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Biomedical subjects

Steven B Heymsfield

Publications and source records attributed to Steven B Heymsfield.

88 records · Page 5Linked to original sources
PubMed2002

Quantitative prediction of body diameter in severely obese individuals.

The prevalence of obesity and severe obesity continues to increase in the developed world. Apart from obesity's strong association with a variety of health conditions, severely obese individuals (i.e. > or = 300 lb [136 kg]) sometimes have difficulty with ambulation, and often cannot use regular sized clothes, furniture, and assistive devices such as walkers and wheelchairs. The purpose of this study was to assess the relationship between linear body measurements (anthropometry) and weight in severely obese people in order to generate equations to predict such measurements from weight alone. Various body size measurements were obtained from three independent data sets (74 severely obese individuals evaluated at the New York Obesity Research Center, 103 severely obese individuals who participated in the National Center for Health Statistics' National Health and Nutrition Examination Survey III, and a further 90 severely obese individuals evaluated at the New York Obesity Research Center). Linear regression analyses revealed that for each increase of 10 kg (22.04 lb) above 136 kg (300 lb), body diameter measurements increase by 0.9-1.1 cm. These analyses provide body size-to-weight estimates that may help manufacturers develop products and services that are more appropriate for increasing numbers of severely obese individuals.

Adolescent↗
PubMed2002

DXA: potential for creating a metabolic map of organ-tissue resting energy expenditure components.

OBJECTIVE: This study tested the hypothesis that tissue-organ components can be derived from DXA measurements, and in turn, resting energy expenditure (REE) can be calculated from the summed heat productions of DXA-estimated brain, skeletal muscle mass (SM), adipose tissue, bone, and residual mass (RM). RESEARCH METHODS AND PROCEDURES: Subjects were divided into five groups of adults <50 years of age. The specific metabolic rate of RM was developed in 13 Group I healthy subjects and a DXA-brain mass prediction formula in 52 Group II subjects. SM, adipose tissue, and bone models were developed based on earlier reports. The composite REE prediction model (REEp) was tested in 154 Group III subjects in whom REEp was compared with measured REE (REEm). Features of the developed model were determined in 94 normal-weight men and women (Group IV) and seven spinal cord injury patients and healthy matched controls (Group V). RESULTS: REEp and REEm in Group III were highly correlated (y = 0.85x + 233; r = 0.82, p < 0.001), and no bias was detected. Both REEm (mean +/- SD, 1,579 +/- 324 kcal/d) and REEp (1,585 +/- 316 kcal/d) were also highly correlated (r values = 0.85 to 0.98; p values < 0.001) and provided similar group values to REE estimated by the Harris-Benedict equations (1,597 +/- 279 kcal/d) and Wang's composite fat-free mass-based REE equation (1,547 +/- 248 kcal/d). New insights into the sources and distribution of REE were provided by analysis of the demonstration groups. DISCUSSION: This approach offers a new practical and educational opportunity to examine REE in subject groups using modeling strategies that reveal the magnitude and distribution of fundamental somatic heat-producing units.

Absorptiometry, Photon↗
PubMed2002

Association of lean tissue and fat mass with bone mineral content in children and adolescents.

OBJECTIVES: There has been uncertainty in the adult body composition literature about whether fat mass (FM) or fat free mass is a better predictor of bone mineral content and bone mineral density. This issue has recently also been raised in the pediatric literature. Based on suggested skeletal muscle-bone relationships, this study tested the hypothesis that in children and adolescents lean tissue mass (LTM) is a better predictor of total bone mineral content (TBMC) than is FM. RESEARCH METHODS AND PROCEDURES: Subjects were 133 Italian children and adolescents, 5 to 17 years of age, undergoing a routine medical screen. FM (kilograms), LTM (kilograms), and TBMC (kilograms) were measured by DXA. Multiple regression analyses tested the independent association of FM and LTM with bone mineral content. RESULTS: Regression analyses, adjusting for pubertal status and other covariates, showed that FM and LTM were independently associated with TBMC. These associations were similar for boys and girls. TBMC was more strongly associated with LTM than FM. DISCUSSION: These observations support the hypothesis that in children and adolescents a close association exists between LTM, a measure of skeletal muscle, and skeletal characteristics.

Absorptiometry, Photon↗
PubMed2002

Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability.

OBJECTIVES: To establish the prevalence of sarcopenia in older Americans and to test the hypothesis that sarcopenia is related to functional impairment and physical disability in older persons. DESIGN: Cross-sectional survey. SETTING: Nationally representative cross-sectional survey using data from the Third National Health and Nutrition Examination Survey (NHANES III). PARTICIPANTS: Fourteen thousand eight hundred eighteen adult NHANES III participants aged 18 and older. MEASUREMENTS: The presence of sarcopenia and the relationship between sarcopenia and functional impairment and disability were examined in 4,504 adults aged 60 and older. Skeletal muscle mass was estimated from bioimpedance analysis measurements and expressed as skeletal muscle mass index (SMI = skeletal muscle mass/body mass x 100). Subjects were considered to have a normal SMI if their SMI was greater than -one standard deviation above the sex-specific mean for young adults (aged 18-39). Class I sarcopenia was considered present in subjects whose SMI was within -one to -two standard deviations of young adult values, and class II sarcopenia was present in subjects whose SMI was below -two standard deviations of young adult values. RESULTS: The prevalence of class I and class II sarcopenia increased from the third to sixth decades but remained relatively constant thereafter. The prevalence of class I (59% vs 45%) and class II (10% vs 7%) sarcopenia was greater in the older (> or = 60 years) women than in the older men (P <.001). The likelihood of functional impairment and disability was approximately two times greater in the older men and three times greater in the older women with class II sarcopenia than in the older men and women with a normal SMI, respectively. Some of the associations between class II sarcopenia and functional impairment remained significant after adjustment for age, race, body mass index, health behaviors, and comorbidity. CONCLUSIONS: Reduced relative skeletal muscle mass in older Americans is a common occurrence that is significantly and independently associated with functional impairment and disability, particularly in older women. These observations provide strong support for the prevailing view that sarcopenia may be an important and potentially reversible cause of morbidity and mortality in older persons.

Activities of Daily Living↗
PubMed2002

Use of a Durnin-Womersley formula to estimate change in subcutaneous fat content in HIV-infected subjects.

BACKGROUND: HIV-infected individuals may develop malnutrition or lipodystrophy, leading to losses of subcutaneous adipose tissue (SAT). OBJECTIVE: We compared the ability of a Durnin-Womersley formula for total adipose tissue (TAT) to estimate change in SAT with the use of whole-body magnetic resonance imaging (MRI) as a criterion measure. DESIGN: We analyzed data from 2 clinical trials: a prospective randomized trial of protein supplements, progressive resistance training, or combined treatment in 29 malnourished, HIV-positive women, and a prospective open-label trial of recombinant human growth hormone in 25 HIV-infected subjects with visceral adipose tissue (VAT) accumulation. Changes in fat by the Durnin-Womersley formula and in SAT, TAT, and VAT by MRI were compared by linear regression, and Bland-Altman analyses were used to assess the agreement between the prediction and criterion methods. The repeatability of the Durnin-Womersley measurement was evaluated in 14 weight-stable, healthy adults studied twice within 1 y. RESULTS: At baseline, Durnin-Womersley fat was significantly associated with SAT (r(2) = 0.75, P < 0.001) and TAT (r(2) = 0.79, P < 0.001) but not with VAT. Change in Durnin-Womersley fat was significantly associated with change in SAT (r(2) = 0.66, P < 0.001) and in TAT (r(2) = 0.57, P < 0.001) but not in VAT. The limits of agreement for the Durnin-Womersley estimation of change in SAT were -3.4 to 2.6 kg and the SEE was 1.5 kg. The SEE for repeated measures of SAT in healthy control subjects was 0.84. CONCLUSIONS: The Durnin-Womersley formula can be used to predict change in SAT. The limits of agreement and the SEE for predicting change in SAT by MRI are approximately twice as great as the error of repeated Durnin-Womersley measures in control subjects.

Adipose Tissue↗
PubMed2002

Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat.

BACKGROUND: It is unknown whether the ability of waist circumference (WC) to predict health risk beyond that predicted by body mass index (BMI) alone is explained in part by the ability of WC to identify those with elevated concentrations of total or abdominal fat. OBJECTIVE: We sought to determine whether BMI and WC independently contribute to the prediction of non-abdominal (total fat - abdominal fat), abdominal subcutaneous, and visceral fat. DESIGN: Fat distribution was measured by magnetic resonance imaging in 341 white men and women. Multiple regression analysis was performed to measure whether the combination of BMI and WC explained a greater variance in non-abdominal, abdominal subcutaneous, and visceral fat than did BMI or WC alone. These fat depots were also compared after a subdivision of the cohort into 3 BMI (normal, overweight, and class I obese) and 3 WC (low, intermediate, and high) categories according to the classification system used to identify associations between BMI, WC, and health risk. RESULTS: Independent of age and sex, the combination of BMI and WC explained a greater variance in non-abdominal, abdominal subcutaneous, and visceral fat than did either BMI or WC alone (P < 0.05). For non-abdominal and abdominal subcutaneous fat, BMI was the strongest correlate; thus, by adding BMI to WC, the variance accrued was greater than when WC was added to BMI. However, when WC was added to BMI, the added variance explained for visceral fat was greater than when BMI was added to WC. Furthermore, within each of the 3 BMI categories studied, an increase in the WC category was associated with an increase in visceral fat (P < 0.05). CONCLUSIONS: BMI and WC independently contribute to the prediction of non-abdominal, abdominal subcutaneous, and visceral fat in white men and women. These observations reinforce the importance of using both BMI and WC in clinical practice.

Abdomen↗
PubMed2002

Total-body skeletal muscle mass: estimation by a new dual-energy X-ray absorptiometry method.

BACKGROUND: Skeletal muscle (SM) is an important body-composition component that remains difficult and impractical to quantify by most investigators outside of specialized research centers. A large proportion of total-body SM is found in the extremities, and a large proportion of extremity lean soft tissue is SM. A strong link should thus exist between appendicular lean soft tissue (ALST) mass and total-body SM mass. OBJECTIVE: The objective was to develop prediction models linking ALST estimated by dual-energy X-ray absorptiometry (DXA) with total-body SM quantified by multislice magnetic resonance imaging in healthy adults. DESIGN: ALST and total-body SM were evaluated with a cross-sectional design in adults [body mass index (in kg/m(2)) < 35] with an SM-prediction model developed and validated in model-development and model-validation groups, respectively. The model-development and model-validation groups included 321 and 93 ethnically diverse adults, respectively. RESULTS: ALST alone was highly correlated with total-body SM (model 1: R(2) = 0.96, SEE = 1.63 kg, P < 0.001), although multiple regression analyses showed 2 additional predictor variables: age (model 2: 2-variable combined R(2) = 0.96, SEE = 1.58 kg, P < 0.001) and sex (model 3: 3-variable combined R(2) = 0.96, SEE = 1.58 kg, P < 0.001). All 3 models performed well in the validation group. An SM-prediction model based on the SM-ALST ratio was also developed, although this model had limitations when it was applied across all subjects. CONCLUSION: Total-body SM can be accurately predicted from DXA-estimated ALST, thus affording a practical means of quantifying the large and clinically important SM compartment.

Absorptiometry, Photon↗
PubMed2002

Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds.

BACKGROUND: Waist circumference (WC) is strongly linked to obesity-associated risks. However, currently proposed WC risk thresholds are not based on associations with obesity-related risk factors but rather with body mass index (BMI; in kg/m(2)). OBJECTIVE: The objective was to determine the relations of WC to obesity-associated risk factors in a representative sample of US whites and to derive comparable risk thresholds for WC and BMI. DESIGN: Data on 9019 white participants of the third National Health and Nutrition Examination Survey were divided into 2 groups according to the presence of >or= 1 of 4 obesity-associated risk factors: low HDL cholesterol, high LDL cholesterol, high blood pressure, and high glucose. Odds ratio (OR) equations were derived from logistic regression models for WC and BMI with the use of the 25th percentile in the study population as the reference. Receiver operating characteristic curves for identifying risk factors were computed for WC and BMI. RESULTS: At BMIs of 25 and 30, ORs were 1.19 (95% CI: 1.06, 1.35) and 2.37 (95% CI: 1.33, 4.22) for men and 1.56 (95% CI: 1.29, 1.91) and 3.16 (95% CI: 1.94, 5.28) for women, respectively. The corresponding ORs for WC were at 90 and 100 cm for men and at 83 and 93 cm for women. Minima on the receiver operating characteristic curves for men were at 96 cm for WC and at 26 for BMI and for women were at 86 cm for WC and 25 for BMI. CONCLUSION: WC is more closely linked to cardiovascular disease risk factors than is BMI.

Body Constitution↗
PubMed2002

Multicomponent methods: evaluation of new and traditional soft tissue mineral models by in vivo neutron activation analysis.

BACKGROUND: Practical and accurate methods for quantifying the soft tissue mineral component of multicomponent fat-estimation models are needed. OBJECTIVES: The aims were to develop a new complete model for estimating soft tissue minerals based on measured total body water (TBW) and extracellular water (ECW) and a simplified new model based on TBW measurements only and to compare these estimates with those determined with 2 traditional models (ie, the Brozek and Selinger models) and with criterion estimates based on in vivo neutron activation (IVNA) analysis. DESIGN: The subjects were 156 healthy adults and 50 patients with AIDS. Total body potassium, sodium, chlorine, and calcium were measured by IVNA; TBW by (3)H(2)O or D(2)O dilution; ECW by bromide dilution; and bone mineral by dual-energy X-ray absorptiometry. RESULTS: The mean (+/- SD) mass of total-body soft tissue minerals in healthy adults was 467 +/- 62 g with the IVNA model, 492 +/- 62 g with the new model, and 487 +/- 59 g with the simplified new model. Compared with the IVNA model, the complete and simplified new models overestimated soft tissue minerals by 5.4% and 4.6% (both P < 0.001), respectively. In contrast, the Brozek and Selinger models overestimated overall mean soft tissue minerals by 35% and 99% (both P < 0.001), respectively. Overall results for soft tissue mineral prediction with the 2 new models were less satisfactory for the patients with AIDS, although the results were better than those with the traditional models. CONCLUSIONS: The physiologically formulated complete new model for estimating soft tissue minerals provides the opportunity to upgrade the accuracy of current multicomponent models for estimating total body fat.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Application of simple anthropometry in the assessment of health risk: implications for the Canadian Physical Activity, Fitness and Lifestyle Appraisal.

Incremental improvements in our knowledge of the associations between human body composition and disease have been facilitated by advances in research technology. Magnetic resonance imaging and computerized tomography are among the technological advances that have helped unravel the mechanisms that link body composition and disease. However, because the use of these methods in large-scale studies and field settings is impractical, the potential relationships between body composition and health risk rely on the use of anthropometric tools. Indeed, the application of simple anthropometry to identify relationships between body composition and health risk in clinical practice is no less valuable than the use of advanced technologies to gain insight into the mechanistic links between body composition and disease in the laboratory. Accordingly, the purpose of this review is to summarize current knowledge regarding the ability of anthropometry to predict health risk and to act as surrogate measures of total and abdominal fat distribution. Because the ultimate objective is to make recommendations for revision to the Healthy Body Composition section of the Canadian Physical Activity, Fitness and Lifestyle Appraisal (CPAFLA) manual, we focus on those anthropometric methods specific to CPAFLA. Consistent with this objective, when necessary we present original data to reinforce important concepts not suitably addressed in the literature.

Abdomen↗
PubMed2002

Body-size dependence of resting energy expenditure can be attributed to nonenergetic homogeneity of fat-free mass.

An enduring enigma is why the ratio of resting energy expenditure (REE) to metabolically active tissue mass, expressed as the REE/fat-free mass (FFM) ratio, is greater in magnitude in subjects with a small FFM than it is in subjects with a large FFM. This study tested the hypothesis that a higher REE/FFM ratio in subjects with a small body mass and FFM can be explained by a larger proportion of FFM as high-metabolic-rate tissues compared with that observed in heavier subjects. REE was measured by indirect calorimetry, FFM by dual-energy X-ray absorptiometry (DEXA), and tissue/organ contributions to FFM by whole body magnetic resonance imaging (MRI) in healthy adults. Four tissue heat-producing contributions to FFM were evaluated, low-metabolic-rate fat-free adipose tissue (18.8 kJ/kg), skeletal muscle (54.4 kJ/kg), and bone (9.6 kJ/kg); and high-metabolic-rate residual mass (225.9 kJ/kg). Initial evaluations in 130 men and 159 women provided strong support for two key, developed models, one linking DEXA FFM with MRI FFM estimates and the other linking REE predicted from the four MRI-derived components with measured REE. There was an inverse association observed between measured REE/FFM and FFM (r(2) = 0.17, P < 0.001). Allometric models revealed a similar pattern of tissue change relative to body mass across males and females with greater proportional increases in fat-free adipose tissue and skeletal muscle than in FFM and a smaller proportional increase in residual mass than in FFM. When examined as a function of FFM, positive slopes were observed for skeletal muscle/FFM and pooled low-metabolic-rate components, and a negative slope for residual mass. Our linked REE-body composition models and associations strongly support the hypothesis that FFM varies systematically in the proportion of thermogenic components as a function of body mass and FFM. These observations have important implications for the interpretation of between-individual differences in REE expressed relative to metabolically active tissue mass.

Adult↗
PubMed2002

Low dose leptin administration reverses effects of sustained weight-reduction on energy expenditure and circulating concentrations of thyroid hormones.

Maintenance of a reduced body weight is associated with decreased 24-hour energy expenditure, and decreased circulating concentrations of leptin and thyroid hormones. To determine whether these adaptive metabolic and endocrine changes are partly leptin-mediated, we measured body composition, aspects of energy expenditure, and circulating concentrations of leptin and thyroid hormones in 4 subjects at 3 time points: 1.) Usual body weight; 2.) While stable at 10% reduced body weight; and 3.) During a 5-week period at 10% reduced body weight while receiving twice per day leptin injections that restored 8 AM circulating leptin concentrations to those seen at usual body weight. During maintenance of a 10% reduced body weight, circulating T3, T4, and leptin concentrations were decreased. All of these endocrine changes were reversed by administration of "replacement" doses of leptin (r-metHuLeptin). Indirect calorimetry, and subtle changes in body composition associated with leptin administration, were used to calculate the net change in stored calories and in 24-hour energy expenditure. Total energy expenditure increased in all subjects during r-metHuLeptin administration. These data indicate that decrease leptin concentrations resulting from loss of fat mass account for some aspects of the endocrine/metabolic phenotype associated with the weight-reduced state.

Adult↗
PubMed2002

Bone density and amenorrhea in ballet dancers are related to a decreased resting metabolic rate and lower leptin levels.

Osteopenia, which is correlated with amenorrhea and poor nutritional habits, has been well documented in elite ballet dancers. Estrogen replacement therapy and recovery from amenorrhea have not been associated with normalization of bone density. Thus, the osteopenia may be related to changes brought about by chronic dieting or other factors, such as a hypometabolic state induced by poor nutrition. The purpose of this study was to investigate the relationship of chronic dieting and resting metabolic rate (RMR) to amenorrhea and bone density. RMR, bone density, eating disorder assessments, leptin levels, and complete menstrual and medical histories were determined in 21 elite ballet dancers and in 27 nondancers (age, 20-30 yr). No significant correlations were found between high EAT26 scores, a measure of disordered eating, and RMR, bone densities, body weight, body fat, or fat-free mass. However, when RMR was adjusted for fat-free mass (FFM), a significant positive correlation was found between RMR/FFM and bone density in both the arms (P < 0.001) and spine (P < 0.05) in ballet dancers, but not in the normal controls. The dancers also demonstrated significantly higher EAT scores (22.9 +/- 10.3 vs. 4.1 +/- 2.4; P < 0.001) and lower RMR/FFM ratios (30.0 +/- 2.2 vs. 32.05 +/- 2.8; P < 0.01). The only variable to predict lower RMR/FFM in the entire sample was ever having had amenorrhea; this group had significantly higher EAT scores (18.0 +/- 13.5 vs. 10.3 +/- 10.2; P < 0.05), lower leptin levels (4.03 +/- 0.625 vs. 7.10 +/- 4.052; P < 0.05), and lower bone mineral density in the spine (0.984 +/- 0.11 vs. 1.10 +/- 0.13; P < 0.05) and arm (0.773 +/- 0.99 vs. 0.818 +/- 0.01; P < 0.05). We hypothesize that the correlation between low RMR and lower leptin levels and bone density may be more strongly related to nutritional habits in ballet dancers, causing significant depression of RMR, particularly for those with a history of amenorrhea.

Adult↗
PubMed2002

Project Grow-2-Gether: a study of the genetic and environmental influences on child eating and obesity.

"Project Grow-2-Gether" is a child nutrition study of same-sex, 3- to 7-year-old monozygotic and dizygotic twin pairs. The study attempts to bridge two bodies of literature that have rarely interfaced with respect to obesity and ingestive behavior: the first being behavioral genetic approaches to obesity-related traits, and the second being developmental approaches focusing on parent-child relationships. The overarching aim of Project Grow-2-Gether is to disentangle genetic from potential home-environmental influences on child eating behavior and body fat. This paper reviews the rationale for Project Grow-2-Gether, its procedures, and core phenotypic measurement battery. A focus of the study is acquisition of controlled food intake measurements obtained in the laboratory, measurement of specific home environmental variables, and multi-method evaluation of parent-child feeding relations. Future directions may involve longitudinal assessment of child growth and molecular analyses for specific genes that influence child eating behavior.

Absorptiometry, Photon↗
PubMedDate not supplied

Rhoads Lecture. Heat and life: the ongoing scientific odyssey.

The source of body heat has fascinated philosophers and scientists for millennia. Resting heat production is a major component of human energy requirements in health and disease. This review traces through mankind's attempts to understand the nature of resting heat production in humans and animals and its relationships to body mass and composition. Far from being fully understood, the study of heat production is an area of intense research interest bridging the gap between modern biology and physics.

Body Weight↗