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PubMed2006

Body fluid volume determination via body composition spectroscopy in health and disease.

The assessment of extra-, intracellular and total body water (ECW, ICW, TBW) is important in many clinical situations. Bioimpedance spectroscopy (BIS) has advantages over dilution methods in terms of usability and reproducibility, but a careful analysis reveals systematic deviations in extremes of body composition and morbid states. Recent publications stress the need to set up and validate BIS equations in a wide variety of healthy subjects and patients with fluid imbalance. This paper presents two new equations for determination of ECW and ICW (referred to as body composition spectroscopy, BCS) based on Hanai mixture theory but corrected for body mass index (BMI). The equations were set up by means of cross validation using data of 152 subjects (120 healthy subjects, 32 dialysis patients) from three different centers. Validation was performed against bromide/deuterium dilution (NaBr, D2O) for ECW/TBW and total body potassium (TBK) for ICW. Agreement between BCS and the references (all subjects) was -0.4 +/- 1.4 L (mean +/- SD) for ECW, 0.2 +/- 2.0 L for ICW and -0.2 +/- 2.3 L for TBW. The ECW agreement between three independent reference methods (NaBr versus D2O-TBK) was -0.1 +/- 1.8 L for 74 subjects from two centers. Comparing the new BCS equations with the standard Hanai approach revealed an improvement in SEE for ICW and TBW by 0.6 L (24%) for all subjects, and by 1.2 L (48%) for 24 subjects with extreme BMIs (<20 and >30). BCS may be an appropriate method for body fluid volume determination over a wide range of body compositions in different states of health and disease.

Adult↗
PubMed1998

Multicompartmental analysis of magnesium and calcium kinetics during growth: relationships with body composition.

Stable isotope techniques permit a unique approach to the assessment of magnesium metabolism, including absorption, excretion, pool sizes, and turnover. Findings from our recent studies on magnesium and calcium kinetics indicate close relationships between the mass of the magnesium exchangeable pool, efflux from this pool, and body weight. In this report, we further evaluate these data by relating the kinetic values with other measures of body composition. We found that fat-free mass represents the single body composition parameter that most closely correlates with magnesium kinetic data. Body composition has a stronger relationship with magnesium kinetics than with calcium kinetics. These relationships provide justification for basing dietary magnesium requirements in children on body composition measures such as body weight or, where available, fat-free mass. Further studies to evaluate these relationships are indicated in situations where either magnesium status or body composition is abnormal.

Adolescent↗
PubMed2006

The evolution of weight and body composition in renal transplant recipients: Two-year longitudinal study.

UNLABELLED: Previous series have reported weight gain after kidney transplantation. However few studies have investigated the body composition after kidney transplantation, particularly during longitudinal follow-up. In this prospective study, we assessed the changes in body composition after kidney transplantation. We also analyzed the effect of steroid withdrawal from the immunosuppressive regimen on weight gain and body composition. METHODS: Thirty-eight cadaveric kidney transplant recipients were followed for 2 years posttransplant. Total and segmental body composition were measured by dual energy X-ray absorptiometry (DEXA) at the time of transplantation as well as 3, 6, 12, and 24 months later. RESULTS: In 28 patients (group A), prednisone was stopped by month 6, whereas, in 10 patients (group B), it was continued throughout the study. In the overall patient group, there were no significant changes in body weight. However, a trend to increased weight was observed in group B. In this group, patients showed an early increase in total body fat with a central accumulation of fat mass that was maintained during the follow-up period. On the other hand, total lean mass increased significantly in group A but did not change significantly in group B. CONCLUSION: In summary, overall the group showed no major changes in body weight during the 2 years after transplantation. Steroid withdrawal in kidney transplant recipients may have a significant positive effect on body composition.

Absorptiometry, Photon↗
PubMedDate not supplied

A comparison of different methods to measure body composition in patients.

A comparison of different methods to measure body composition in growth hormone deficient patients is presented. The technical limitations of the available methods are discussed. The techniques used to measure body composition and fat free mass has been by total body water, total body potassium, dual energy X-ray absorptiometry, bioelectrical impedance and total body nitrogen.

Absorptiometry, Photon↗
PubMed1993

Hormones, cytokines and body composition: can lessons from illness be applied to aging?

Loss of lean body mass (LBM) is a hallmark of aging and of acute and chronic illness. Loss of more than 40% of lean mass is not compatible with life. The causes of loss of LBM in aging remain obscure, although changes in growth hormone production, physical activity and the cytokines interleukin-1 beta and tumor necrosis factor-alpha may play a role. The usefulness of a disease model based on rheumatoid arthritis (RA) is considered, in which all these changes occur to a greater degree and independently of age. RA is a common autoimmune condition in which cytokine production is increased, LBM is reduced and mortality is greatly accelerated. These observations suggest that, with respect to body composition at least, RA represents a model of "accelerated" aging. A hypothesis is presented that unifies metabolic and immunologic observations and changes in body composition. The interrelationship of the immune system and body composition is an important area that deserves further investigation.

Adult↗
PubMed2001

Effects of estradiol and progesterone on body composition, protein synthesis, and lipoprotein lipase in rats.

Prior studies suggest that estradiol and progesterone regulate body composition in growing female rats. Because these studies did not consider the confounding effect of changes in food intake, it remains unclear whether ovarian hormones regulate body composition independently of their effects on food intake. We utilized a pair-feeding paradigm to examine the effects of these hormones on body composition. In addition, skeletal muscle protein fractional synthesis rate and adipose tissue lipoprotein lipase activity were measured to examine pathways of substrate deposition into fat and fat-free tissue. Female Sprague-Dawley rats [pubertal: 7-8 wk old; 190 +/- 0.5 (SE) g] were separated into four groups: 1) sham-operated (S; n = 8), 2) ovariectomized plus placebo (OVX; n = 8), 3) ovariectomized plus estradiol (OVX+E; n = 8), and 4) ovariectomized plus progesterone (OVX+P; n = 8). All ovariectomized groups were pair-fed to the S group. Body composition was measured using total body electrical conductivity. The relative increase in fat-free mass was greater (P < 0.01) in the OVX group (31 +/- 2%) than in the S (17 +/- 2%), OVX+E (18 +/- 2%), and OVX+P (22 +/- 2%) groups. The fractional synthetic rates of gastrocnemius muscle protein paralleled changes in fat-free mass: OVX had a higher (P < 0.05) synthesis rate (21 +/- 3%/day) than S (12 +/- 2%/day), OVX+E (11 +/- 2%/day), and OVX+P (8 +/- 1%/day) groups. Body fat increased in the S group (31 +/- 7%; P < 0.01), whereas the OVX groups lost fat (OVX: -10 +/- 7%; OVX+E: -15 +/- 7%; OVX+P: -13 +/- 7%). No differences in lipoprotein lipase were found. Our results suggest that estradiol and progesterone may regulate the growth of fat and fat-free tissues in female rats. Moreover, ovarian hormones may influence skeletal muscle growth through their effects on skeletal muscle protein synthesis.

Adipose Tissue↗
PubMed2003

Effects of metal implants on whole-body dual-energy x-ray absorptiometry measurements of bone mineral content and body composition.

OBJECTIVE: The purpose of this study was to evaluate the influence of metal implants on measurements of bone mineral content and body composition by x-ray-based dual-photon absorptiometry. METHODS: Four whole-body dual-photon absorptiometry scans were performed on 13 participants with metal rods either present or absent during the scans. The influence of the amount of metal (50 g, 100 g and 150 g), the proximity of the metal rod to the x-ray source and the reproducibility of any metal-induced effects were evaluated by altering the position or the size of the metal rod used, or both. RESULTS: The presence of metal rods weighing 100 g or 150 g significantly increased reported total body mass and bone mineral content (p < 0.034). Soft-tissue mass was increased when the scan included the 100-g rod (p < 0.003). The proximity of the metal to the x-ray source did not have a significant influence on the body composition changes induced by the metal. The effects of the metal rods on body composition variables were reproducible. CONCLUSION: The presence of metal rods inflated body composition variables measured by dual-photon absorptiometry; however, the effects are reproducible during repeat scans of an individual patient. Metal had the largest impact on whole-body bone mineral content, causing errors of 1.5%-3%.

Absorptiometry, Photon↗
PubMed1996

Effect of nutritional support on routine nutrition assessment parameters and body composition in intensive care unit patients.

OBJECTIVES: To determine whether routine nutrition assessment parameters and body composition change after nutritional support in intensive care unit (ICU) patients and whether the changes, if any, are related to cumulative energy and fluid balances. DESIGN: A prospective study. SETTING: A university teaching hospital. PATIENTS: Forty-five mechanically ventilated medical and surgical patients admitted to the ICU who received nutritional support for 7 days (group 1) and 9 patients of this group who received nutritional support for 3 weeks or longer (group 2). INTERVENTIONS: Enteral and parenteral nutritional support prescribed on the basis of metabolic cart measurements of energy expenditure. OUTCOME MEASURES: Routine nutrition assessment, including determinations of weight, serum albumin and prealbumin, and lymphocyte count and body composition, including measurements of body cell mass, extracellular fluid and body fat, determined from bioelectric impedance analysis. RESULTS: In group 1 patients, weight, albumin and prealbumin levels, and extracellular mass changed, but there was no change in lymphocyte count, body cell mass or body fat. Changes in weight and extracellular mass were slightly related to cumulative fluid balance; changes in albumin and prealbumin levels were not related to cumulative energy or fluid balance. The findings were similar for group 2 patients. CONCLUSIONS: Changes in routine nutrition assessment parameters and body composition are slightly affected by fluid balance but not by energy balance; thus, they are not specific indicators of the adequacy of nutritional support in ICU patients. Improved nutrition assessment parameters are required to better monitor the response to nutritional support in critically ill patients.

Body Composition↗
PubMed2002

Bioelectrical impedance analysis of the body composition of children and adolescents with sickle cell disease.

OBJECTIVES: To examine the body composition of children and adolescents with sickle cell disease (SCD) using bioelectrical impedance analysis and to determine if the impedance parameters resistance, reactance, and phase angle are able to distinguish between subjects with SCD and age- and gender matched controls. STUDY DESIGN: Total body resistance and reactance were obtained for a total of 53 subjects with SCD (27 male and 26 female) between 10 and 18 years of age and 49 control subjects (23 male and 26 female). The fat-free mass, body cell mass, phase angle, and capacitance were also determined. Group comparisons were made using the 2-sample t test. RESULTS: Male subjects with SCD had significantly lower fat-free mass (37.5 +/- 8.8 vs 43.9 +/- 12.3 kg, P =.04), body cell mass (17.4 +/- 4.3 vs 21.7 +/- 5.8 kg,P =.005), and body fat (3.7 +/- 2.6 vs 6.6 +/- 4.7 kg, P =.008) compared with controls. No significant differences in any body composition components were found for the female subjects. Both male and female subjects had significantly lower phase angle measurements (P <.001 and.006, respectively) than their respective controls, indicating possible alterations in cell membrane properties because of an imbalance in membrane composition or function. CONCLUSIONS: Bioelectrical impedance analysis can be used to determine body composition differences in children with SCD. The phase angle may provide a useful method to monitor the efficacy of therapeutic interventions in patients with SCD.

Adolescent↗
PubMed2003

Effects of GH and insulin-like growth factor-I on body composition.

In this review, different methods to estimate body composition are discussed shortly. The effects by GH on total and visceral fat mass, lean mass, muscle strength and body water are described. Gender differences in the sensitivity to GH administration are reviewed. Finally, a short description of the effects of insulin-like growth factor-I (IGF-I) administration on body composition has been included.

Adult↗
PubMedDate not supplied

Study of growth in rural school children from Buenos Aires, Argentina using upper arm muscle area by height and other anthropometric dimensions of body composition.

The primary objective was to compare growth and body composition in an infantile rural population by means of the upper arm muscle area by height and other antropometric measurements. Research was carried out by way of a cross sectional study, including 80% (321 6-13 year olds) of the schoolchildren living in General Lavalle, a rural community of about 3000 inhabitants. The methods and procedures included the evaluation of mother's educational levels and anthropometric measurements. Height (H), weight, mid upper arm circumference, and triceps skinfold (TS) were measured. The body mass index (BMI), the upper arm muscle area (UAMA), the upper arm fat area (UAFA) and the upper arm muscle area by height (UAMAH) were calculated. Variables were grouped by gender and age and transformed into z-scores, using the US anthropometric standards as reference. The results showed that: (1) the mother educational status was, in relation to z-scores, as in an urban population, and (2) the z-scores for BMI, UAFA and TS were above the reference, while the ones for H, UAMA and UAMAH were below the reference. The differences between z-scores in relation to mother's educational levels were statistically significant (p < 0.05). UAMA was correlated strongly with H (r = 0.67). The children of General Lavalle tend to be fatty and overweight, while their muscle mass and H are proportionally low, but with values within the reference. Thus, low muscle mass and H are, in general terms, indicative of low protein reserves, the systematically low-anthropometry found for UAMAH suggests that this index should be used in conjunction with other indexes (e.g. BMI, UAFA) to obtain a more complete assessment of body composition and nutritional status.

Adipose Tissue↗
PubMed1975

Body composition in morbidly obese patients before and after jejunoileal bypass.

A clinical and body compositional study has been made of 150 patients with morbid obesity and their responses to four different dimensional alterations of jejunoileal bypass. Total body potassium was estimated by measuring 40K with the whole body counter and total body water by tritiated water dilution. Body compositional data derived from these measurements were compared in the 4 groups during followup periods up to 4 years and related to clinical results. Initially, patients were two or more times overweight due to excess (60 to 65%) body fat and increased hydration (21%) of lean tissues. The 80 end-to-end jejunoileal bypass procedures of Groups 3 and 4 (30 cm jejunum to 15 or 20 cm ileum) had better weight losses and clinical results in followup were rated "good" in 60% and 81% respectively. These results were accompanied by a greater degree of improvement in body composition than was observed in the other groups under study.

Adolescent↗
PubMed2001

Relation between body composition and age in healthy Japanese subjects.

OBJECTIVE: To describe the relation between body composition and age measured by dual-energy X-ray absorptiometry (DXA) in healthy Japanese adults. DESIGN: Cross-sectional study. SUBJECTS AND MEASUREMENTS: The subjects were 2411 healthy Japanese adults (males 625, females 1786, age 20--79 y) who attended the Fukuoka Health Promotion Center, Fukuoka, Japan for health check-up. Body composition was determined by DXA (QDR-2000, Hologic) for the whole body and three anatomical regions of arms, legs and trunk. RESULTS: The mean values of body mass index (BMI) and percentage fat mass (%FM) were 23.2+/-3.1 (s.d.) kg/m(2) and 21.8+/-6.8% for males and 22.1+/-3.3 kg/m(2) and 32.0+/-7.5% for females, respectively. For males, curvilinear relations with the peaks in their forties or fifties were seen for the variables associated adiposity, ie BMI, waist and hip circumference, waist-hip ratio, total or regional fat mass (FM), %FM and ratio of trunk FM to leg FM. For females, most of these variables increased linearly in older subjects. Lean mass (LM), bone mineral content (BMC) and bone mineral density (BMD) of the whole body and appendicular LM were relatively constant until the forties and then decreased in both sexes. The rates of decrease in the total or appendicular LM were larger for males than for females, whereas those in BMC or BMD were larger for females than for males. CONCLUSIONS: This study presents the first detailed data on body composition in Japanese, which may be useful when comparing with populations of different racial and ethnic backgrounds and studying ill subjects.

Absorptiometry, Photon↗
PubMed2001

Symptom control may improve food intake, body composition, and aspects of quality of life after gastrectomy in cancer patients.

That severe malnutrition affects body function and psychological well-being is well documented. We addressed the question of whether quality of life relates to changes in variables such as food intake, body composition, and gastrointestinal symptomatology after gastrectomy for gastric cancer. Thirty-two patients undergoing gastric resection had their dietary intake, body composition, and specific and general aspects of quality of life determined preoperatively, at 12 months and, in the 15 surviving patients, several years after the operation. The patients lost 10% of their preoperative weight (mainly body fat) during the first year. Food intake did not correlate to changes in body composition or quality of life. Gastrointestinal symptoms adversely related to changes in lean body mass, meal size, and general aspects of quality of life for a long time after the operation. Gastrointestinal symptom control seems important to minimize impairment in quality of life, body composition, and eating after gastrectomy.

Adult↗
PubMed2004

Impact of indexing resting metabolic rate against fat-free mass determined by different body composition models.

OBJECTIVE: To examine the differences arising from indexing resting metabolic rate (RMR) against fat-free mass (FFM) determined using two-, three- and four-compartment body composition models. DESIGN: All RMR and body composition measurements were conducted on the same day for each subject following compliance with premeasurement protocols. SUBJECTS: Data were generated from measurements on 104 males (age 32.1+/-12.1 y (mean+/-s.d.); body mass 81.15+/-12.85 kg; height 179.5+/-6.5 cm; body fat 20.6+/-7.6%). INTERVENTIONS: Body density (BD), total body water (TBW) and bone mineral mass (BMM) were measured by hydrodensitometry, deuterium dilution and dual energy X-ray absorptiometry (DXA), respectively. These measures were used to determine two (hydrodensitometry: BD; hydrometry: TBW)-, three (BD and TBW)- and four- compartment (BD, TBW and BMM) FFM values. DXA also provided three compartment derived FFM values. RMR was measured using open circuit indirect calorimetry. RESULTS: Three (body fat group: lean, moderate, high) x five (body composition determination: hydrodensitometry, hydrometry, three-compartment, DXA, four-compartment) ANOVAs were conducted on FFM and RMR kJ.kg FFM(-1).d(-1). Within-group comparisons revealed that hydrodensitometry and DXA were associated with significant (P<0.001) overestimations and underestimations of FFM and RMR kJ.kg FFM(-1).d(-1), respectively, compared with four-compartment-derived criterion values. A significant interaction (P<0.001) resulted from DXA's greater deviations from criterion values in lean subjects. While hydrometric means were not significantly (P> or =0.68) different from criterion values intraindividual differences were large (FFM: -1.5 to 2.9 kg; RMR: -6.0 to 3.2 kJ.kg FFM(-1).d(-1)). CONCLUSION: The relationship between RMR kJ.kg FFM(-1).d(-1) and exercise status would best be investigated using three (BD, TBW)- or four (BD, TBW, BMM)-compartment body composition models to determine FFM. Other models either significantly underestimate indexed RMR (hydrodensitometry, DXA) or display large intraindividual differences (hydrometry) compared with four-compartment derived criterion values. SPONSORSHIP: Australian Research Council (small grants scheme).

Absorptiometry, Photon↗
PubMed2003

Body composition in the elderly: the influence of nutritional factors and physical activity.

BACKGROUND: Controversy exists regarding the relative contribution of diet and exercise to body composition. Few studies have examined these associations in the elderly, where changes occur in the body fat to muscle ratio. OBJECTIVE: The primary objective of this paper is to determine whether energy intake or physical activity are associated with body composition. Secondly, to investigate whether specific macronutrients are associated with fat or lean tissue. DESIGN: Data (n= 1404) for this cross-sectional analysis were collected from a population-based sub-sample of elderly enrollees in the Cardiovascular Health Study (CHS). Dietary intake and physical activity were assessed by questionnaires. Body composition was measured by Dual Energy X-ray Absorptiometry (DEXA). Linear regression models were used to assess the associations of diet and activity with body composition. RESULTS: Total energy intake was not associated with any of the body composition measures. Higher dietary saturated fat was associated with higher percent body mass as fat and trunk fat in both sexes (p<0.01), and in men other dietary fats were associated with body fat. In women, distance walked was inversely associated with fat masses even after adjustment for pace of walking. In both sexes, faster pace of walking was associated with lower body and fat mass (p<0.01). Lean muscle mass was not associated with physical activity or dietary intakes. CONCLUSION: Physical activity and dietary fat intake in this the elderly population were more closely associated with body fat mass than was total energy intake.

Absorptiometry, Photon↗
PubMed1998

Effects of orthotopic liver transplantation on body composition.

AIMS/BACKGROUND: The effects of orthotopic liver transplantation on body composition are unclear. We aimed to assess changes in body composition after transplantation using dual energy x-ray absorptiometry and total body potassium. METHODS: Dual energy x-ray absorptiometry and total body potassium counting to assess muscle mass were performed in 55 patients before and up to 24 months after liver transplantation and the results expressed as paired data before and at time intervals after transplantation. RESULTS: The results showed that total body weight fell by 3.6 +/- 1.3 kg (p < 0.02) at 1 month, with a maximal fall in lean tissue mass at 2-5 months of 4.8 +/- 1.2 kg (p < 0.003). Thereafter, no change in lean tissue mass was recorded, although there were increases at 12 and 24 months of total body weight (11.5 +/- 2.4 kg, 7.8 +/- 3.1 kg; p < 0.03, respectively) and fat mass (12.9 +/- 2.2 and 10.5 +/- 2.7 kg; p < 0.003). A fall in total body potassium was seen at 1 month (118 +/- 12 mmol; p < 0.003) and 2-5 months (176 +/- 9.9 mmol; p < 0.03), which mirrored the fall in lean mass. CONCLUSIONS: After liver transplantation there is an initial fall in body weight due to a loss of lean mass. Lean mass does not recover after transplantation, although there is an increase in fat mass that leads to the observed increase in total body weight.

Absorptiometry, Photon↗