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Relationship between body composition changes and changes in physical function and metabolic risk factors in aging.

PURPOSE OF REVIEW: Several body composition changes are known to occur with aging. The purpose of this review is to evaluate recent literature examining body composition changes with aging and how these relate to changes in physical function and metabolic risk. RECENT FINDINGS: Cross-sectional and longitudinal studies have observed increases in fat mass and decreases in muscle mass or lean tissue mass in older adults, often in the absence of differences or changes in body weight. Cross-sectional studies have also reported increases in intramyocellular lipid and liver fat in older versus younger adults and related changes in body composition with changes in physical function and metabolic risk, but few longitudinal data are available. Furthermore, most longitudinal studies lack precise methods of assessing body fat distribution and muscle and organ quality, resulting in a lack of detailed and precise information on body composition changes with aging and their relationship to health. SUMMARY: Research to date has outlined a need for more detailed body composition measurements of aging adults. Absence of change in a total body compartment may mask a change in subcompartments that may impact health. Furthermore, intervention studies to determine ways to maintain body composition are consistent with healthy living throughout the aging process.

Adipose Tissue↗

Comparison of body composition and somatotype of trained female triathletes.

The body composition and somatotype of 16 trained female triathletes aged 18.8-32.8 years were measured. All of the subjects were engaged in a competitive training programme and participated in the same triathlon. Anthropometric variables included height, mass, selected diameters, girths and skinfolds, and a Heath-Carter anthropometric somatotype. Body composition was determined by hydrostatic weighing procedures and skinfold patterns. Comparisons were made with Olympic swimmers and runners. The triathletes had a mean body mass of 55.2 kg and a mean height of 162.1 cm. When compared to swimmers, the triathletes were somewhat shorter and significantly (P less than 0.005) older. On most other measures, including a balanced mesomorph somatotype of 3.1-4.3-2.6, they were similar to swimmers. This group of triathletes were generally heavier, less lean, more mesomorphic and less ectomorphic than elite runners. Reported body densities from other studies indicated little difference between the triathletes and other groups. Skinfold patterns were similar in shape for all groups, but the runners had smaller values, at all sites, than either swimmers or triathletes. Because of lack of information on cyclists, adequate comparisons were not possible. Regression analysis indicated that training parameters were more important than anthropometric measures in the prediction of performance. It was concluded that this group of triathletes were closer, with respect to both body composition and somatotype, to swimmers than to runners.

Adolescent↗

Impact of the age at menarche on adult body composition in healthy pre- and postmenopausal women.

The present study focuses on the impact of age at menarche on body composition development during adulthood. With 459 healthy middle-class women between 18 and 67 years (x = 41.5) the association between age at menarche and body composition was tested. Body composition, described by absolute and relative amount of fat mass, lean body mass, and bone mass, was estimated by means of dual energy x-ray absorptiometry. In order to exclude the influence of the menopausal transition on body composition, pre- and postmenopausal females were examined separately. The absolute amount of body fat was significantly lower within the group of women whose menarche occurred later. However, postmenopausal females exhibit less significant relations between the two trait systems than premenopausal women. This may be due to the impact of menopausal transition which affected the hormone levels and body composition development independently from the adolescent hormonal transition. While in both proband groups the quantitative amount of body fat was significantly related to menarcheal age, a significant relation between menarcheal age and adult body fat distribution could not be verified.

Adolescent↗

Body composition of neonates from fan beam dual energy X-ray absorptiometry measurement.

BACKGROUND: Fan beam dual energy x-ray absorptiometry (FB DXA) has recently been validated for the measurement of body composition in small subjects. This study represents the first report of body composition (bone mineral content, fat mass, and lean mass) in human neonates measured by FB DXA. METHODS: FB DXA measurements were performed in 73 healthy singleton neonates with mean +/- SD birth weights 3354 +/- 316 g (range, 2720 to 3982 g) and gestational ages 39.5 +/- 1.2 weeks (range, 37 to 42 weeks). There were 26 white (11 male infants, 15 female infants), 42 African American (17 male infants, 25 female infants), and 5 Hispanic (4 male infants, 1 female infant) infants. The predictive ability of physiologic parameters to predict body composition measurements was determined with regression analysis. RESULTS: The mean +/- SD for bone mineral content was 89.3 +/- 14.1 g, fat mass was 485 +/- 14.1 g, and lean mass was 2898 +/- 281.5 g. Weight was significantly correlated with all DXA measurements and was the single best predictor of body composition. Weight alone contributed 32% to 98% of the variance of the DXA measured parameters. Gender, race, and length were additional predictors that could be forced into a predictive equation for selected DXA dependent variables according to statistical significance. An independent gender effect was also demonstrated, with male infants having higher lean mass but lower fat mass. CONCLUSIONS: Our data in human neonates demonstrated the ability of FB DXA to measure body composition. Body weight is the best physiologic predictor of overall body composition. There is also an independent gender effect on soft tissue body composition.

Absorptiometry, Photon↗

The use of body mass index to predict body composition in children.

BACKGROUND: Simple anthropometric indices of body composition have particular appeal for use in children, and as such body mass index (BMI) has been used to predict percentage body fat in a number of studies. AIM: To evaluate the relationship between BMI and percentage body fat (%body fat) and a proposed, more appropriate relationship between BMI and fat mass/height(2) in a cohort of young children. SUBJECTS AND METHODS: Cross-sectional study of 109 children aged between 6 and 10 years residing in either Sydney or Brisbane, Australia. Weight and height were measured using standard methods. Body composition was measured using a stable isotope method to firstly determine total body water and subsequently fat free mass. RESULTS: The correlation between BMI and fat mass/height(2) was markedly greater than that between BMI and percentage body fat. In the entire group of children the R(2) (x100%) value for the relationship between BMI and fat mass/height(2) was 73.3% compared with 46.5% for the relationship between BMI and percentage body fat. CONCLUSIONS: We have shown that the use of BMI to predict fat mass/height(2), and consequently percentage body fat, is superior to the use of BMI to predict percentage body fat based directly upon the R(2) values of the above analysis.

Anthropometry↗

The potential role of dual-energy X-ray absorptiometry in the assessment of body composition in cirrhotic patients.

Very little information is available on body composition in patients with cirrhosis. Difficulties arise in studying these patients because they tend to retain fluid and this results in changes in tissue density and in the hydration fraction of fat-free mass. As the classic body composition techniques rely on the assumption that these variables remain constant, use of these methods will result in either under- or overestimates of body composition variables. Use of multicomponent models, employing two or more measurement techniques, will obviate the need for some of the assumptions inherent in the use of single techniques, thereby increasing the accuracy of the assessments without loss of precision. Dual-energy x-ray absorptiometry can be used to measure total body bone mineral, fat, and fat-free soft tissue mass. In healthy individuals excellent agreement is observed between data obtained using this technique and data obtained from the more established reference methods. However, the degree to which the absorptiometry measurements of soft tissue are sensitive to the hydration is not known. Thus, in order to assess this method of body composition analysis in patients with chronic liver disease, a multicomponent model must be devised which incorporates the absorptiometry technique and allows cross-validation of the individual component measures.

Absorptiometry, Photon↗

Influence of photoperiod and prolactin on body composition and in vitro lipid metabolism in wether lambs.

An experiment was conducted to determine the possible effects of photoperiod and prolactin on the physical and chemical composition of body weight gain. Prolactin was manipulated by im injections of 2-Br-alpha-ergocryptine (CB154) or sc injections of ovine prolactin (oPRL) and by two light:dark regimens (16L:8D and 8L:16D). The four treatments employed were: 1) 16L:8D, placebo injections; 2) 16L:8D, CB154 injections; 3) 8L:16D, placebo injections and 4) 8L:16D, oPRL injections. After a 9-wk growth study, animals were slaughtered at similar body weights over the next 2-wk period. Weight of intestines was directly related and weight of pelt inversely related to circulating concentrations of prolactin. Content of N and lipid in the carcass was not influenced by treatment. However, N content of the noncarcass components was elevated (P less than .01) in animals receiving CB154. In vitro rates of acetate incorporation (nmol X 100 mg tissue-1 X 3 h-1) were higher in subcutaneous than in perirenal adipose tissue (1,920 vs 777; P less than .001). Rates for treatments 1, 2, 3 and 4 were 1,770, 953, 1,350, respectively. The rate for treatment 1 was greater than that for treatments 2 (P less than .001) and 3 (P less than .05). There was no stimulation of lipogenesis in response to insulin added to the incubation medium. In vitro rates of glycerol release (nmol X 100 mg tissue-1 X 2 h-1) were higher in perirenal than in subcutaneous adipose (135 vs 81; P less than .001). The respective treatment rates were 120, 84, 104 and 124, with treatment 1 being greater (P less than .05) than treatment 2. Epinephrine addition elevated glycerol release (156 vs 60; P less than .001). Differences for in vitro lipid metabolism between the perirenal and subcutaneous depots were independent of differences in cell size. Overall, these data indicate that the increased body weight gain due to extended lighting was not accompanied by detrimental effects on carcass composition. Nor was there any clear relationship between circulating concentrations of prolactin and in vitro lipid metabolism.

Adipose Tissue↗

Body composition in HIV-infected women.

Although loss of lean body mass is a common complication of human immunodeficiency virus (HIV) infection that can occur across the disease trajectory, few studies have characterized the body composition of HIV-infected women. We used bioelectrical impedance analysis to characterize the body composition of HIV-infected (n = 56) and uninfected (n = 12) women who were matched on percentage of ideal body weight. The HIV-infected women did not differ from the uninfected women by height-adjusted fat mass or body cell mass. Intergroup comparisons among the HIV-infected women showed that underweight women had significantly less fat mass than did normal-weight women but did not significantly differ with respect to body cell mass. Among all HIV-infected women, CD4(+) lymphocyte count was positively correlated with fat mass (r = 0.32, P = 0.01) but not with body cell mass. No significant correlations were found between any body-composition parameter and plasma viral load. Our findings suggest that, unlike men, HIV-infected underweight women show a preferential loss of fat mass and a relative preservation of body cell mass. This altered pattern of weight loss may relate to higher premorbid fat stores in women and/or hormonal differences.

Adipose Tissue↗

The effect of body composition on hexarelin-induced growth hormone release in normal elderly subjects.

OBJECTIVE: Growth hormone (GH) release is influenced by several factors including age, gender, physical exercise, nutritional status, sex steroids and body composition. The relationship with body composition is complex. Obesity is accompanied by suppression of spontaneous and stimulated GH release. As increasing body fat reduces stimulated GH secretion following a standard provocative test, the potential clinical uses of GH-releasing peptides (GHRPs), therapeutically or diagnostically, may be dependent on the relationship between body fat and GHRP-stimulated GH release. We have therefore assessed the effect of body composition and gender on the GH releasing capacity of hexarelin. DESIGN: A single bolus of subcutaneous hexarelin at a dose of 1.5 micrograms per kg of body weight was administered at time 0. Blood samples were taken at -10, 0, 10, 20, 30, 40, 50, 60, 90, 120, 170 and 180 min. SUBJECTS: Twenty-one (eight male) healthy elderly subjects with a median (range) age of 68 (60-81) years and BMI of 26 (19-30) kg/m2 were studied. METHODS: Dual-energy X-ray absorptiometry (DEXA) was used to assess body composition. RESULTS: Peak GH response correlated negatively with fat mass, BMI, percentage body fat, and weight [r = -0.72, P = 0.0001; r = -0.56, P = 0.009; r = -0.63, P = 0.002 and r = -0.48, P = 0.029, respectively,]. AUC GH correlated negatively with fat mass, BMI and percentage fat mass [r = -0.58, P = 0.006; r = -0.51, P = 0.019 and r = -0.66, P = 0.001 respectively]. Using multiple linear regression, fat mass was the most useful predictor for both peak GH response [R2 = 0.61, P < 0.0001] and AUC GH [R2 = 0.38, P = 0.003]. Gender was not a significant variable. CONCLUSIONS: Increasing total fat mass results in a blunted GH response following subcutaneous hexarelin. Total fat mass appears to be a useful predictor of peak GH response even in normal individuals as none of the subjects in the present study was morbidly obese. This indicates that there is a continuum of effect of fat mass on hexarelin-stimulated GH release. Any impact of gender on the GH response to hexarelin is almost certainly indirect and mediated via differences in body composition. This observation will have an impact on the potential diagnostic and therapeutic uses of hexarelin and related GH secretagogues.

Aged↗

The role of radiologic methods in assessing body composition and related metabolic parameters.

The measurement of body composition and related metabolic parameters has become an important issue in clinical nutrition. Numerous techniques to assess visceral fat, which is strongly associated with metabolic disorders, have been developed. Other techniques focus mainly on the measurement of specific body components related to metabolic disturbances. This paper reviews methods that directly assess body composition and associated metabolic parameters. The principles of these methods and their accuracy, reproducibility and safety, as well as the clinical implications of their use, are discussed. Recent studies have documented the safety and efficacy of radiologic methods of assessing visceral fat, muscle mass, and morphology to obtain body composition data related to metabolic disturbances. Because these techniques have been documented to be safe and effective, clinicians should consider using them in the evaluation and follow-up of patients with various conditions.

Absorptiometry, Photon↗

Low-cost measurement of body composition with 18O-enriched water.

Total body water (TBW) and body composition are crucial for the estimation of nutritional status in many clinical circumstances. While the measurement of TBW with 18O-enriched water is technically easier than with 2H2O, the cost of 10% 18O-enriched water can be regarded as prohibitive. The aim of this study was to prove that less enriched (i.e. 2%) and cheaper (about 25 ECU per dose per subject, i.e. $30) 18O water can be used to measure TBW. In the 41 subjects studied, isotopic equilibrium was achieved 4 hours after the isotope was administered. Plateau enrichments in urine, saliva, and plasma samples did not differ significantly between 5 and 8 hours after the dose. TBW measurements in 8 of these subjects showed no significant differences, regardless of whether 2% or 10% water was used. We conclude that accurate estimates of TBW and body composition can be obtained with low-cost, 2% 18O-enriched water.

Aged↗

Bedside and field methods for assessing body composition: comparison with the deuterium dilution technique.

Estimates of body composition by the deuterium dilution technique were made in 55 healthy subjects (38 men and 17 women) with a mean age of 28.4 years, weight 65.5 kg and height 173.7 cm (body mass index 16.9-29.4 kg/m2). The results were compared with estimates obtained in the same subjects by 5 bedside techniques (skinfold thickness, impedance, resistance and 2 equations predicting body composition from weight and height). The results of all the bedside predictive methods were found to differ significantly from those of the deuterium dilution method (P less than 0.001). The Holtain impedance method underestimated the fat-free mass (FFM) obtained by deuterium dilution (50.8 +/- 7.9 kg) by a mean difference (mean bias) of 4.1 kg while the other methods overestimated FFM (mean bias or mean difference of -1.3 to -2.4 kg). The resistance (Valhalla equations) and skinfold methods showed the narrowest 95 per cent limits of agreement, when compared with the deuterium dilution technique, while the weight and height equations showed the widest limits of agreement. It is concluded that in this population, the resistance (Valhalla equations) and the skinfold thickness methods were the best predictors of body composition as measured by deuterium dilution. Discrepancies between the bedside methods and deuterium dilution method may be due to (a) methodological or biological differences between the test population used in this study and the original population used to validate the method, (b) differences in the structure of the equations used to interpret the measured biological variables, such as impedance and resistance, and (c) the use of predictive equations that are based on different 'reference' methods, such as deuterium dilution or densitometry, and on different assumptions. Predictive equations based on a combination of these reference methods are preferable to those based on single methods.

Adolescent↗

An introduction to body composition models used in nutritional studies.

Chemical analysis of cadavers has led to the definition of 'reference' man but diseases may result in significant changes in body composition. By measuring body composition in patient groups the nature of disease progression can be followed and management regimens evaluated. Various techniques are available which attempt to measure body composition in vivo. Several models of body composition have evolved with the introduction of new measurement techniques. A description of these models is presented. The limitations of the models and the techniques adopted for their measurement are discussed.

Body Composition↗

[Evaluation of the nutritional status through determination of anthropometric parameters: new charts for the working population of Catalonia. Group for the Evaluation of body composition in the population of Catalonia].

BACKGROUND: Body composition measure by anthropometric parameters permits the detection of populations at risk of developing diseases with greater impact in public health and provides standard values of normality of nutritional state. METHODS: A prospective transversal study was carried out with a randomly selected sample of 6,445 individuals taken from 25,279 workers evaluated in Safety and Hygiene Centers during 1990. Chronically ill patients were excluded with 5,019 healthy individuals between 16 and 65 years of age being selected. The following data were obtained: height, weight, skin fold of the biceps and triceps, subscapular and abdominal and arm perimeter. Calculation of the weight/height, weight/height, weight/height, sum of two and four folds, mid-arm muscle circunference, area fo the arm, muscle area of the arm, adipose area of the arm and muscle adipose index was performed. RESULTS: The tables of the percentiles 1, 5, 10, 20, 30, 40, 50, 60, 70, 80, 90, 95, and 99 of the anthropometric parameters according to sex and age are presented. Significant differences were found among the age groups for the fat parameters which were greater from the third decade for the fold of the fat of the trunk in males and from the fourth decade of the fat parameters of the trunk and extremities of females. The muscle parameters successively increased in both sexes and for each age group up to the fourth decade and thereafter remained stable. CONCLUSIONS: The values of the anthropometric parameters may be used as standard patterns of the working population in Catalonia. The differences between sexes and age groups, such as with the values of the Catalan population previously referred and those of the American population, indicate that the anthropometric measurements of body composition must be periodically determined to ensure adequate standards of each population.

Adolescent↗

The menstrual cycle's effect on the reliability of bioimpedance measurements for assessing body composition.

We examined the reliability of resistance (R) and body composition estimates measured by bioelectrical impedance analysis (BIA) in 25 women during their menstrual cycle. Weight and bioimpedance were measured daily for one cycle and sodium intake was assessed. The precision of bioimpedance measures was examined and subjects' average resistance, weight, Na intake, and calculated body composition during the four phases of menses were compared by using paired t tests. Significant differences were observed between phases 1 and 2 for R (p less than 0.001), weight (p less than 0.05), and fat-free mass (p less than 0.05) and differences were observed between phases 2 and 4 for R (p less than 0.05) and weight (p less than 0.05); no significant differences were observed for percent body fat. Changes in body weight (p less than 0.001) associated with Na intake explained a significant proportion of error in resistance measures. These data suggest the reliability of the BIA body composition approach during menses; small weight changes related to hydration status may, however, be a confounding influence.

Adipose Tissue↗

Age- and gender-related changes in body composition in Japanese subjects.

Age-dependent changes in body composition, namely a decrease in bone mass and lean mass and a reciprocal increase in fat mass, are often observed in normal populations. The recent development of dual-energy x-ray absorptiometry (DXA) made it possible to analyze bone mineral content (BMC), fat mass (fat), and lean body mass (LBM) more precisely and easily. We measured BMC, fat, and LBM in Japanese subjects by DXA to describe the changes in body composition with aging in the Japanese population. A total of 34 female (aged 20-74) and 34 male (aged 18-78) volunteers were divided into three groups according to their age: young (18-22 years), middle-aged (39-48 years), and old (61-78 years). Mean values for body height (BH), body weight (BW), and body mass index (BMI) of the subjects were very similar to Japanese normative values. The BMI of the middle-aged group was the highest of all groups of both sexes. BMC decreased significantly with aging in females but not in males. A decrease in LBM and a reciprocal increase in fat were found between young and middle-aged males but not in females. The correlation between BMC and LBM tends to be greater in males than in females. On the other hand, the correlation between BMC and fat was greater in females than males. These results demonstrate the age- and gender-related difference in body components in Japanese subjects. DXA may be useful for the analysis of body composition in different age and sex groups.

Absorptiometry, Photon↗

Body composition and its relationship with physical activity and anthropometric factors in Chinese adults.

To evaluate the relationship of body composition with physical activity and other anthropometric factors, a group of 437 healthy Chinese men and women were recruited. Body composition was measured using the bioelectric impedance technique. Levels of physical activity (LPA) were classified as light, moderate and heavy. Anthropometric factors evaluated included body mass index (BMI), ponderal index (PI), waist-to-hip ratio (WHR), triceps skinfold thickness (TSF), mid-arm circumference, mid-forearm circumference, arm muscle circumference (AMC) and arm muscle area (AMA). Sex was found to be highly associated with body composition, with females having a higher percentage of body fat and males having a higher percentage of body lean mass. This gender difference was independent of age, physical activity or other anthropometric factors. An increased level of physical activity was associated with higher body lean mass and lower body fat. Sex, LPA, TSF, PI and WHR were all entered into the regression equations to estimate body composition. Sex and physical activity have an independent effect on body composition and the commonly used estimators for adiposity and fat distribution such as BMI, PI, TSF and WHR are closely correlated with body composition.

Adult↗

The interrelationships between age, physical measurements and body composition at menarche in schoolgirls at Ilorin, Nigeria.

A cross-sectional study of age, physical size and body composition at menarche was made at Ilorin, Nigeria among 162 secondary school girls who reached menarche between March and June, 1983. The findings show that the mean age, height and weight are 13.7 +/- 1.0 years, 156.2 +/- 6.3 cm and 47.4 +/- 6.7 kg, respectively. The estimated body composition is: total body water (TBW), 25.7 +/- 2.3 l; lean body mass (LBM), 35.7 +/- 3.3 kg; and fat content, 11.8 +/- 3.8 kg. Whereas the coefficient of variation was highest for fat content (32.2), it was least for height (4.0). Menarcheal age has a weak correlation to all the variables, but strong correlation existed between weight and the parameters of body composition. The findings of body composition at menarche in Nigerian and North American schoolgirls are similar.

Adolescent↗