMI 24--28 kg/m(2)). When BMI was held constant, hyperinsulinemia and triglyceridemia increased dose-dependently with changes in waist size. CONCLUSION: Waist circumference, an easily obtained index of central adiposity, is a more sensitive measure of relative disease risk than is BMI in middle-aged and older women, particularly in normal-weight individuals.

Adipose Tissue↗

Body composition estimates from multicomponent models using BIA to determine body water.

PURPOSE: The purpose of this study was to compare estimates of body fat (%BF) from three- and four-component models with total body water (TBW) determined by single-frequency bioelectrical impedance analysis (BIA; %BF3C-BIA and %BF4C-BIA) to %BF estimates from densitometry (%BF2C-D) and from three- and four-component models with TBW determined using deuterium dilution (%BF3C-D2O and %BF4C-D2O), the criterion methods. METHODS: Measures of body density by hydrostatic weighing, TBW by BIA and D2O dilution, and bone mineral by dual energy x-ray absorptiometry (DXA) were obtained in 40 men and 93 women, 18-42 yr. TBW was estimated from BIA resistance (RJL analyzer) using an equation developed and cross-validated in two independent samples. Body fat was estimated using the three-component model of Siri (1961) and a four-component model modified from Lohman (1986). RESULTS: There was a strong relation and no significant difference between TBW estimated by BIA and D2O [r = 0.94, SEE = 2.4; xDiff = 0.0 +/- 2.4 L (SD), P > 0.05]. There were strong relations between methods for estimating %BF, with deviations from %BF4C-D2O (errors) for %BF3C-BIA [r = 0.99, SEE = 2.4% BF, xDiff = -0.4 +/- 2.4% BF (SD)] and %BF4C-BIA [r = 0.99, SEE = 2.3% BF, xDiff = 0.2 +/- 2.3% BF (SD)] being nonsignificant (P > 0.05) although greater than for %BF3C-D2O [r = 1.00, SEE = 0.5% BF, xDiff = -0.6 +/- 0.5% BF (SD)], and comparable or slightly worse than for %BF2C-D [r = 0.99, SEE = 2.3% BF, xDiff = 0.4 +/- 2.3% BF (SD)]. CONCLUSIONS: We conclude that because estimates of %BF from multicomponent models with TBW estimated from BIA are not more accurate than from body density alone using a two-component model, estimates of %BF from three- and four-component models using TBWBIA are not acceptable substitutes for estimates from the same models using TBWD2O.

Adipose Tissue↗

Use of air displacement plethysmography for estimating body fat in a four-component model.

PURPOSE: To compare measurements of body density (D(b)) obtained from air displacement plethysmography (AP) and hydrostatic weighing (HW) and to determine the accuracy of substituting D(b) via AP (D(b)-AP) for D(b) via HW (D(b)-HW) in estimating body fatness (%Fat(4C)) and the composition and density of the fat-free mass (Dffm) from a four-component model (fat, mineral, water, and protein). METHODS: D(b) was measured in 50 young adults using AP and HW. Total body water via deuterium dilution, bone mineral content via dual-energy x-ray absorptiometry, and D(b) were used to estimate %Fat(4C). RESULTS: D(b)-AP and D(b)-HW were highly correlated (r = 0.89, SEE = 0.008 g x mL(-1)), but D(b)-AP (1.065 +/- 0.003 g x mL(-1)) was significantly higher (P < 0.05) than D(b)-HW (1.058 +/- 0.003 g x mL(-1)), resulting in a mean difference of 2.8%fat. Differences between %Fat(4C-AP) (17.8 +/- 1.2%) and %Fat(4C-HW) (19.3 +/- 1.2%) were significant (P < 0.05), but the SD of the differences (2.3%) was low. When D(b)-AP was used in a four-component model in place of D(b)-HW, the calculated Dffm was significantly higher (1.109 +/- 0.002 vs 1.105 +/- 0.002 g x mL(-1)) based on a higher (P < 0.05) protein fraction (22.0 +/- 0.4% vs 20.6 +/- 0.4%) and lower (P < 0.05) water (71.1 +/- 0.4% vs 72.4 +/- 0.4%) and mineral fractions (7.0 +/- 0.1% vs 7.1 +/- 0.1%). CONCLUSIONS: AP yields a higher D(b) than HW and may not be a valid method for measuring D(b) or estimating %fat using densitometry. However, due to relatively small bias and low individual error, D(b)-AP is an acceptable substitute for D(b)-HW when estimating %fat with a four-component model in young adults.

Adipose Tissue↗

Congenital tuberculosis presenting as sepsis syndrome: case report and review of the literature.

We report an infant with congenital tuberculosis who presented with fulminant septic shock, disseminated intravascular coagulation and respiratory failure. Aggressive resuscitation and supportive care and prompt initiation of antituberculosis medications led to resolution of the shock state. We reviewed six other cases with a similar presentation. Congenital tuberculosis should be in the differential of the infant presenting acutely with sepsis syndrome.

Diagnosis, Differential↗

Muscularity and the density of the fat-free mass in athletes.

The purpose of this study was to use estimates of body composition from a four-component model to determine whether the density of the fat-free mass (D(FFM)) is affected by muscularity or musculoskeletal development in a heterogenous group of athletes and nonathletes. Measures of body density by hydrostatic weighing, body water by deuterium dilution, bone mineral by whole body dual-energy X-ray absorptiometry (DXA), total body skeletal muscle estimated from DXA, and musculoskeletal development as measured by the mesomorphy rating from the Heath-Carter anthropometric somatotype were obtained in 111 collegiate athletes (67 men and 44 women) and 61 nonathletes (24 men and 37 women). In the entire group, D(FFM) varied from 1.075 to 1.127 g/cm3 and was strongly related to the water and protein fractions of the fat-free mass (FFM; r = -0.96 and 0.89) and moderately related to the mineral fraction of the FFM (r = 0.65). Skeletal muscle (%FFM) varied from 40 to 68%, and mesomorphy varied from 1.6 to 9.6, but neither was significantly related to D(FFM) (r = 0.11 and -0.14) or to the difference between percent fat estimated from the four-component model and from densitometry (r = 0.09 and -0.16). We conclude that, in a heterogeneous group of young adult athletes and nonathletes, D(FFM) and the accuracy of estimates of body composition from body density using the Siri equation are not related to muscularity or musculoskeletal development. Athletes in selected sports may have systematic deviations in D(FFM) from the value of 1.1 g/cm3 assumed in the Siri equation, resulting in group mean errors in estimation of percent fat from densitometry of 2-5% body mass, but the cause of these deviations is complex and not simply a reflection of differences in muscularity or musculoskeletal development.

Adipose Tissue↗

Effects of HRT and exercise training on insulin action, glucose tolerance, and body composition in older women.

The independent and combined effects of exercise training and hormone replacement therapy (HRT) on body composition, fat distribution, glucose tolerance, and insulin action were studied in postmenopausal women, aged 68 +/- 5 yr, assigned to control (n = 19), exercise (n = 18), HRT (n = 15), and exercise + HRT (n = 16) groups. The exercise consisted of 2 mo of flexibility exercises followed by 9 mo of endurance exercise. HRT was conjugated estrogens 0.625 mg/day and trimonthly medroxyprogesterone acetate 5 mg/day for 13 days. Total and regional body composition were measured by dual-energy X-ray absorptiometry. Serum glucose and insulin responses were measured during a 2-h oral glucose tolerance test. There were significant main effects of exercise on reductions in total and regional (trunk, arms, legs) fat mass, increase in leg fat-free mass, and improvements in glucose tolerance and insulin action. There were significant main effects of HRT on the reduction of total fat mass (HRT, -3.0 +/- 4.0 kg; no HRT, -1.3 +/- 2.6 kg), with a strong trend for reductions in trunk and leg fat mass (both P = 0.07). There was also a significant improvement in insulin action in response to HRT. These results suggest that there are independent and additive effects of exercise training and HRT on the reduction in fat mass and improvement in insulin action in postmenopausal women; the effect of HRT on insulin action may be mediated, in part, through changes in central adiposity.

Adipose Tissue↗

Relation of bone mineral density and content to mineral content and density of the fat-free mass.

Differences in the mineral fraction of the fat-free mass (M(FFM)) and in the density of the FFM (D(FFM)) are often inferred from measures of bone mineral content (BMC) or bone mineral density (BMD). We studied the relation of BMC and BMD to the M(FFM) and D(FFM) in a heterogeneous sample of 216 young men (n = 115) and women (n = 101), which included whites (n = 155) and blacks (n = 61) and collegiate athletes ( n = 132) and nonathletes (n = 84). Whole body BMC and BMD were determined by dual-energy X-ray absorptiometry (DXA; Hologic QDR-1000W, enhanced whole body analysis software, version 5.71). FFM was estimated using a four-component model from measures of body density by hydrostatic weighing, body water by deuterium dilution, and bone mineral by DXA. There was no significant relation of BMD to M(FFM) (r = 0.01) or D(FFM) (r = -0.06) or of BMC to M(FFM) (r = -0.11) and a significant, weak negative relation of BMC to D(FFM) (r = -0.14, P = 0.04) in all subjects. Significant low to moderate relationships of BMD or BMC to M(FFM) or D(FFM) were found within some gender-race-athletic status subgroups or when the effects of gender, race, and athletic status were held constant using multiple regression, but BMD and BMC explained only 10-17% of the variance in M(FFM) and 0-2% of the variance in D(FFM) in addition to that explained by the demographic variables. We conclude that there is not a significant positive relation of BMD and BMC to M(FFM) or D(FFM) in young adults and that BMC and BMD should not be used to infer differences in M(FFM) or D(FFM).

Absorptiometry, Photon↗

Use of fluorogenic histocompatibility leukocyte antigen-A*0201/HPV 16 E7 peptide complexes to isolate rare human cytotoxic T-lymphocyte-recognizing endogenous human papillomavirus antigens.

Cervical cancer (CaCx) is the second most common female malignancy worldwide and remains a clinical problem despite improvements in early detection and therapy. CaCx and preinvasive cervical intraepithelial neoplasia (CIN3) are strongly associated with infection by human papillomavirus (HPV), particularly types 16 and 18. Two nonstructural viral proteins, E6 and E7, are constitutively expressed in cervical tumors and are crucial for the maintenance of the transformed phenotype. These proteins thus provide attractive targets for immunotherapy of CaCx mediated by CD8+ CTLs. However, reliable detection and generation of HPV-specific CTLs in humans has been difficult. Recently, soluble fluorogenic MHC-peptide complexes (tetramers) have greatly increased the sensitivity of antiviral and antitumor CTL detection. To examine the feasibility of this approach for detecting HPV-specific CTLs, we constructed a tetramer consisting of HLA-A*0201 and the best studied HPV CTL peptide epitope, HPV 16 E711-20. Between 2 and 12% of short-term HPV 16 E711-2 CTL lines derived from CaCx patients stained highly with the tetramer. Direct ex vivo staining of peripheral blood mononuclear cells revealed CD8+ tetramer+ high cells at low frequencies in both CIN3 patients (1 of 1,260 to 1 of 19,073) and normal controls (1 of 1,855 to 1 of 42,004). However, short-term in vitro stimulation with the HPV 16 E711-20 peptide expanded CD8+tetramer+ cells to a greater extent in the peripheral blood mononuclear cells from CIN3 patients. Furthermore, the tetramer provided a powerful tool to isolate polyclonal and clonal peptide-specific CTLs from an established HPV 16 E7,11-20-specific CTL line. These purified CTLs were able to lyse both peptide-pulsed targets and targets expressing endogenously processed HPV antigens. This tetramer may therefore be useful for selecting rare high-affinity HPV-specific CTLs for the immunotherapy of CaCx.

Adult↗

Foreigners in a strange land: self-construal and ethnic identity in male Arabic immigrants.

Many authors have emphasized the importance of cultural sensitivity in delivering mental health services to immigrants. Self-construal and ethnic identity are important components of the acculturative process, which may be useful in the diagnosis, assessment, and treatment of immigrant clients. This study investigated the self-construal and ethnic identity of male Arabic immigrants in the United States. Based on pilot interview data and existing measures, a Male Arabic Ethnic Identity Measure (MAEIM) was developed using a sample of 115 male Arabic immigrants. Satisfactory reliability is reported for the overall MAEIM as well as its four factor analytically derived scales, including Religious-Family Values, Sense of Belonging/Ethnic Pride, Friendship, and Ethnic Arabic Practices. Arabs reporting a strong Arabic ethnic identity had a more salient interdependent sense of self than those reporting a weaker ethnic identity. Independent self-construal was not significantly correlated with any of the individual MAEIM scales or the total MAEIM scale. The implications of these findings for research and clinical practice are discussed.

Journal Article↗

Muscle activation and the slow component rise in oxygen uptake during cycling.

PURPOSE: During constant-rate high-intensity exercise, a steady state for oxygen uptake (VO2) is not achieved and, after the initial rapid increase, VO2 continues to increase slowly. The mechanism underlying the slow-component rise in VO2 during high-intensity exercise is unknown. It has been hypothesized that increased muscle use may be a contributing factor, but only limited electromyograph (EMG) data are available supporting this hypothesis. The purpose of this study was to determine whether there is an association between the VO2 slow component and muscle use assessed by contrast shifts in magnetic resonance images (magnetic resonance imaging (MRI)). METHODS: The VO2 slow component was measured in 16 subjects during two 15-min bouts of cycling performed at high and low intensities. EMG and MRI transverse relaxation times (T2) were obtained after 3 and 15 min to determine muscle activity at each intensity. RESULTS: Low-intensity cycling produced no VO2 slow component, and no increases in muscle activity, except for a small increase (P < 0.05) in the T2 of the vastus lateralis. During high-intensity cycling, VO2, T2 of the vastus lateralis, rectus femoris and whole leg, and EMG activity and median power frequency of the vastus lateralis rose significantly (P < 0.05) from 3 to 15 min. Percent increases in VO2 and muscle T2 were related during high-intensity cycling (r = 0.63), but not during low-intensity cycling (r = 0.00). CONCLUSION: We conclude that increased muscle use is in part responsible for the slow component rise in oxygen uptake. The results support the hypothesis that during constant-rate exercise at intensities above lactate threshold, progressively greater use of fast-twitch motor units increases energy demand and causes concomitant progressive increases in VO2 and lactate.

Adult↗

Body-composition changes with diet and exercise in obese women: a comparison of estimates from clinical methods and a 4-component model.

BACKGROUND: Most methods available to clinicians for estimating body-composition changes have been validated against estimates from densitometry, based on a 2-component (fat mass and fat-free mass) model. OBJECTIVE: Estimates of changes in percentage body fat (%BF) from dual-energy X-ray absorptiometry (DXA), skinfold thicknesses (SFTs), bioelectrical impedance analysis (BIA), and body mass index (BMI; in kg/m2) were compared with estimates from a 4-component (fat, water, mineral, and protein) model (%BFd,w,m), a more accurate method. DESIGN: Determinations of body density from hydrostatic weighing, body water from deuterium dilution, bone mineral and %BF from whole-body DXA, resistance from BIA, and anthropometric measures were made in 27 obese women (BMI: 31.1 +/- 4.9) assigned to 1 of 3 groups: control (C; n = 9), diet only (DO; n = 9), or diet plus aerobic exercise (DE; n = 9). RESULTS: After the 16-wk intervention, changes in body mass (BM) averaged 0.5 +/- 2.0, -7.2 +/- 7.4, and -4.0 +/- 3.3 kg and changes in %BFd,w,m averaged 2.1 +/- 1.0%, -1.2 +/- 1.4%, and -2.4 +/- 1.6% in the C, DO, and DE groups, respectively. Compared with changes in %BFd,w,m, the errors (SD of bias) for estimates of changes in %BF by DXA, BIA, SFTs, and BMI were similar (range: +/-2.0-2.4% of BM). BIA, SFTs, and BMI provided unbiased estimates of decreases in %BFd,w,m, but DXA overestimated decreases in %BF in the DO and DE groups. CONCLUSIONS: DXA, BIA, SFTs, and BMI are comparably accurate for evaluating body-composition changes induced by diet and exercise interventions; however, small changes in %BF may not be accurately detected by these clinical methods.

Absorptiometry, Photon↗

Effects of diet and exercise on the density and composition of the fat-free mass in obese women.

PURPOSE: The purpose of this study was to determine whether the density (D(FFM)) and composition of the fat-free mass (FFM) and the accuracy of estimates of body composition from body density (%Fat(d)) are affected by diet and exercise. METHODS: Twenty-nine obese women (body mass index (BMI) = 25.0-43.7 kg x m(-2) and %Fat(d) = 35.7-47.1%) were assigned to one of three groups: diet only (DO, N = 9); diet and aerobic exercise (DE, N = 9); or control (C, N = 11). Measures of body density by hydrostatic weighing, body water by deuterium dilution, and bone mineral by whole-body dual-energy x-ray absorptiometry, and estimates of body composition from body density and from a four-component model were obtained before and after a 16-wk diet and exercise intervention. RESULTS: Mean (+/- SD) changes in body mass were -7.2 +/- 7.4, -3.9 +/- 3.3, and +1.2 +/- 2.8 kg for the DO, DE, and C, respectively. The density and composition of the FFM did not change significantly (P > 0.05) in any of the groups. Individual changes in D(FFM) (-0.011 to +0.011 g x mL(-1)), and differences between changes in %Fat estimated using a four-component model and %Fat(d) (-2.1 to +2.7% body mass) were not related to changes in body mass (r = -0.08). Individual changes in D(FFM) were most strongly related to changes in water fraction (r = -0.95) and protein fraction (r = +0.88), and were unrelated to changes in the mineral fraction (r = +0.04) of the FFM. CONCLUSIONS: We conclude that in obese women, the density and composition of the FFM are unaltered and densitometry correctly assesses group mean changes in body composition with moderate weight loss induced by diet or diet and aerobic exercise. However, individual deviations in D(FFM) from the assumed value of 1.1 g x mL(-1) are substantial, and a multi-component model in which body water is measured is needed to accurately assess individual body composition changes resulting from diet and exercise.

Adult↗

Impact of bone mineral estimates on percent fat estimates from a four-component model.

PURPOSE: The primary purpose of this study was to determine the impact of bone mineral content (BMC) from QDR 1000/W and DPX-L dual-energy x-ray absorptiometers (DXA(QDR) and DXA(DPX-L) on percent fat (%fat) estimates from a four-component model. A secondary purpose was to test the accuracy of %fat estimates from DXA(QDR) and DXA(DPX-L) using %fat estimates from a four-component model as the criterion. METHODS: Percent fat, fat mass, and fat-free mass (FFM) were determined from DXA(QDR) and DXA(DPX-L) and from a four-component model based on measures of body density from underwater weighing, body water from deuterium dilution, and BMC from DXA(QDR) (4C(QDR)) or DXA(DPX-L) (4C(DPX-L)) in young men (N = 14) and women (N = 10). RESULTS: BMC was significantly lower using DXA(QDR) compared with DXA(DPX-L) (approximately 11%), resulting in slightly lower estimates of %fat and fat mass and slightly higher estimates of FFM from 4C(QDR) than 4C(DPX-L). Although estimates of %fat, fat mass, and FFM from DXA(QDR) and DXA(DPX-L) were not different than those from a four-component model, there was considerable individual variability between methods. Furthermore, %fat from DXA(QDR) was lower than %fat from 4C(DPX-L). CONCLUSIONS: We conclude that using BMC from different DXA instruments has a minimal impact on %fat, fat mass, and FFM estimates from a four-component model. The large variability in %fat estimates between the two DXA instruments and those from a four-component model does not support DXA as a criterion method of body composition. Further studies involving larger sample sizes and specific population groups are needed to assess the validity of body composition measurements from DXA.

Absorptiometry, Photon↗