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Assessment of body composition by bioelectrical impedance in adolescent patients with celiac disease.

OBJECTIVE: Assessment of body composition is of primary importance in the management of celiac adolescents. We aimed to evaluate body composition by dual-energy x-ray absorptiometry and bioelectrical impedance in celiac adolescents on a gluten-free diet to investigate whether impedance may provide an alternative method to assess nutritional status in these patients. METHODS: We studied body composition in 43 adolescents affected by celiac disease on a gluten-free diet for > or = 1 yr and 30 healthy subjects. Fat, fat-free, and bone masses were assessed by dual-energy x-ray absorptiometry. Fat and fat-free masses were also assessed by bioelectrical impedance. All anthropometric measurements were performed according to standard procedures. RESULTS: All patients had a significantly lower body weight, height, fat-free mass, bone mineral density (p < 0.001), and body mass index (p < 0.01) compared with controls. In contrast, parameters predicting fat compartment (sum of skinfolds and fat mass) did not differ from those of controls. No significant difference was found between patients strictly adherent to a gluten-free diet and patients partially compliant. Compared with dual-energy x-ray absorptiometry measurements, bioelectrical impedance showed a high accuracy to estimate fat-free mass (R2 = 0.97) and limited accuracy for fat mass (R2 = 0.75). Furthermore, impedance was more reliable for estimating hydration of soft tissue underlying the fat-free mass changes. CONCLUSIONS: In adolescents with celiac disease, after a mean of 1 yr of gluten-free diet all the parameters assessing body compartments, except fat mass, were affected, compared with healthy controls. Bioelectrical impedance holds promise for routine assessment of body composition changes in celiac adolescents on a gluten-free diet.

Absorptiometry, Photon↗

Modest effects of exercise training alone on coronary risk factors and body composition in coronary patients.

BACKGROUND: Cardiac rehabilitation programs have evolved to become secondary prevention centers. However, the independent effect of exercise alone on coronary risk factors and body composition in patients with coronary artery disease has not been well studied. OBJECTIVE: The aim of this study was to determine the effect of exercise training alone, without modification of dietary intake, on coronary risk factors and body composition in a coronary population. METHODS: The authors studied 82 coronary patients (23 females and 59 males) aged 61.2 +/- 12.2 years (mean +/- SD) before and after a 3-month exercise training program. Outcome variables included serum lipid values, glucose, insulin, body composition, body fat distribution, macronutrient intake, and peak aerobic capacity. RESULTS: Neither male nor female patients experienced a significant overall improvement in plasma cholesterol, low-density lipoprotein (LDL)-cholesterol, triglycerides, glucose, or insulin levels after the 3-month exercise training program. Dietary macronutrient intake was unaltered during the study period. Peak aerobic capacity increased by 3.4 +/- 4.7 ml/kg/min (17%, P < 0.0001) and high-density lipoprotein (HDL)-cholesterol increased from 38 +/- 10 to 41 +/- 11 mg/dL (8%, P < 0.001) after the rehabilitation program. Patients with baseline triglyceride levels over 200 mg/dL experienced a 22% decrease (from 374 +/- 205 to 293 +/- 190 mg/dL; P < 0.05) after conditioning. Patients with baseline HDL-cholesterol levels under 35 mg/dL also improved overall by 17% (from 29 +/- 3 to 34 +/- 5 mg/dL; P < 0.0001). Exercise-induced changes in plasma HDL-cholesterol were more related to changes in body composition and/or body fat distribution, rather than changes in peak aerobic capacity. CONCLUSION: Exercise conditioning alone resulted in relatively modest risk factor improvements in coronary patients after 3 months. High-density lipoprotein cholesterol measures increased by 3 +/- 8 mg/dL (8%). Patients with baseline triglyceride elevations experienced a 22% decrease. On the other hand, there were no overall effects on body weight, total cholesterol, LDL-cholesterol, triglycerides, glucose, or insulin levels. For most patients, exercise effects were minimal and nutritional and medical therapy will need to be used more aggressively to attain nationally recognized risk factor goals.

Adult↗

Microbial Interactions with Protein Intake and Preterm Infant Body Composition: Secondary Analysis of a Randomized Trial.

BACKGROUND: Enteral protein supplementation improves preterm infant growth and may impact body composition and the gut microbiota. OBJECTIVES: This study aimed to identify the effects of additional enteral protein supplementation on the gut microbiota and microbial and clinical drivers of body composition. METHODS: Secondary analysis of a masked randomized trial of additional enteral protein vs. standard fortification in preterm infants born at 25 to 28 weeks of gestation (NCT03586102) was conducted. Stool samples at weeks 4 and 8 underwent 16S rRNA sequencing; functional potential was predicted by Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt2). Body composition was measured by air-displacement plethysmography at 36 wk postmenstrual age (PMA). Least absolute shrinkage and selection operator (LASSO) regression with multivariable linear regression identified body composition predictors. RESULTS: Among 46 infants, gestational age (P = 0.16) and sex (P = 0.55) did not differ between groups. The protein group had higher week 4 Shannon diversity than standard fortification (median 1.2 vs. 0.87, P = 0.049). Week 4 Shannon diversity was positively correlated with fat-free mass z-score at 36 wk PMA (r2 = 0.34, P = 0.02). Adjusting for covariates, the protein group had higher Peptoniphilus (&#x3b2; = 1.6, Padj = 0.10) and lower Vibrio centered log-ratio abundance (&#x3b2; = -0.98, Padj = 0.10); 62 predicted metabolic pathways were lower in the protein group (false discovery rate < 0.20). In combined LASSO models, Bacillus abundance at week 4 was the strongest predictor of fat-free mass z-score (&#x3b2; = -0.17, P < 0.001; R2 = 0.80) and fat mass z-score (&#x3b2; = -0.31, P < 0.001; R2 = 0.66). CONCLUSIONS: Additional protein supplementation is associated with fat-free mass z-score and alterations to the gut microbiota. Clinical variables and microbial variables are key predictors of body composition, suggesting that nutrition, clinical factors, and the gut microbiota jointly contribute to body composition in extremely preterm infants. This study was registered at clinicaltrials.gov as NCT03586102 https://clinicaltrials.gov/study/NCT03586102 (registered in March 2020).

Humans↗

Body composition and metabolic factors in obese children and adolescents.

OBJECTIVE: Body composition is associated with metablic factors in adults; however, data are limited regarding obese children. This study was undertaken to assess body composition, regional fat distribution, and metabolic factors in obese 6-18-y-old children and adolescents. DESIGN: Cross-sectional assessment. SUBJECTS: Thirty-six obese children and adolescents, (mean+/-s.e.m.) age 11.8+/-0.5 y, BMI 34.1+/-1.2 kg/m(2). MEASUREMENTS: Body composition was assessed by dual energy X-ray absorptiometry and computerized tomography. Fasting insulin, glucose and leptin levels, and the homeostasis model assessment of insulin sensitivity (HOMA-IR) were assessed. RESULTS: The girls had significantly lower glucose levels than the boys. The ethnic group differences (African American children vs white children) in fat mass, total CT fat, subcutaneous CT fat, insulin level, leptin level, and higher HOMA-IR were not significant after adjusting for age or pubertal stage. These differences in abdominal fat and subcutaneous abdominal fat were also not independent of total body fat or BMI. No ethnic group differences in visceral abdominal fat were noted. Insulin level and HOMA IR were associated with leptin level (independent of fat mass) and fat mass. Leptin level was associated with fat mass, total CT fat, and subcutaneous CT fat; however the associations between the CT fat measures and leptin were not independent of total body fat mass. CONCLUSIONS: Neither visceral abdominal fat, subcutaneous abdominal fat, insulin levels, or insulin resistance differed by ethnic group when adjusted for age or pubertal status. This contrasts with findings in adults and non-obese children which suggest lower levels of visceral fat and higher insulin levels and insulin resistance in African American children and adolescents.

Adolescent↗

Body composition in spinal cord injury.

A study of body composition was conducted on 45 patients with spinal cord injury (SCI) and 12 able-bodied healthy subjects who served as controls. Body composition was assessed in terms of water (W), fat (F), protein (P), and mineral (M) content. SCI patients exhibited lower absolute amounts of W, F, and P, but no differences in the the amounts of these components when expressed relative (percentage) to gross body weight (BW). As estimated in this study, the amount of bone mass constituted a higher percentage of the gross BW. This suggests that, although SCI patients lose calcium in the early stages of the disease, the loss of weight that follows SCI is principally due to the loss of W, F, and P.

Adipose Tissue↗

Body composition and energy expenditure in acromegaly.

To investigate whether GH is a regulator of body composition and energy metabolism in adult life, we have compared body composition and resting energy expenditure (REE) in a cross-sectional study in 20 acromegalic and 20 normal subjects, pair-matched for sex, age, height, and weight. In a longitudinal study, 8 acromegalic patients were also studied before and after 12 weeks of treatment [n = 6 during octreotide (100 micrograms, 3 times/day); n = 2 after pituitary surgery], and 7 patients were studied 12 weeks after withdrawal of octreotide. REE was measured by indirect calorimetry and fat mass and fat-free soft tissue mass (FFSTM) by dual energy x-ray absorptiometry. A subgroup of 12 matched pairs of subjects and 7 treated patients had measurement of extracellular water (ECW) by 24Na dilution, which when subtracted from FFSTM provided an estimate of body cell mass (BCM). Fat mass was significantly reduced (25.4 +/- 2.2 vs. 29.7 +/- 2.7 kg; P = 0.007) and FFSTM increased (53.3 +/- 2.2 vs. 49.2 +/- 2.3 kg; P = 0.003) in acromegaly with ECW (25.6 +/- 1.6 vs. 21.1 +/- 0.9 L; P = 0.0003), but not BCM, significantly elevated. Treatment of acromegaly increased fat mass and reduced FFSTM [change (delta), -1.3 +/- 0.4 kg; P = 0.004]; the latter reflected a significant fall in ECW (delta, -2.2 +/- 0.4 L; P = 0.002), but not BCM. The opposite effect on body composition occurred after treatment withdrawal. REE was increased in acromegaly (1682 +/- 49 vs. 1540 +/- 45 Cal/24 h; P = 0.02) and significantly related to insulin-like growth factor-I (P = 0.02). REE was significantly reduced (delta, -154 +/- 17 Cal/24 h; P = 0.0001) with treatment and increased after treatment withdrawal (P = 0.003). In acromegaly, there is a reversible 1) reduction in fat mass; 2) increase in FFSTM, accounted for by an increase in ECW, but not BCM; and 3) increase in REE, which is dependent on disease activity. We conclude from these observations in acromegaly that GH is a regulator of energy metabolism and body composition.

Absorptiometry, Photon↗

Determination of body composition from skinfold thickness: a validation study.

Measurement of body composition is proving increasingly important in clinical nutrition and research. Skinfold thickness is a simple means of estimating body composition which is widely used in children, but there is little information on its validity. There has been a proliferation of equations for estimation of body composition from skinfolds, but some doubt as to their general applicability. The aim of the present study was to validate five currently used equations for this purpose in a sample of 98 healthy prepubertal children (64 boys, 34 girls), mean (SD) age 9.1 (1.7) years by comparison of estimates from each equation with measurements of fatness derived from hydrodensitometry. Differences between methods were determined by calculation of biases and limits of agreement. Limits of agreement between predicted and measured fatness were wide, particularly in the girls, and some distinct biases were apparent. Choice of prediction equation therefore has a substantial influence on the estimate of fatness obtained when using skinfolds in children. The existing published equations are associated with large random errors or significant systematic errors. For the time being skinfolds might best be regarded as indices (rather than measures) of body fatness in individuals, or means of estimating body fatness of groups. Estimating the total body fatness of individual prepubertal children using skinfolds, on the basis of this evidence, is not advisable at present.

Adipose Tissue↗

Body composition by the four-compartment model: validity of the BOD POD for assessing body fat in Mexican elderly.

OBJECTIVE: The aims of this study were to validate BOD POD in a wide sample of healthy and independent Mexican elderly men and women subjects using the 4 compartment (4C) model as the reference method, and to evaluate the assumptions of the densitometric two-compartment (2C) model. DESIGN: Cross-sectional study designed to assess body composition and validation of a method based on 2C model (BOD POD). SETTING: Urban and rural regions of Sonora, Mexico. SUBJECTS: Two hundred and two free-living subjects >or=60 years old were completed in this study. METHODS: Body density and body fat were measured by the BOD POD, total body water by deuterium dilution and total body bone ash by dual energy X-ray absorptiometry. Body composition was determined using Baumgartner's equation. RESULTS: Percent body fat by the 4C model was 31.2 and 42.5% in men and women, respectively (P<0.001). Group mean accuracy of body fat by BOD POD against that of the 4C model showed an effect of sex (P<0.001), but not the method (P=0.27). Results of individual accuracy showed no significant difference with the identity line and the slope was significantly different from zero or a slope similar to one. Precision assessed by model R (2) was high for all subjects and for men and women by separate. The standard error of the estimate was low for all and for men and women by separate. Bland and Altman analysis showed no significant bias. CONCLUSION: The BOD POD technique is a valid and reliable method compared to the 4C model and it could be applied in subjects with similar physical and anthropometric characteristics to subjects of this study.

Absorptiometry, Photon↗

Influence of gilt age and body composition at first breeding on sow reproductive performance and longevity.

Regression analysis was used to evaluate the effects of gilt age and body composition at first breeding on sow performance over three parities. Eighty-seven Yorkshire x Landrace F1 gilts were used. Variation in age and body composition at first breeding was obtained by breeding gilts at puberty, second, or third estrus and by providing those gilts bred after puberty one of four nutritional regimens from puberty until breeding: 1) 2.7 kg/d of a 14.3% CP, 3.5 Mcal ME/kg diet (H), 2) maintenance ME and CP/d (M), 3) half-maintenance ME and CP/d (1/2M), and 4) M or 1/2M until anestrus, then 2.27 kg/d of a 14.0% CP corn-soybean meal diet until first breeding. Body composition at first breeding was determined using live weight, backfat thickness, and deuterium oxide space as variables in prediction equations. All females were treated similarly after first breeding. Age and body composition at first breeding were not related (P > .10) to litter size at birth or weaning in parities 1, 2, 3, or overall. Increasing age at first breeding was related to small increases in pig birth weights (P < .001) in parity 1 and average pig weaning weight (P < .001) in parities 1, 2, and overall. Body composition of gilts at first breeding was not related (P > .10) to pig birth weights and was inconsistently related to pig weaning weights in parities 2 and 3 (P < .001). Females heavier at first breeding remained heavier (P < .01) throughout the experiment. Age and body composition at first breeding were not different (P > .10) for gilts completing three parities (n = 53) compared with gilts failing to complete three parities (n = 34). Results show no large effects of gilt age or body composition at first breeding on sow productivity and longevity over three parities.

Aging↗

History of the study of human body composition: A brief review.

This review assembles a chronology of human body composition research with the goal of exposing historical roots and identifying future potential trends. Body composition research has emerged over the past several decades as a distinct field, and for many scientists body composition is their primary investigative focus. Technological advances will likely move the field forward and, ultimately, help to expand knowledge of human body composition variability in health and disease. Am. J. Hum. Biol. 11:157-165, 1999. Copyright 1999 Wiley-Liss, Inc.

Journal Article↗

Validation of body composition determination by bioelectrical impedance analysis in acromegaly.

Body composition determination by bioelectrical impedance analysis (BIA) has been compared with measurement of total body water (TBW) by tritiated water dilution and estimation of body fat (BF) by measurement of TBW and total body potassium (TBK) in a four-compartment model, in patients with acromegaly. This disorder is accompanied by a profound aberration in body composition. Furthermore TBW and BF were predicted on the basis of anthropometric variables alone. Paired comparisons of TBW estimations by isotope dilution and BIA showed good correlation (Spearman's rank correlation 0.95, P less than 0.01). Isotope dilution resulted in a mean of 1.7 liter (standard deviation 1.87) higher values. Comparison of BF estimations showed also a significant correlation (Spearman's rank correlation 0.75, P less than 0.01), with slightly higher values for BIA (mean 1.4 kg; standard deviation 2.99). BIA improved the prediction of TBW and BF compared with predictions based on anthropometric variables. In a population of acromegalic patients, BIA seemed to be a useful method to estimate TBW and BF.

Acromegaly↗

Resting metabolic rate and diet-induced thermogenesis in young and elderly subjects: relationship with body composition, fat distribution, and physical activity level.

To investigate the relationship between age and energy expenditure, resting metabolic rate (RMR) and diet-induced thermogenesis (DIT; for 180 min after a 1.3-MJ meal) were measured by indirect calorimetry in 56 young and 103 elderly subjects. In addition, the influence of body composition, body-fat distribution, and physical activity level on this relationship was studied. RMR was significantly lower in elderly (3.98 +/- 0.46 and 3.33 +/- 0.39 kJ/min for men and women, respectively) than in young (5.29 +/- 0.53 and 4.08 +/- 0.33 kJ/min for men and women, respectively) subjects, which persisted after adjustment for body composition. DIT was significantly lower in older than in younger men (126 +/- 27 vs 154 +/- 34 kJ/180 min) but not in women (111 +/- 26 vs 115 +/- 25 kJ/180 min). The difference in men disappeared after adjustment for body composition. No clear relation between physical activity level and RMR or DIT was observed. These results demonstrate a relationship of age per se with RMR but not with DIT.

Adult↗

Relationship of dietary fat and lysine level with body composition in broiler chickens.

The effect of dietary fat and/or lysine supplementation on the body composition of broiler chickens was studied. Body composition was measured by computed tomography (CT) and direct chemical analysis. Cockerel chicks from a previous experiment (Fekete et al., 1992) were used in this study. Ten chickens from each treatment group were euthanised, deep frozen and subjected to CT. Subsequently the bodies were dissected and ground to obtain homogeneous samples for chemical analysis. Supplementation of the diet with 6 g/kg lysine did not change total body composition but positively influenced the final body weight. In the treatment group receiving 40 g/kg added fat and 3 g/kg feed lysine (F-LYS-I) the higher body weight ran parallel with a higher fat content. The difference between the frozen body weight and final live body weight shows that lysine supplementation increased the water-holding capacity of muscle, which was the best in groups receiving a diet of normal energy content plus high lysine supplementation.

Animal Feed↗

Insulin-like growth factor-I as a reflection of body composition, nutrition, and puberty in sixth and seventh grade girls.

Large variations in nutritional intake have profound effects on the GH-insulin-like growth factor-I (IGF-I) axis in children and adults, but the effect of normal variations in nutrition on IGF-I concentrations is largely unstudied, particularly during puberty. We measured serum IGF-I concentrations in 325 sixth and seventh grade girls (12.4 +/- 0.7 yr) at the beginning of a multisite school-based health curriculum. The mean serum IGF-I level among the 243 girls with complete data was 573 +/- 244 micrograms/L. Pubertal stage was significantly associated with IGF-I (P less than 0.0001, by analysis of variance). Mean concentrations rose from 427 +/- 198 micrograms/L among those at the earliest pubertal stages to 639 +/- 219 micrograms/L among the mature girls. After adjusting for the association with the stage of pubertal development, serum IGF-I was not significantly associated with measures of body composition (body mass index, triceps skin fold thickness, waist/hip ratio, height, and weight). Additionally, IGF-I concentrations were not associated with nutritional intake (total calories, total protein, total fat, and total carbohydrate) or such measures of nutrition as serum iron, hemoglobin, red cell mean corpuscular volume, white cell count, and cholesterol. IGF-I concentrations, however, were significantly correlated with transferrin concentrations, another possible index of nutritional status (r = 0.29; P less than 0.0001). IGF-I is not a clinically useful index of nutritional status among normal pubertal girls.

Adolescent↗

Body composition analysis in liver cirrhosis. The measurement of body fat by dual energy X-ray absorptiometry in comparison to skinfold anthropometry, bioelectrical impedance and total body potassium.

In this cross-sectional study of methods to determine total body fat in patients with abnormal body composition secondary to chronic liver disease, we have demonstrated that TBFDXA by four-site skinfold anthropometry was highly correlated to TBFDXA, with small SEE and no bias in patients with ascites, but a small and significant bias in patients without ascites. TBFBIA showed no bias but a weaker correlation with a large SEE. In the presence of fluid retention the correlation coefficient decreased. TBFTBK showed a highly significant bias, and the correlation was not as good as SFA, and decreased in the presence of fluid retention.

Absorptiometry, Photon↗

Factor analysis and multivariate scaling of anthropometric variables for the assessment of body composition.

This study was designed to identify the body composition factors measured by skinfold fat (S), girth (G), and diameter (D) variables and to provide multivariate scaling models that measure fat (F) and lean body weight (LBW) factors. A total of 7S, 11G, and 7D measurements were determined on 83 young women (YW) and 95 young men (YM). Body density (BD) was determined by the hydrostatic technique. All variables were factor analyzed, and F and LBW were used to validate isolated factors. The YM data showed one F factor and two LBW factors. LBW factor I measured muscle mass and bone structure; LBW factor II, bone D. The YW data isolated four factors: the same three of YM plus a second F factor specific to the pelvic girdle. Factor score models were used to develop scaling strategies to measure F and LBW factors. Full models of all 27 variables and restricted models of 14 S, G, and D variables were developed; the correlations between factor scores scaled from the full and restricted models ranged from 0.84 to 0.98. The multiple correlation between factor scores calculated from the restricted models and laboratory-determined F and LBW ranged from 0.90 to 0.94 for YM and from 0.88 to 0.89 for YW. The multivariate scaling models provide a valid field method of measuring body composition.

Adolescent↗

[The application of impedance analysis to the study of body composition].

We have reviewed the physical theory of body composition assessment using bioelectrical impedance analysis. We discuss the measurement reproducibility, the application to the estimation of total body water, extracellular water, nutritional assessment and the measurement of total body fat. We also comment the application to the study of body composition in children, other physiological and pathological situations and the utility in epidemiological studies.

Biophysical Phenomena↗

Reliability and validity of the lung volume measurement made by the BOD POD body composition system.

The BOD POD Body Composition System uses air-displacement plethysmography to measure body volume. To correct the body volume measurement for the subject's lung volume, the BOD POD utilizes pulmonary plethysmography to measure functional residual capacity (FRC) at mid-exhalation as that is the subject's lung volume during the body volume measurement. Normally, FRC is measured at end-exhalation. The BOD POD FRC measurement can be corrected to an end-exhalation volume by subtracting approximately one-half of the measured tidal volume. Our purpose was to determine the reliability and validity of the BOD POD FRC measurement at end-exhalation. Ninety-two healthy adults (half female) underwent duplicate FRC measurements by the BOD POD and one FRC measurement by a traditional gas dilution technique. The latter method was used as the reference method for the validity component of the study. The order of the FRC measurements by the two methods was randomized. The test-retest correlation coefficients for the duplicate BOD POD FRC measurements for the male and female subjects were 0.966 and 0.948, respectively. The mean differences between the BOD POD FRC trial #1 measurement and gas dilution FRC measurement for the male and female subjects were -32 and -23 ml, respectively. Neither difference was statistically significant. The correlation coefficients for these two measurements in the male and female subjects were 0.925 and 0.917, respectively. Based on these results, we conclude that the BOD POD FRC measurement in healthy males and females is both reliable and valid.

Adolescent↗