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Plasma lipids and apoproteins, body fat distribution and body fatness in early pubertal children.

Besides body fatness, the body fat distribution is associated with coronary risk in adults, but little has been reported on this aspect in children. This study describes body fatness, body fat distribution (waist-to-hip ratio, WHR) and the plasma lipid and apoprotein profile (TC, HDL-C, LDL-C, TG, apo A-I and apo B) in 60 boys (age 10.8 +/- 0.1 year; mean +/- s.e.m.) and 64 girls (age 10.2 +/- 0.1 year), all caucasian. To avoid interference by the large changes in plasma sex hormone levels during puberty, only pre- and early pubertal children (Tanner stages of genital c.q. breast development 1 or 2) participated. Physical and sports activity was scored in hours per week using a questionnaire. The boys were taller than the girls (146.2 +/- 0.7 vs 143.2 +/- 0.9 cm; ANOVA, P less than or equal to 0.05) and their WHR was larger (0.88 +/- 0.01 vs 0.83 +/- 0.01; ANOVA, P less than or equal to 0.05). The boys spent 8.0 +/- 0.4 hours weekly on physical and sports activities, the girls 5.5 +/- 0.3 (ANOVA, P less than or equal to 0.05). The plasma lipid and apoprotein profiles were similar in both groups. Body fatness was significantly associated with the lipid and apoprotein profile, although in different ways in boys and girls. In boys there was a relationship with TG (r = 0.49), with apo B (r = 0.33) and with the apo A-I to apo B ratio (r = -0.24); in girls with TG (r = 0.25), HDL-C (r = -0.39), apo A-I (r = -0.28) and with the HDL-C to TC ratio (r = -0.31); P less than 0.05 for all correlations. A regional component of the subcutaneous fatmass, assessed by the partial correlations of the individual skinfold thicknesses with the plasma lipid and apoprotein profile after controlling for body fatness, was lacking in these early and prepubertal children. The WHR was associated with TC (r = 0.35), LDL-C (r = 0.32), apo B (r = 0.36) and with apo A-I/apo B (r = -0.34) in the girls after controlling for body fatness. Although closer investigation into the validity of the WHR as a measure of fat distribution in children is needed, the tentative conclusion is that in pre- and early pubertal girls the WHR has an impact on the plasma lipid and apoprotein profile similar to that seen in adults. It is suggested that in boys these relationships develop later in puberty.

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Body mass index as an estimate of body fat.

Body mass index (BMI) was compared with percentage body fat (%Fat) measured by dual energy X-ray absorptiometry (DXA) in 233 adolescent schoolgirl volunteers and 179 adult female patients. Repeat measurements were made on 67 of the adolescents and 51 of the adults. The correlations between BMI and %Fat were established from the 300 adolescent measurements and the 230 adult measurements. Although highly significant relationships were found between BMI and %Fat, only 58% of the variance in %Fat in adolescents and 66% in adults could be predicted by BMI. At the 95% confidence levels, a BMI of 20 kg m-2 can correspond to a range of 18-33% body fat in adolescents and 13-32% in adults. Without any change in BMI, an adolescent's percentage fat can change by as much as -3% to +7%. For an individual adult the same BMI can correspond to changes in fat of +/-5%. Since the strength of prediction of percentage body fat from BMI is poor, caution should be exercised in its use for eating disorders research.

Absorptiometry, Photon↗

Percentage of body fat and body mass index are associated with mobility limitations in people aged 70 and older from NHANES III.

OBJECTIVES: To assess the association between functional limitations and body composition indices, including percentage of body fat, muscle mass, and body mass index (BMI). DESIGN: A cross-sectional, population-representative sample. SETTING: All noninstitutionalized people living in the United States (National Health and Nutrition Examination Survey). Data were collected between 1988 and 1994. PARTICIPANTS: One thousand five hundred twenty-six women and 1,391 men aged 70 and older. MEASUREMENTS: Independent variables included BMI, muscle mass, and percentage of body fat; the latter two were assessed using predictive equations. The dependent variable, functional limitations, was defined as difficulty in performing at least three of five functional living tasks, such as carrying a 10-pound bag of groceries. RESULTS: Women in the highest quintile for percentage of body fat and women with a BMI of 30 or greater were two times more likely to report functional limitations than women in the comparison groups. Similar, but weaker, relationships were found among men; men in the highest quintile for body fat and men with a BMI of 35 or greater were 1.5 times more likely to report limitations. Low muscle mass (sarcopenia) and sarcopenia in combination with high percentage of body fat (sarcopenic obesity) were not associated with a greater likelihood of reporting functional limitations. CONCLUSIONS: Prevention of excessive accumulation of body fat and maintenance of a BMI in the normal range may reduce the likelihood of functional limitations in old age.

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Absolute fat mass, percent body fat, and body-fat distribution: which is the real determinant of blood pressure and serum glucose?

Associations of body mass index (BMI), absolute fat mass, percent body fat, and regional fat distribution with concentrations of fasting blood glucose and blood pressure were examined cross-sectionally in 1551 men and women aged 15-79 y from two study centers. Measurements included height, weight, multiple skinfold thicknesses, body density by underwater weighing, and waist and hip girths. Three principal findings emerged: 1) Absolute overall body mass and fat mass were stronger predictors of blood pressure and blood glucose than were relative fat mass, after age, height, and current cigarette-smoking status were adjusted for; 2) when diastolic blood pressure and serum glucose were used as the external validity criteria, densitometry was not a "gold standard" for body composition associated with risk for increased blood pressure and serum glucose; and 3) BMI was as good a predictor of blood pressure and glucose as was any other measure of body fat in nearly all analyses.

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Effects of structured medium- and long-chain triacylglycerols in diets with various levels of fat on body fat accumulation in rats.

The effects of structured medium- and long-chain triacylglycerols (MLCT) in diets containing 50-200 g fat/kg on body fat accumulation were compared with those of long-chain triacylglycerols (LCT) in rats. In rats fed ad libitum, weights of intra-abdominal adipose tissues and carcass fat contents were significantly smaller (P<0.05) in rats fed the 150-200 g MLCT/kg diet than in rats fed 150-200 g LCT/kg diet. Serum and liver triacylglycerol contents were significantly greater (P<0.05) in rats fed 200 g MLCT/kg diet, as were hepatic capacities of citrate synthase and cytochrome oxidase (P<0.05). The effects of MLCT on body fat were also examined in adult rats fed a limited amount of food (approximately 50 % of ad libitum intake). Reduction of body fat deposition during the food restriction was the same between in LCT and MLCT groups. These results suggest that accumulation of body fat was less efficient during long-term feeding of MLCT than LCT in rats fed high-fat diets ad libitum. The effect of MLCT on body fat might be influenced by the dietary fat content or by energy sufficiency.

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Calmodulin activity in whole body and fat body tissue extracts of Heliothis virescens larvae.

Calmodulin is an activator of many enzymatic activities. Total calmodulin activity in tissue extracts of Heliothis virescens larvae (5th instar), assayed by cyclic phosphodiesterase activation, was 0.48 unit/gm for whole body and 22.2 units/gm for fat body. Specific calmodulin activity was 0.1 unit/mg protein for whole body and 3.0 units/mg protein for fat body. The larval fat body is therefore the main site of calmodulin activity in this lepidopterous larva.

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Dietary fat and body fat: a multivariate study of 205 adult females.

This study examined the association between diet composition, particularly dietary fat intake, and body-fat percentage in 205 adult females. Subjects completed a written questionnaire regarding lifestyle factors, such as exercise participation and smoking, demographic data, and the diet section of the National Cancer Institute's Health Habits and History Questionnaire by Block. Skinfold-thickness measures were used to ascertain the body-fat percentage of each subject. Results showed that intake of dietary fat was related significantly with adiposity, without (F = 13.65, R2 = 0.063, P = 0.0003) and with (F = 8.74, R2 = 0.033, P = 0.0035) control for multiple potential confounding factors: age, total energy intake, total exercise time per week, years of regular physical activity, consumption of other macronutrients, and smoking. Unlike dietary fat intake, protein consumption and carbohydrate intake were not significant individual predictors of body-fat percentage when the potential confounding variables were controlled. The findings suggest that dietary fat intake may play a role in obesity beyond dietary energy content.

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Measurement of body fat and hydration of the fat-free body in health and disease.

Body fat mass, fat-free body mass and body water are basic components of body composition which are used in nutritional and metabolic studies and in patient care. A method of measuring total body fat (TBF), fat-free mass (FFM) and its hydration (TBW/FFM) involving prompt gamma in vivo neutron activation analysis (IVNAA) and tritium dilution has been compared with the more traditional methods of densitometry and skinfold anthropometry in 36 normal volunteers, and with skinfold anthropometry in 56 patients presenting for nutritional support. While the mean values of TBF were in reasonable agreement for the three methods in normals it was founds that skinfold anthropometry underestimated TBF relative to the IVNAA/tritium method by, on average, 3.0 kg (19%) in patients. Furthermore, the ranges of values in normals of the ratio TBW/FFM for the anthropometric (0.62 to 0.80) and densitometric (0.65 to 0.80) methods were much wider than the range for the IVNAA/tritium method (0.69 to 0.76), in which TBW was measured by tritium dilution in all cases. In the patients, the ranges of this ratio were 0.52 to 0.90 for the anthropometric method and 0.67 to 0.82 for the IVNAA/tritium method; clearly anthropometry yields values of TBW/FFM which are outside accepted biological limits. On the basis of these findings, ranges of TBW/FFM are suggested for both normal adults (0.69 to 0.75) and patients requiring nutritional support (0.67 to 0.83). Finally it is concluded that the IVNAA/tritium method is a suitable method for measuring TBF and FFM and particularly so when body composition is abnormal.

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Body Mass Index, percent body fat, and regional body fat distribution in relation to leptin concentrations in healthy, non-smoking postmenopausal women in a feeding study.

BACKGROUND: The relationship between BMI and leptin has been studied extensively in the past, but previous reports in postmenopausal women have not been conducted under carefully controlled dietary conditions of weight maintenance using precise measures of body fat distribution. The aim of the present study was to examine the association between serum leptin concentration and adiposity as estimated by BMI and dual energy x-ray absorptiometry (DEXA) measures (percent body fat, central and peripheral fat, and lean mass) in postmenopausal women. METHODS: This study was conducted as a cross-sectional analysis within the control segment of a randomized, crossover trial in which postmenopausal women (n = 51) consumed 0 (control), 15 (one drink), and 30 (two drinks) g alcohol (ethanol)/d for 8 weeks as part of a controlled diet. BMIs were determined and DEXA scans were administered to the women during the 0 g alcohol treatment, and a blood sample was collected at baseline and week 8 of each study period for leptin analysis. RESULTS AND DISCUSSION: In multivariate analysis, women who were overweight (BMI > 25 to < or = 30 kg/m2) had a 2-fold increase, and obese women (BMI > 30 kg/m2) had more than a 3-fold increase in serum leptin concentrations compared to normal weight (BMI < or =25 kg/m2) women. When the models for the different measures of adiposity were assessed by multiple R2, models which included percent body fat explained the highest proportion (approximately 80%) of the serum leptin variance. CONCLUSION: Under carefully controlled dietary conditions, we confirm that higher levels of adiposity were associated with higher concentrations of serum leptin. It appears that percent body fat in postmenopausal women may be the best adiposity-related predictor of serum leptin.

Absorptiometry, Photon↗

Fasting insulin and leptin serum levels are associated with systolic blood pressure independent of percentage body fat and body mass index.

OBJECTIVE: To examine the relationship between leptin and insulin serum levels and systolic and diastolic blood pressure in young men. SETTING: Kobe University of Mercantile Marine, Kobe, Japan. PARTICIPANTS: One hundred and ninety-eight male students aged 18-20 years (comprising 100% of those eligible). DESIGN AND MEASUREMENTS: A cross-sectional survey of a sample of male college students was performed, with measurements to include anthropometry, blood pressure and blood tests after overnight fasting. RESULTS: Compared with 90 men with an optimal blood pressure, 56 men with high-normal and high blood pressure had an increase in body mass index (23.7 +/- 5.2 versus 20.4 +/- 2.2 kg/m2), percentage body fat (21.7 +/- 8.0 versus 16.3 +/- 4.2%) and serum leptin (3.7 +/- 4.7 versus 1.5 +/- 0.8 ng/ml). In addition, they had greater serum insulin (59 +/- 31 versus 43 +/- 12 pmol/l) despite there being no differences in plasma glucose, resulting in a reduction of the ratio of glucose to insulin (x 10(6)) (107 +/- 43 versus 126 +/-, which is an estimate of insulin sensitivity in a nondiabetic population. Furthermore, the 56 men had higher serum triglyceride levels, although there was no difference in low density lipoprotein-cholesterol and high density lipoprotein-cholesterol between men with optimal and high-normal plus high blood pressure. Similar differences were found between men in a top versus low tertile of systolic and diastolic blood pressure. In multiple regression analysis, both log leptin and log insulin emerged as determinants for systolic blood pressure independent of body mass index and percentage body fat, but an association with diastolic blood pressure was only shown for log leptin. CONCLUSION: Hyperleptinemia and hyperinsulinemia may be regulators of arterial pressure, independent of body mass index or percentage body fat.

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Assessment of cutaneous fat and body fat by ultrasound.

A new rapid and simple method is introduced to measure subcutaneous fat and evaluate total body fat. It is based on real-time ultrasound and requires equipment that is used in routine examination of subcutaneous structures, e.g., thyroid gland. Results from seven regions of skin in 100 subjects correlated well with total body weight, Broca's index, and deviation from average weight 0.02 greater than P greater than 0.001). Comparisons were also made with measurements of subcutaneous fat from skinfolds. There was an excellent correlation of values (P less than 0.001 in all experiments), although ultrasound results tended to be slightly higher. For calculation of total body fat, ultrasound values were converted by regression equations to "calculated skinfold thickness"; when applying established mathematical models for calculating body fat from skinfold thickness results were equal in both methods (P greater than 0.1).

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Impact of total body water fluctuations on estimation of body fat from body density.

The purpose was to investigate the possibility that variability in body weight in females due to water retention causes differences in body density (Db) values determined by hydrostatic weighing (HW). Determination of total body water (TBW) and Db were concurrently measured in seven females who experienced considerable fluctuations in body weight (1.5-4.5 kg) and seven males, ages 19-24. Females were measured when they felt they were at their lowest (LO) and highest (HI) body weights (BW) during a menstrual cycle. Males were randomly tested approximately 3 wk apart. Mean values of selected variables were compared in the LO vs HI testing sessions by paired t-tests. Significant mean differences were found in the females (P less than 0.01) for the following variables: BW (kg) (LO = 58.9, HI = 61.1), Db (g.cc-1) (LO = 1.0430, HI = 1.037), and percent body fat (%BF) as determined by HW alone (LO = 24.8%, HI = 27.6%). Variables significant at the P less than 0.05 level were TBW(l) (LO = 33.6, HI = 35.1) and %TBW of the fat-free body (LO = 74.5, HI = 75.9). However, changes in TBW could not entirely account for observed changes in Db. Only mean BW (kg) was significant (P less than 0.01) in the males (LO = 74.3, HI = 74.6). It is concluded that changes in TBW can in part result in significantly different Db values obtained from HW in females who did experience perceptible changes in BW during a menstrual cycle. The remaining differences may be due to changes in fat and protein content or methodological errors.

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The effect of sex, age and race on estimating percentage body fat from body mass index: The Heritage Family Study.

OBJECTIVE: To study the effects of sex, age and race on the relation between body mass index (BMI) and measured percent body fat (%fat). DESIGN: Cross-sectional validation study of sedentary individuals. SUBJECTS: The Heritage Family Study cohort of 665 black and white men and women who ranged in age from 17 to 65 y. MEASUREMENTS: Body density determined from hydrostatic weighing. Percentage body fat determined with gender and race-specific, two-compartment models. BMI determined from height and weight, and sex and race in dummy coded form. RESULTS: Polynomial regression showed that the relationship between %fat and BMI was quadratic for both men and women. A natural log transformation of BMI adjusted for the non-linearity. Test for homogeneity of log transformed BMI and gender showed that the male-female slopes were within random variance, but the intercepts differed. For the same BMI, the %fat of females was 10.4% higher than that of males. General linear models analysis of the women's data showed that age, race and race-by-BMI interaction were independently related to %fat. The same analysis applied to the men's data showed that %fat was not just a function of BMI, but also age and age-by-BMI interaction. Multiple regression analyses provided models that defined the bias. CONCLUSIONS: These data and results published in the literature show that BMI and %fat relationship are not independent of age and gender. These data showed a race effect for women, but not men. The failure to adjust for these sources of bias resulted in substantial differences in the proportion of subjects defined as obese by measured %fat.

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Randomized trial of measures of body fat versus body weight in the treatment of anorexia nervosa.

OBJECTIVE: To determine whether treatment goals based on body weight or body fat assessed by anthropometrics caused a larger reduction in the Eating Disorder Examination (EDE) over 3 months during the treatment of anorexia nervosa (AN). METHODS: Randomized trial comparing the use of body weight versus measures of body fat by anthropometrics, with the EDE as the outcome measure. Of 23 patients enrolled, 11 subjects who met diagnostic criteria for AN (DSM-IV) and received outpatient treatment from the Eating Disorders clinic of a university teaching hospital completed the study. RESULTS: Comparison of the 2 methods by independent t-tests, verified by Mann-Whitney and Sign tests, suggests no difference (p = 0.33). Due to the small sample size, statistical significance could not be assured. A cross-sectional survey of 48 clinic users found the majority of patients preferred to be followed by skinfold measurements and felt they were more helpful than weight. DISCUSSION: Regardless of which measurement is used, if the clinic staff firmly believe that a method is more helpful and more useful, it is likely that the patients will find it acceptable.

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Estimation of body fatness from body mass index and bioelectrical impedance: comparison of New Zealand European, Maori and Pacific Island children.

OBJECTIVE: To compare percentage body fat (%BF) for a given body mass index (BMI) among New Zealand European, Maori and Pacific Island children. To develop prediction equations based on bioimpedance measurements for the estimation of fat-free mass (FFM) appropriate to children in these three ethnic groups. DESIGN: Cross-sectional study. Purposive sampling of schoolchildren aimed at recruiting three children of each sex and ethnicity for each year of age. Double cross-validation of FFM prediction equations developed by multiple regression. SETTING: Local schools in Auckland. SUBJECTS: Healthy European, Maori and Pacific Island children (n=172, 83 M, 89 F, mean age 9.4+/-2.8(s.d.), range 5-14 y). MEASUREMENTS: Height, weight, age, sex and ethnicity were recorded. FFM was derived from measurements of total body water by deuterium dilution and resistance and reactance were measured by bioimpedance analysis. RESULTS: For fixed BMI, the Maori and Pacific Island girls averaged 3.7% lower %BF than European girls. For boys a similar relation was not found since BMI did not significantly influence %BF of European boys (P=0.18). Based on bioimpedance measurements a single prediction equation was developed for all children: FFM (kg)=0.622 height (cm)(2)/resistance+0.234 weight (kg)+1.166, R(2)=0.96, s.e.e.=2.44 kg. Ethnicity, age and sex were not significant predictors. CONCLUSIONS: A robust equation for estimation of FFM in New Zealand European, Maori and Pacific Island children in the 5-14 y age range that is more suitable than BMI for the determination of body fatness in field studies has been developed.

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Density of fat-free body mass: relationship with race, age, and level of body fatness.

The two-compartment body composition method assumes that fat-free body mass (FFM) has a density of 1.100 kg/l. This study tested the hypothesis that FFM density is independent of race, age, and body fatness. Subjects were 703 black and white subjects, ages 20-94 yr, with body mass index (BMI) 17-35 kg/m2. Body composition was assessed using a four-compartment model based on tritium dilution volume, body density by underwater weighing, bone mineral by dual-energy X-ray absorptiometry, and body weight. No relationship was observed between FFM density and race or BMI. A tendency was observed for a lower FFM density only in older white women. The difference in percent body fat (delta fat) between the four-compartment model and underwater weighing was < 2% for all groups. Race, age, and BMI explained only 2.3 (women) and 1.4% (men) of the variance in delta fat, whereas the total body water fraction of FFM explained 77%. In contrast to current thinking, these results show that the assumption of constant FFM density is valid in black, elderly, and obese subjects.

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Dietary fat and body fat: an intervention study.

OBJECTIVE: Assessment of body composition in relation to the habitual diet and after a six month dietary intervention. DESIGN: After a baseline measurement subjects were randomly assigned to either a group consuming reduced-fat products or a group consuming full-fat products for six months. SUBJECTS: 108 women and 109 men, equally distributed over the age range 19-35 with BMI between 21 and 28, and the age range 36-55 with BMI between 24 and 30. MEASUREMENTS: Food intake was measured by three day dietary record, body composition by deuterium dilution. RESULTS: At baseline, explained variance of %body fat on age and fat-carbohydrate ratio in the diet together were 17% (P < 0.0001) and 36% (P < 0.0001) for women and men, respectively, and on diet alone 7-8% (P < 0.01) independent of gender. The diet intervention caused on average a change in fat intake and body fat mass in subjects of the reduced-fat group of -5 +/- 29 g/d (P < 0.05) and -0.1 +/- 2.1 kg (ns), respectively, and of +23 +/- 31 g/d (P < 0.0001) and +0.5 +/- 2.3 kg (P < 0.05) in subjects of the full-fat group. The change in the fat content of the diet was positively related to a change in energy intake (fat-carbohydrate ratio: R2 = 0.15, P < 0.0001; g fat: R2 = 0.70, P < 0.0001), the latter explaining 5% of the variation in the change in body fat mass (P < 0.001). Subjects changing the fat content of the diet showed a consequent change in body fat mass only when energy intake changed as well. CONCLUSION: The fat content of the diet has an effect on body fat as a function of the effect of dietary fat on energy intake.

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