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Relationship among habitual tea consumption, percent body fat, and body fat distribution.

OBJECTIVE: To disclose the possible relationship between habitual tea consumption and changes in total body fat and fat distribution in humans. RESEARCH METHODS AND PROCEDURES: A cross-sectional survey of 1,210 epidemiologically sampled adults (569 men and 641 women) were enrolled in our study. Tea consumption and other lifestyle characteristics were obtained by structured questionnaires. Percent body fat (BF%) was measured using bioelectrical impedance analysis. Body fat distribution was assessed using waist-to-hip ratio (WHR). RESULTS: Among the 1,103 analyzed subjects, 473 adults (42.9%) consumed tea once or more per week for at least 6 months. The habitual tea drinkers were male-dominant, more frequently current smokers, and alcohol or coffee drinkers than the nonhabitual tea drinkers. Habitual tea drinkers for more than 10 years showed a 19.6% reduction in BF% and a 2.1% reduction in WHR compared with nonhabitual tea drinkers. The multiple stepwise regression models revealed that men, older age, higher BMI, and current smokers were positive factors for BF% and WHR. In contrast, longer duration of habitual tea consumption and higher total physical activity were negative factors for BF%. Longer duration of habitual tea consumption, higher socioeconomic status, and premenopausal status were negative factors for WHR. DISCUSSION: An inverse relationship may exist among habitual tea consumption, BF%, and body fat distribution, especially for subjects who have maintained the habit of tea consumption for more than 10 years.

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Associations of body fat distribution, circulating sex hormones, and bone density in postmenopausal women.

The associations of body fat distribution, sex hormone levels, and bone mineral density (BMD) were examined in 52 postmenopausal Caucasian women. Body fat distribution was assessed by waist to hip ratio (WHR) and abdominal fat weight (between the iliac crest and L1), as determined by dual energy x-ray absorptiometry. Bone mineral densities were determined by dual energy x-ray absorptiometry, and total estradiol, total testosterone, and sex hormone-binding globulin (SHBG) levels were determined by RIA. Subjects taking hormone replacement had significantly greater total estradiol and SHBG concentrations and a lower free androgen index. BMDs tended to be higher in subjects taking estrogen replacement after adjustment for body weight. There was no difference between subjects taking hormone replacement or not taking hormone replacement in WHR or abdominal fat weight. Subjects with a gynoid (lower body) distribution of body fat had higher SHBG concentrations than subjects with a more android (upper body) distribution of body fat. Subjects with an android distribution of body fat had greater BMDs than subjects with a gynoid distribution of body fat. Abdominal fat weight and WHR were significant predictors in regression models for all BMD parameters. The results of this study suggest that there is an association between body fat distribution and BMD, with the android distribution having higher BMDs.

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Urinary catecholamines, plasma insulin and environmental factors in relation to body fat distribution.

The relationship of body fat distribution to insulin and the catecholamines, hormones that affect lipolysis differentially by fat site, was examined within an environmental context, including factors of medication use, physical activity, dietary intake, educational attainment, and age. Four cross-sectional body fat areas (cm2) were determined by three computed tomography (CT) scans (subcutaneous chest fat at the level of the nipples, subcutaneous and intra-abdominal fat at the level of the umbilicus, and subcutaneous left mid-thigh fat) in 191 second-generation Japanese-American men aged 45-74 years. The site-specific fat measurements were first examined in relation to use of beta-adrenergic antagonists, then to fasting plasma insulin and C-peptide levels and to urinary epinephrine and norepinephrine levels from a 24-h urine collection made during usual daily activities. Greater fat stores in the intra-abdominal area, even after adjustment for body mass index (BMI, weight/height2) and presence of coronary heart disease, were found to be related to use of beta-adrenergic antagonists. In men taking no adrenergic antagonists (n = 157), after adjustment for BMI, truncal fat measurements of the chest (partial r = -0.16, P less than 0.05) and intra-abdominal area (partial r = -0.21, P less than 0.05) were found to be inversely related to epinephrine, and intra-abdominal fat (partial r = 0.25, P less than 0.01) alone was directly related to fasting plasma insulin. With respect to other environmental variables, the significant inverse relationship of intra-abdominal fat (adjusted for BMI) with physical activity (partial r = -0.17, P less than 0.05) and the significant difference in intra-abdominal fat by educational attainment (college 102.3 +/- 5.7 vs no college 115.7 +/- 6.1 cm2, P = 0.03) became non-significant with adjustment, using multiple regression analysis, for insulin in the case of physical activity and epinephrine in the case of educational attainment. Thus, intra-abdominal fat showed a unique set of relationships to metabolic parameters which could be further related to certain environmental variables.

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Precedence of the shift of body-fat distribution over the change in body composition after menopause.

AIM: This study investigated the sequence of certain phenomena after menopause: decrease in bone mineral density (BMD), change in body composition (lean and fat components), and the shift toward upper body fat distribution. METHODS: Subjects were 188 postmenopausal women aged 50-65 years old. They were divided into four subgroups based on 4-year increments in age. Regularly menstruating women (n = 51) aged 50-53 years old served as controls. Age, height, weight, and years since menopause were recorded. Body fat mass, percentage of body fat (%fat), lean body mass (LBM), lumbar spine (L2-4), total body BMD, and the trunk-leg fat mass ratio were measured by dual-energy X-ray absorptiometry. RESULTS: In postmenopausal women (n = 42) aged 50-53 years, BMD was lower compared to age-matched controls (P < 0.05), while other variables did not differ. Trunk-leg fat mass ratio in women aged 54-57 years or more was significantly higher than that in control. LBM was significantly lower while percentage fat was significantly higher in women aged 58-61 years old or more. CONCLUSION: An initial event during the menopausal process is BMD loss, which is followed by body fat distribution shift, then LBM loss and reciprocal increase in body fat mass.

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Sodium-lithium countertransport and body fat distribution.

The relationship between erythrocyte sodium-lithium countertransport (Na-Li CT) and body fat distribution is analyzed in a sample (n = 101) of normotensive and untreated hypertensive men participating in an epidemiological study of coronary heart disease risk factors. Na-Li CT is significantly and positively associated with both subscapular skinfold and waist to hip ratio, but not with triceps skinfold. The univariate correlation between Na-Li CT and blood pressure is diminished when adjusted for body mass index and waist to hip ratio. These findings support the existence of an association between Na-Li CT and central body fat distribution and suggest that the metabolic abnormalities associated with centrally distributed body fat could explain, at least in part, the association between Na-Li CT and blood pressure. The maximal velocity of the sodium-lithium countertransport (Na-Li CT) in erythrocytes has been reported to be directly associated with blood pressure and hypertension in numerous reports from both clinical and epidemiological studies. In most of these studies, indices of weight and/or adiposity (body mass index, in particular) have been shown to be among the most important correlates of Na-Li CT. Adiposity is an important determinant of blood pressure, and there is evidence suggesting that the patterning of the fat cells in the body is linked to a number of metabolic disturbances that could lead to hypertension and an increase in other CHD risk factors. The present report analyses the relationship between Na-Li CT and body fat distribution in a sample of normotensive and untreated hypertensive men participating in an epidemiological study.

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Menopause-related changes in body fat distribution.

Menopause-related changes in body fat distribution may partially explain the greater risk of cardiovascular and metabolic disease during the postmenopausal years. To date, however, the effect of the menopause transition on body fat distribution remains unclear. Cross-sectional and longitudinal studies using waist circumference or the waist-to-hip ratio show no effect of menopause on body fat distribution. By contrast, studies using dual-energy X-ray absorptiometry showed increased trunk fat in postmenopausal women. Moreover, studies using computed tomography (CT) and magnetic resonance imaging (MRI) show that postmenopausal women have greater amounts of intra-abdominal fat compared to premenopausal women. Collectively, these studies suggest that the menopause transition is associated with an accumulation of central fat and, in particular, intra-abdominal fat. Whether menopause-related differences in trunk or intra-abdominal fat are independent of age and/or adiposity, however, is unclear. Thus, we recently examined the effect of menopausal status on body composition and abdominal fat distribution in 53 middle-aged, premenopausal women (47 +/- 3 years) and 28 early postmenopausal women (51 +/- 4 years). Postmenopausal women had 36% more trunk fat (p < 0.01), 49% greater intra-abdominal fat area (p < 0.01), and 22% greater subcutaneous abdominal fat area (p < 0.05) than premenopausal women. The menopause-related difference in intra-abdominal fat persisted (p < 0.05) after statistical adjustment for age and fat mass, whereas no differences were noted in trunk or abdominal subcutaneous fat. A similar pattern of differences in trunk, subcutaneous, and intra-abdominal fat was observed in subsamples of pre- and postmenopausal women matched for age or fat mass. Our data and that of others suggest that early postmenopausal status is associated with a preferential increase in intra-abdominal fat that is independent of age and total adiposity. Thus, CT and MRI should be used when examining menopause-related changes in body fat distribution.

Absorptiometry, Photon↗

Plasma leptin levels and body fat distribution.

The relation between body fat distribution and plasma leptin levels in the human was investigated in 51 obese and 41 non-obese subjects. Plasma levels of leptin showed a positive correlation with body mass index and subcutaneous fat area at the umbilicus level. However, a significant correlation between its plasma levels and visceral fat area was found in neither non-obese nor obese subjects. These results suggest that plasma leptin levels might be attributed mainly to the extent of subcutaneous adiposity in human obesity.

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BMI and objectively measured body fat and body fat distribution in prepubertal children.

BACKGROUND: Body Mass Index (BMI) is often used as a surrogate estimate of body fat in epidemiological studies. This study explores the association between BMI, body fat and body fat distribution assessed by Dual-Energy X-Ray Absorptiometry (DXA) in younger children. METHODS: Cross-sectional study of 246 children (138 boys and 108 girls) aged 8-11 years. DXA was used to quantify abdominal fat mass (AFM), total body fat (TBF) and also total body fat as percentage of total body mass (BF%). Body fat distribution was calculated as AFM/TBF. RESULTS: We found close correlations between BMI vs. TBF, BF% and AFM (r = 0.94, r = 0.92 and r = 0.93) for boys and (r = 0.95, r = 0.92 and r = 0.95) for girls, respectively (P<0.05 for all r-values). However, significantly lower correlation (P<0.001 for difference between the r-values) existed for body fat distribution (r = 0.64 for boys and 0.73 for girls). CONCLUSION: Percentage body fat, TBF and AFM were all closely associated with BMI, suggesting that BMI serves as a good surrogate marker for obesity in population studies. However, a significantly lower correlation existed for BMI vs. body fat distribution, which may be a limitation when BMI is used to study cardiovascular risk factors in epidemiological studies.

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Discriminating glucose tolerance status by regions of interest of dual-energy X-ray absorptiometry. Clinical implications of body fat distribution.

OBJECTIVE: To determine whether measuring body fat distribution by dual-energy X-ray absorptiometry (DEXA) can be used to discriminate glucose tolerance status. RESEARCH DESIGN AND METHODS: Using a 75-g oral glucose tolerance test, a total of 1,015 Chinese subjects (559 men and 456 women) were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), or diabetes. Blood pressure and lipid profiles of these subjects were measured. Waist-to-hip ratio (WHR) and DEXA were used to evaluate the varying patterns of body fat distribution among the groups. RESULTS: Body fat distribution, as reflected by WHR and the centrality index, showed significant partial correlation coefficients with glycosylated hemoglobin, blood pressure, and lipid profiles in all subjects. After adjusting for age and BMI, there were significant differences among the three glycemic groups for all the cardiovascular risk factors except for total cholesterol level. The diabetic group had a significantly higher WHR and centrality index, but lower femoral fat percentage than the NGT and IGT groups. The diabetic group also showed higher abdominal fat percentage than the NGT group. Moreover, the IGT group had a higher centrality index than the NGT group. However, no significant differences were found in the percentage of lean tissue mass among the three groups. Using multiple stepwise logistic regression models, the centrality index remained a significant factor for discriminating different glucose tolerance status independent of the percentage total body fat. CONCLUSIONS: Central obesity has shown significant correlation with cardiovascular risk factors among the three different glycemic groups. Centrality index measured by DEXA appears to be the better predictor of glucose intolerance, compared with WHR, abdominal fat, and general obesity (reflected by percentage total body fat or BMI) in a large cohort of the Chinese population.

Absorptiometry, Photon↗

Genetic and environmental influences on body fat distribution, fasting insulin levels and CVD: are the influences shared?

Central body fat distribution has been shown to be related to hyperinsulinemia, insulin resistance, hypertriglyceridemia, and atherosclerosis to a greater degree than general obesity. There are known to be both genetic and environmental effects on all components of this clustering. Whether these genetic effects are due to one set of genes in common to the components or whether genetic influences on insulin resistance and/or general/abdominal fatness 'turn on' other genes that affect other components of the syndrome is not clear. We analyzed data from the Swedish Adoption/Twin Study of Aging (60% female; monozygotic = 116, dizygotic = 202; average age 65 years) to determine whether there were genetic and/or environmental factors shared among general body fat distribution, abdominal body fat distribution, fasting insulin levels and cardiovascular disease. We found additive genetic effects in males to be significantly different from those in females with genetic effects accounting for variance in waist-hip ratio (males = 28%; females = 49%), body mass index (males = 58%; females = 73%), fasting insulin levels (FI) (males = 27%; females = 49%), and cardiovascular disease (CVD) (males = 18%; females = 37%). There were also shared genetic and environmental effects among all the variables except CVD, but a majority of the genetic variance for these measures was trait specific.

Abdomen↗

Which measure of body fat distribution is best for epidemiologic research among adolescents?

Body fat distribution is a cardiovascular health risk factor in adults. The development of body fat distribution patterns in childhood remains to be explored and the appropriate index and relations of body fat distribution to cardiovascular risk factors in children is not clear. Data are available from the US Health Examination Survey (1966-1970), which included measurements of skinfold thickness, body and limb circumferences, biologic maturity, and risk factors (blood pressure, total cholesterol). Using canonical correlation analysis, the relation between sets of anthropometric variables and risk factors was explored, controlling for age, race, sex, and maturity stage. The relation of various body fat distribution and fatness indices used in adult studies to the risk factors was also explored using stepwise regression and partial correlation analyses. The first canonical correlations were significant between risk factors and both sets of anthropometric variables (skinfolds, 0.36-0.46; circumferences, 0.39-0.54). However, neither method revealed a clear cut pattern suggesting a role of centralized fatness. Rather, body fatness or size appeared to be the major correlate with risk factors in both races (black, white) and sexes and in each maturity status group. In the stepwise regression analysis, a body fatness or "size" variable (e.g., body mass index, hip circumference) invariably entered on step one. Only among the sexually mature did body fat distribution indices enter on the second step in a consistent manner. No one index seemed "better," although indices based on skinfold measures entered more often than the waist/hip ratio.

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Cardiovascular risk factors in obese children in relation to weight and body fat distribution.

To assess the relationship between obesity and body fat distribution with cardiovascular risk factors in children, various measures of obesity and waist-to-hip circumference ratio (WHR) were related to serum lipids, lipoproteins, apolipoproteins, glucose, insulin, uric acid, systolic (SBP) and diastolic blood pressure (DBP). In boys univariate analysis revealed an association of triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), the ratio ApoAI/ApoB, cholesterol/HDL-C, glucose and insulin to WHR. SBP and DBP and serum uric acid correlated with all measures of obesity [body mass index (BMI), percent overweight, percent body fat, skinfolds], but not with WHR. In girls lipid parameters (triglycerides, LDL-C, HDL-C, HDL2, ApoAI, ApoB) and atherogenic ratios correlated with measures of obesity and WHR. Glucose, insulin, SBP and DBP showed the highest correlation with WHR (r = 0.598, p less than 0.001 and r = 0.713, p less than 0.001). Multivariate analysis in girls revealed a first step dependency of ApoAI, the ratio cholesterol/ApoAI, insulin, SBP and DBP on WHR, triglycerides, HDL-C, LDL-C and the ratio ApoAI/ApoB, a first step dependency on percent body fat mass. In boys triglycerides, ApoB and the ratio ApoAI/ApoB were related to WHR for insulin, SBP and DBP, but a positive association with the WHR was found, explaining 33, 21.8, and 22.6% of the variance. This study demonstrates that cardiovascular risk factors in obese children are related to obesity and body fat distribution. Obese children with predominantly abdominal fat mass show a risk profile that is less favorable than gluteal-femoral fat distribution. Evaluation of body fat distribution in obese children, therefore, may help to identify persons most susceptible to cardiovascular risk in adulthood.

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Improved insulin sensitivity and body fat distribution in HIV-infected patients treated with rosiglitazone: a pilot study.

The insulin-sensitizing drugs thiazolidinediones (TZDs), such as rosiglitazone, improve insulin sensitivity and also promote adipocyte differentiation in vitro. The authors hypothesized that TZDs might be beneficial to patients with HIV disease to improve insulin sensitivity and the distribution of body fat by increasing peripheral fat. The ability of rosiglitazone (8 mg/d) to improve insulin sensitivity (from hyperinsulinemic-euglycemic clamp) and to improve body fat distribution (determined from computed tomography measurements of visceral adipose tissue [VAT] and subcutaneous adipose tissue [SAT]) was determined in 8 HIV-positive patients. Before treatment, the insulin sensitivity of the patients was reduced to approximately 34% of that in control subjects. The rate of glucose disposal during a hyperinsulinemic-euglycemic clamp (Rd) was 3.8 +/-.4 (SEM) mg glucose/kg lean body mass/min compared with 11.08 +/- 1.1 (p<.001) in healthy age- and body mass index (BMI)-matched control subjects. After rosiglitazone treatment of 6 to 12 weeks, Rd increased to 5.99 +/-.9 (p=.02), an improvement of 59 +/- 22%. SAT increased by 23 +/- 10% (p=.05), and, surprisingly, VAT was decreased by 21 +/- 8% (p=.04) with a trend for increased SAT/VAT that failed to reach statistical significance. There were no significant changes in blood counts, viral loads, or CD4 counts with rosiglitazone treatment. The study demonstrates that rosiglitazone therapy improves insulin resistance and body fat distribution in some patients with HIV disease.

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Contribution of breast volume and weight to body fat distribution in females.

Breast volume and body composition were measured in 45 adult females to determine the contribution of breast weight and breast volume to total body fat. Plaster casts were filled with sand of known density to obtain breast volume. Breast weight was computed as breast volume times its density. The correlation between total breast volume and percent body fat was r = .40. Breast weight (mean = 484 grams) accounted for 3.5 percent of the total weight of body fat, and at most, 12 percent of the estimated quantities of sex-specific fat. A theoretical model is proposed for the distribution of body fat in the female which subdivides total body fat into three components: reserve storage fat, essential fat, and expendable storage fat.

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Relationship between anthropometric indices of body fat distribution and basal energy metabolism in healthy Maltese women.

A sample taken from a population (Maltese) with a high incidence of the metabolic complications of central obesity was studied to determine: (1) whether the standard Schofield equations adequately predict the basal metabolic rate (BMR) in this population; (2) whether the Maltese have a greater tendency for central obesity compared with other populations; (3) whether the distribution of body fat influences energy expenditure and fuel selection. Healthy women responding to a public advertisement were sampled randomly from the Maltese population. Correlation analysis and analysis of variance were used to study relationships between BMR and body composition. Anthropometric parameters (including body fat distribution indices, bioimpedance) and BMR were measured after an overnight fast. Six percent of the respondent were excluded because of recent illness, instability of diet or of body weight. Fifty subjects attended a clinic at the Medical School. The distribution of excess fat between central and peripheral areas in the Maltese population was similar to that reported for the British population. The Waist-hip ratio (WHR) reflected neither basal heat production (BMR) nor the contribution of fat oxidation to BMR. The Schofield equations systematically underestimated BMR by 5.4% +/- 0.86% (P < 0.05). The study suggests a limitation in using the Schofield equations for predicting BMR in the female Maltese population studied. It also suggests that the fat distribution between central and peripheral areas in this population has no effect on BMR.

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Body fat distribution and osteoarthritis.

The association of body fat distribution with single and combined site osteoarthritis was investigated using data from the US Health Examination Survey I, 1960-1962 (HES I) and the first National Health and Nutrition Examination Survey I, 1971-1975 (NHANES I). The study included 1,636 adults aged 35-79 years from HES I with hands and feet radiographs and four anthropometric fat distribution measures--subscapular and triceps skinfolds, waist girth, and seat breadth--and 3,885 adults aged 45-74 from NHANES I with knee radiographs and subscapular and triceps skinfold measures. Sex-specific data, adjusted for age, race, and body mass index, were analyzed using polychotomous logistic regression. There was a positive association of body mass index with knee osteoarthritis and with combined hands and feet osteoarthritis. A peripheral body girth pattern was associated with combined site osteoarthritis of the hands and feet; however, there was no consistent pattern of association of body fat distribution with knee osteoarthritis nor with osteoarthritis of the hands or feet only. These findings suggest that the central body fat pattern observed in previous studies to be associated with cardiovascular and gallbladder disease, and with diabetes, is not associated with osteoarthritis of the hands, feet, or knees.

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Indices of obesity and body fat distribution in arteriographically defined coronary artery disease in men.

Anthropometric measurements descriptive of obesity, body fat distribution and body build were made in 186 males undergoing diagnostic coronary arteriography. Using stepwise multiple logistic regression analysis, two indices of body fat distribution were independently associated with coronary disease, while the widely used indices of obesity, namely body mass index and percentage body fat, were not. A significant association with disease was found for the ratio of waist to thigh circumferences (waist/thigh ratio), which emerged in the first step of the multivariate model (p < 0.005). The ratio of waist to hip circumferences (waist/hip ratio), a widely used index of body fat distribution, was found to have a negative association with disease (p < 0.05). This study suggests that use of body fat distribution indices may assist in the assessment of the risk factor profile of cardiac patients.

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Body fat distribution patterns and blood pressure in black and white women.

The prevalence of obesity and being overweight and the distribution of body fat in relation to blood pressure were assessed in a college population of 181 black and white US women and 124 black Nigerian women. The mean ages ranged from 18.6 to 22.4 years. Twenty-nine percent of black US women were overweight and 12.9% were obese; whereas 13.6% of white US women were overweight and 2.3% were obese. Only 18.6% of Nigerians were overweight and 1.6% were obese. More upper body fat was found among the black US women and Nigerians than among white US women. There was no significant correlation between body fat distribution and blood pressure among Nigerians. In general, among US blacks and whites, there were positive associations among body mass index, waist-hip girth measurements, and blood pressure, particularly for systolic blood pressure.

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