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Influence of orlistat on bone turnover and body composition.

OBJECTIVE: To investigate the influence of the pancreas lipase inhibitor orlistat (OLS) on calcium metabolism, bone turnover, bone mass, bone density and body composition when given for obesity as adjuvant to an energy- and fat-restricted diet. DESIGN: Randomized controlled double-blinded trial of treatment with OLS 120 mg three times daily or placebo for 1 y. SUBJECTS: Thirty obese subjects with a mean body mass index (BMI) of 36.9+/-3.7 kg/m(2) and a mean age of 41+/-11 y. Sixteen patients were assigned to OLS and 14 to placebo. MEASUREMENTS: Dual energy X-ray absorptiometry (DXA) measurements of bone mineral and body composition included total bone mineral content (TBMC), total bone mineral density (TBMD), lumbar spine BMC and BMD, forearm BMC and BMD, fat mass (FM), fat free-mass (FFM), percentage fat mass (FM%) as well as a DXA estimate of the body weight. Body composition (FM, FFM and FM%) was estimated by total body potassium (TBK). Indices of calcium metabolism and bone turnover included serum values of ionized calcium (Ca(++)), iPTH (parathyroid hormone), alkaline phosphatase, 25(OH)-vitamin D, 1,25(OH)(2) vitamin D and osteocalcin as well as fasting urinary ratios of hydroxyproline/creatinine and Ca/creatinine (fU-OHpr/creat, fUCa/creat). RESULTS: There were no significant differences between OLS and placebo groups as to any of the body composition variables (FFM, FM, FM%) at baseline or after 1 y treatment. Weight loss was of 11.2+/-7.5 kg in the OLS group and 8.1+/-7.5 kg in the placebo group (NS). The changes in FM and FM% were significant in both groups determined by DXA as well as by TBK, but the group differences between these changes were not significant. The composition of the weight loss was approximately 80% fat in both groups. FFM only changed significantly by DXA in the OLS group (-1.3 kg), but the difference from the placebo group was not significant. Forearm BMD in both groups, forearm BMC in the OLS group and TBMD in the placebo group fell discretely but significantly, but there were no significant group differences between the OLS and the placebo-treated group. All biochemical variables except s-osteocalcin changed significantly after 1 y in the OLS group, disclosing a pattern of an incipient negative vitamin D balance, a secondary increase in PTH-secretion, and an increase in bone turnover with the emphasis on an increase in resorption parameters (fU-OHpr/creat, fUCa/creat). In the placebo group, only s-25(OH)vitamin D and fU-OHpr/creat changed significantly, but the pattern was also that of a deteriorated vitamin D status and an increase in PTH levels and bone turnover. The only biochemical variable which was significantly different between OLS and placebo groups after one year was the fU-OHpr/creat ratio, which increased from 12.0 to 20.1 in the OLS group but only from 10.9 to 1 3.2 in the placebo group. CONCLUSION: One year's treatment with OLS induces a lipid malabsorption which enhances a dietary weight loss without any significant deleterious effects on body composition. OLS induces a relative increase in bone turnover in favour of resorption, possibly due to malabsorption of vitamin D and/or calcium. However, no changes in bone mass or density are seen after 1 y of OLS treatment apart from those explained by the weight loss itself. Thus 1 y of OLS treatment seems safe from a 'bone preserving' point of view. A vitamin D and calcium supplement should be taken during the treatment.

Absorptiometry, Photon↗

Physical training improves body composition of black obese 7- to 11-year-old girls.

We determined the effect of supervised physical training without dietary intervention, on body composition of obese girls. The subjects were 25 obese 7- to 11-year-old black girls, divided into physical training and lifestyle education groups which were comparable on baseline body composition; 22 girls finished all aspects of the study. Twelve girls engaged in aerobic training (10 weeks, 5 days/week) while 10 engaged in weekly lifestyle discussions without formal physical training. Total body and regional body composition were measured with dual energy x-ray absorptiometry, skinfolds and circumferences. Aerobic fitness was measured by heart rate response to submaximal treadmill exercise. The physical training group attended 94% of scheduled sessions and kept their heart rates at an average of 163 bpm for 28 minutes/session. The lifestyle group attended 95% of their sessions; they remained stable in aerobic fitness and most body composition measurements. The physical training group showed a significant improvement in aerobic fitness and a significant decline of 1.4% body fat. Skinfold and circumference indices of fatness also declined significantly in the training group. We conclude that controlled physical training, without dietary intervention, improved the fitness and body composition of obese black girls.

Absorptiometry, Photon↗

Body composition prediction equations for elderly men.

BACKGROUND: The purpose of this study was to develop and validate anthropometric body composition prediction equations for elderly (i.e., > or =65 years old) men. This was necessary because of a lack of accurate and reliable predictive equations specifically developed for this population. METHODS: Seventy-five elderly men were randomly assigned to either an equation development sample (on = 50) or an equation validation sample (n = 25). Subject anthropometric measures were analyzed in a regression procedure with hydrodensitometry-determined body density, percentage of fat, fat-free mass, and fat weight to develop prediction equations for each body composition variable. The equation estimates were then validated against the hydrostatically determined measures. RESULTS: Four equations were developed and validated for the estimation of elderly male body composition variables [one each for body density (R2 = .66, SEE = +/- .01, where SEE is the standard error of estimate), percentage of fat (R2 = .66, SEE = +/- 4.43), fat-free mass (R2 = .88, SEE = +/- 3.94, and fat weight (R2 = .90, SEE = +/- 4.11)]. The equations provided estimates of body density, percentage of fat, fat-free mass, and fat weight, which were not statistically different from the hydrostatically determined criterion variables. CONCLUSIONS: The results of this study indicate that accurate and reliable anthropometric predictive equations can be developed for an active and healthy elderly male population. These equations may be used for accurate epidemiological testing of this group's body composition variables.

Adipose Tissue↗

Measurement of the body composition of living gray seals by hydrogen isotope dilution.

The body composition of living gray seals (Halichoerus grypus) can be accurately predicted from a two-step model that involves measurement of total body water (TBW) by 2H or 3H dilution and application of predictive relationships between body components and TBW that were derived empirically by slaughter chemical analysis. TBW was overestimated by both 2HHO and 3HHO dilution; mean overestimates were 2.8 +/- 0.9% (SE) with 2H and 4.0 +/- 0.6% with 3H. The relationships for prediction of total body fat (TBF), protein (TBP), gross energy (TBGE), and ash (TBA) were as follows: %TBF = 105.1 - 1.47 (%TBW); %TBP = 0.42 (%TBW) - 4.75; TBGE (MJ) = 40.8 (mass in kg) - 48.5 (TBW in kg) - 0.4; and TBA (kg) = 0.1 - 0.008 (mass in kg) + 0.05 (TBW in kg). These relationships are applicable to gray seals of both sexes over a wide range of age and body conditions, and they predict the body composition of gray seals more accurately than the predictive equations derived from ringed seals (Pusa hispida) (Stirling et al., Can. J. Zool. 53: 1021-1027, 1975) and from the equation of Pace and Rathbun (J. Biol. Chem. 158: 685-691, 1945), which has been reported to be generally applicable to mammals.

Aging↗

A new approach for the estimation of body composition: infrared interactance.

A new method for the estimation of body composition in humans, called infrared interactance, is discussed. Infrared interactance is based on the principles of light absorption, reflection, and near-infrared spectroscopy. Body composition (percentage fat) was estimated in 53 adults (23 to 65 yr of age) by infrared interactance and compared to results from deuterium oxide dilution (r = 0.94), skinfold (r = 0.90), and ultrasound (r = 0.89) measurements. The method is safe, noninvasive, rapid, easy to use, and may prove useful to predict percentage body fat, especially in the obese.

Adipose Tissue↗

Body composition and muscle constituents during weight loss: studies in obese patients following gastroplasty.

BACKGROUND: The influence of rapid and prolonged weight loss on body composition and muscle constituents in the obese patient is not well known. There are serious complications related to rapid and prolonged weight loss. It is of general interest to increase the understanding of the mechanisms and consequences of significant weight loss in man. METHODS: In 40 obese patients, the body composition and muscle constituents were studied before and during 1 year of weight loss following gastroplasty. The study was undertaken in two groups (A and B) of obese patients, comprising 32 women and eight men, body weight 82-175 kg and aged 24-49 years. Mean BMI in group A and B was 45 (W/H(2)) and 43 (W/H(2)) respectively. Body composition was assessed by total body potassium measurements and muscle constituents were determined by analyses of muscle specimens obtained percutaneously. RESULTS: The preoperative body composition was found to be equal parts of lean body mass and body fat. Preoperatively, muscle constituents revealed a higher protein content per cell and a lower potassium concentration related to fat-free solids. The loss of 18-28% body fat and lean body mass occurred in equal proportions during the first 3 postoperative months of rapid weight loss, followed by a continuous decrease of body fat but not of lean body mass. The concentrations of proteins and potassium per muscle cell revealed a reduction during the period of rapid weight loss. The RNA/DNA ratio 1 year after surgery was still reduced, indicating a low protein synthesis rate. CONCLUSIONS: Preoperatively mean body fat accounted for 50% of the body weight in obese patients. Following weight loss, body fat, lean body mass and concentrations of proteins were reduced compared to preoperative values. After the period of rapid weight loss, with reduction of lean body mass and body fat in parallel, a progressive reduction of body fat was observed whereas the lean body mass did not decrease further. Protein synthesis rate was still low 12 months after surgery.

Adult↗

Bioelectric impedance phase angle and body composition.

The use of bioelectric impedance phase angle for predicting body composition was determined in 53 males and 69 females 9-62 y of age. The phase angle describes the amount of reactance (Xc) in a conductor relative to the amount of resistance (R). Bioelectric resistance (R) and reactance (Xc) were determined for the whole body and separately for arm, leg, and trunk. Weight, stature, and skinfold thicknesses were measured. Body composition was determined from densitometry. Phase angles for the trunk (phi t), leg (phi 1), and whole body (phi w) had significant (p less than 0.05) negative correlations with percent body fat (%BF) in each sex, and positive correlations with fat-free mass (FFM) in males. In multiple regression analyses, phi t was associated significantly with %BF after controlling for age, mean skinfold thickness, and weight/stature2 in each sex. Bioelectric phase angle for the trunk may be useful for predicting %BF in clinical and survey research.

Adipose Tissue↗

Quality of life, body composition and muscle strength in adult growth hormone deficiency: the influence of growth hormone replacement therapy for up to 3 years.

OBJECTIVE: Adults with GH deficiency complain frequently of low energy levels, emotional lability and mental fatigue resulting in a low perceived quality of life (QOL). Body composition is altered with increased fat mass and decreased lean body mass and muscle strength is reduced. The aims of this study were to determine the effects of replacement GH treatment on: (a) body composition and muscle strength and (b) QOL, using specifically selected and adapted measures. DESIGN: A 12-month study (double-blind placebo-controlled for the first 6 months and open for the second 6 months) of GH replacement injections (0.125 iu/kg/week for the first month and 0.25 iu/kg/week for the following 5 months of each study period) in GH deficient adults on QOL, body composition and muscle strength. This was followed by an open study of a further 12 months' GH treatment assessing QOL and muscle strength. Finally, QOL was assessed after up to 3 years of GH replacement treatment. PATIENTS: Thirty of the 32 adult patients with GH deficiency enrolled completed the initial 12-month study (10 male, mean age 33.5 years, mean (SD) stimulated serum GH response 3.0 mU/l (2.86)). Nineteen patients then opted to continue GH treatment. Of these, 13 patients were available for assessment after a further 12 months' and 24 months' treatment. MEASUREMENTS: Health-related QOL was assessed using 2 specifically adapted scales for adults with GH deficiency: the Life Fulfillment Scale and the Impact Scale. In addition 4 other self-rating questionnaires were used: Nottingham Health Profile, Hospital Anxiety and Depression Scale, Self Esteem Scale and Mental Fatigue Scale. Body composition was assessed by DEXA and quadriceps muscle strength by measuring maximum voluntary contractions. RESULTS: In the initial 12 months' placebo-controlled study perceived energy levels increased after 6 and 12 months of GH treatment (P < 0.01 compared with baseline) in the patients receiving GH for the full 12-month period. There were no changes in energy levels throughout the study in the group receiving placebo for the first 6 months. Also small improvements in impact scores were found after 6 months of GH treatment (P < 0.05) but this was not sustained at 12 months. In both GH and placebo groups life fulfillment worsened after 6 months, but then improved to baseline values after 12 months. In the patients who persisted with GH replacement, energy levels continued to improve (at 2 years, P < 0.01 compared with baseline) but then fell (at 3 years, P = NS compared with baseline). A similar pattern was observed in emotional reaction scores. However, improvements in self-esteem were maintained (at 3 years, P < 0.05 compared with baseline). Body composition altered favourably over the initial 12-month study period with a significant increase in lean mass and decrease in fat mass in both groups after 6-12 months of GH. There were no changes in muscle strength in either group during the initial 12-month study. However, in the patients who were available for assessment after a further 12 months of GH treatment, muscle strength increased significantly (P < 0.02 compared with baseline). CONCLUSION: GH replacement treatment for 6-12 months leads to significant improvements in body composition (DEXA) but longer-term treatment may be needed to increase muscle strength. Self-esteem scores improve and are maintained after 3 years of treatment. Energy levels and emotional reaction improve during treatment for up to 2 years but decline thereafter.

Adult↗

Guidelines for using body composition measurement in patients with human immunodeficiency virus infection.

Wasting remains a significant condition of human immunodeficiency virus (HIV) infection despite antiretroviral treatment. Early identification requires the measurement of various body composition parameters, particularly body cell mass (BCM). Anthropometry may provide some useful information. Cost and complexity issues make many body composition techniques unsuitable for the clinical setting. Bioelectrical impedance analysis (BIA) may be the best method available to caregivers for monitoring serial changes in BCM over time and for determining the occurrence of wasting. It is not useful, however, for detecting body composition changes in patients with fat redistribution syndromes. Portability, low cost, ease of use, and patient acceptance make anthropometry and BIA ideally suited for the clinical setting.

Anthropometry↗

Effects of low-dose estrogen oral contraceptives on weight, body composition, and fat distribution in young women.

OBJECTIVE: To determine prospectively whether the use of low-dose estrogen oral contraceptives (OC) is associated with changes in weight, body composition, or fat distribution. DESIGN: Anthropometric measurements were performed in 49 healthy young (16 to 21 years old) women before commencement of OC use (30 micrograms ethinyl estradiol [EF2] plus 75 micrograms gestodene) and after three and six treatment cycles. Thirty one age- and weight-matched women who were not using OC served as controls. SETTING: Outpatient gynecological clinic of Hadassah Medical Center, a tertiary level hospital, and the "Shilo" voluntary service for the prevention of unwanted pregnancy. MAIN OUTCOME MEASURES: Anthropometric measurements included body mass index (BMI), waist-to-hip girth ratio, and body composition (the percentage of body fat and water), estimated by mean of infrared interactance. RESULTS: In the group of OC users, baseline BMI, percent fat, percent water, and waist-to-hip girth ratio were 21.1 +/- 0.32 (kg/m2), 23.8% +/- 0.63%, 57.4% +/- 0.39%, and 0.73 +/- 0.01, respectively, and did not change significantly after six cycles (20.6 +/- 0.41 [kg/m2], 23.9% +/- 0.57%, 58.1% +/- 0.49%, and 0.72 +/- 0.03, respectively). These measurements were not significantly different when compared with the nonusers. Fifteen OC users (30.6%) gained weight (> 0.5 kg). Weight gain was due to a significant accumulation of fat (from 22.5% +/- 1.1% to 25.6% +/- 0.74%), whereas the percentage of body water remained stable. The waist-to-hip girth ratio also was not changed significantly. Similarly, 11 nonusers (35.4%) gained weight because of similar nonabdominal fat accumulation. Ten OC users (20.4%) lost weight (57 kg +/- 1.51 to 55.4 +/- 1.47 [mean +/- SEM]) and 6 nonusers (19.3%) also lost weight (59 kg +/- 1.42 to 57.3 +/- 1.92). In both groups the loss of weight was not associated with significant change in body composition. CONCLUSIONS: The use of low-dose OC (EE2 plus gestodene) was not associated with overall impact on weight, body composition, or fat distribution. However, when weight gain did occur during OC use, it was due to increase in body fat and not in volume of body water, and it was not associated with changes in fat distribution.

Adipose Tissue↗

Relationship between growth hormone-IGF-I-IGFBP-3 axis and serum leptin levels with bone mass and body composition in patients with rheumatoid arthritis.

OBJECTIVES: Hormonal factors playing a role in bone mass and body composition have been rarely assessed in rheumatoid arthritis (RA). In this study, we aimed to evaluate the growth hormone (GH)-insulin-like growth factor-I (IGF-I)-insulin-like growth factor binding protein-3 (IGFPB-3) axis and serum leptin levels in patients with RA and to determine whether these hormonal/growth factors may influence bone mass and body composition in RA. METHODS: Serum GH, IGF-I, IGFPB-3 and leptin were evaluated in 38 corticosteroid-treated RA patients, 14 non-RA patients under corticosteroids (corticosteroid controls, CC) and 32 healthy controls (HC). Bone density was evaluated using dual X-ray absorptiometry (DEXA), and expressed as bone mineral density (BMD), and quantitative ultrasound (QUS). Body composition was assessed by DEXA. RESULTS: The three groups differed regarding femoral neck, total body BMD, lean mass and QUS parameters with lower values in the RA group (all P < or = 0.05). Growth hormone was higher in RA patients (P=0.0001) while IGF-I and IGFBP-3 did not differ between the three groups. In RA patients there was a tendency to high serum leptin levels and leptin strongly correlated with fat mass (r=0.83, P<0.0001), but not with bone mass measurements or inflammatory parameters. There were no differences for lean mass, GH and leptin between CC and HC. CONCLUSION: Our results suggest that these GH and leptin modifications could have an influence on both bone mass and body composition in RA.

Absorptiometry, Photon↗

Body composition in disease: what can we measure and how can we measure it?

This manuscript presents a brief overview of the topic of body composition in disease. The purpose of this paper is threefold: (1). to present examples of diseases in which body composition assessment might provide valuable information to physicians and other clinical personnel in patient care; (2). provide basic information on the types of methodologies available for various aspects of body composition assessment; and (3). give a brief review of some of the research literature available on the topic of body composition use in disease. Materials in this paper should not be interpreted as providing all the relevant information in this area of research, but the paper does represent a limited overview of the topic.

Adipose Tissue↗

Proton magnetic resonance spectroscopy for assessment of human body composition.

BACKGROUND: The usefulness of magnetic resonance spectroscopy (MRS)-based techniques for assessment of human body composition has not been established. OBJECTIVE: We compared a proton MRS-based technique with the total body water (TBW) method to determine the usefulness of the former technique for assessment of human body composition. DESIGN: Proton magnetic resonance spectra of the chest to abdomen, abdomen to pelvis, and pelvis to thigh regions were obtained from 16 volunteers by using single, free induction decay measurement with a clinical magnetic resonance system operating at 1.5 T. The MRS-derived metabolite ratio was determined as the ratio of fat methyl and methylene proton resonance to water proton resonance. The peak areas for the chest to abdomen and the pelvis to thigh regions were normalized to an external reference (approximately 2200 g benzene) and a weighted average of the MRS-derived metabolite ratios for the 2 positions was calculated. TBW for each subject was determined by the deuterium oxide dilution technique. RESULTS: The MRS-derived metabolite ratios were significantly correlated with the ratio of body fat to lean body mass estimated by TBW. The MRS-derived metabolite ratio for the abdomen to pelvis region correlated best with the ratio of body fat to lean body mass on simple regression analyses (r = 0.918). The MRS-derived metabolite ratio for the abdomen to pelvis region and that for the pelvis to thigh region were selected for a multivariate regression model (R = 0.947, adjusted R(2) = 0.881). CONCLUSION: This MRS-based technique is sufficiently accurate for assessment of human body composition.

Adipose Tissue↗

Body composition and bone measurements in intra-uterine growth retarded and early postnatally undernourished male and female rats at the age of 6 months: comparison with puberty.

Undernutrition in early life may permanently change body structure, physiology and metabolism and leads to chronic diseases in later life. To test whether malnutrition during different critical time periods around birth in the rat has long-lasting effects on body composition and skeletal growth, we examined body weight and body composition in pubertal rats and adult rats of 6 months after pre- and postnatal malnutrition. Prenatal malnutrition or intra-uterine growth retardation (IUGR) was induced by ligation of the uterine arteries on day 17 of gestation and postnatal food restriction (FR) by litter enlargement to 20 pups per mother from day 2 after birth until weaning (day 24). Pubertal markers were balanopreputial separation (BPS) in the male and vaginal opening (VO) in the female. IUGR as well as FR resulted in a persistent growth retardation. From birth in IUGR rats and from day 4 after birth in FR rats until 6 months of age body weight in male and female rats was significantly lower compared with controls (P < 0.01 and P < 0.05). Although total body bone mineral content (TBBMC) did not differ between male IUGR rats and controls at BPS, at the age of 6 months TBBMC was significantly lower (P < 0.01) compared with controls. At BPS as well as at 6 months of age, TBBMC was significantly lower in male FR rats compared with controls (P < 0.05 and P < 0.01). In the female IUGR rats TBBMC was significantly lower compared with controls at VO (P < 0.01) and 6 months (P < 0.05). TBBMC in the female FR rats was significantly lower at VO (P < 0.01), but did not differ from controls at the age of 6 months. For both IUGR and FR male and female rats these differences disappeared after adjusting for body weight. Body composition in terms of total fat mass, percentage fat and percentage lean did not differ from controls in male and female IUGR rats at 6 months and the same results were observed in the female FR rats. However, in the male FR rats, total fat mass and percentage fat were significantly lower compared with controls (P < 0.01 and P < 0.05), while the percentage lean mass was significantly higher (P < 0.05). We conclude that different critical time periods of malnutrition around birth have different effects later in life on growth, which do not disappear at least after 6 months of life. With respect to body composition, only in the FR male rats, differences are found in total fat mass and the balance of percentage fat mass and lean mass. At time of puberty and at the age of 6 months bone mass adjusted for body weight does not seem to be affected by perinatal undernutrition.

Aging↗

The effect of live weight gain and live weight loss on body composition of Merino wethers: chemical composition of the noncarcass organs and the empty body.

Chemical composition of the noncarcass organs, combined noncarcass organs, and fleece-free empty body (FFEB) was measured during live weight gain (LWG) and live weight loss (LWL) to determine the effect of different periods of normal and retarded growth on chemical composition of noncarcass organs and FFEB. Thirty-five Merino wethers had ad libitum access to the experimental diet (17.23% CP and 12.09 MJ/kg of DE) to grow from 23.0 to 33.0 kg live weight and then were fed to lose a total of 10 kg in three periods of 25 d each at the rate of 133 g/d. Groups of five wethers were slaughtered at live weights of 23.0, 26.3, 29.6, and 33.0 kg during LWG and 29.6 (first period), 26.3 (second period), and 23.0 kg (third period) during LWL. The lower combined noncarcass weight in LWL wethers than in LWG wethers at 23.0 and 26.3 kg of live weights was due to the significantly lower protein weight at 23.0 and 26.3 kg (P < .01) and water weight at all common slaughter weights (P < .01). Chemical fat in the combined noncarcass organs was significantly greater in LWL wethers than in LWG wethers at 23.0, 26.3 (P < .01), and 29.6 kg (P < .05). The general increase of chemical fat in the combined noncarcass organs of the LWL wethers was mainly due to the significant increase in the chemical fat in the head and feet at 23.0 (P < .01), 26.3, and 29.6 kg (P < .05), liver at 23.0 kg (P < .01), and total alimentary tract fat at 23.0 (P < .01) and 29.6 kg (P < .05). Although fleece-free empty body weight (FFEBW) was similar in LWG and LWL wethers at all common slaughter weights, FFEB water weight was lower significantly in LWL wethers at 23.0, 26.3 (P < .01), and 29.6 kg (P < .05) and that of chemical fat was greater significantly in LWL wethers at 23.0 (P < .01), 26.3, and 29.6 kg (P < .05) than in LWG wethers. Wethers after weight loss had more chemical fat and less water in their FFEB than normal growing wethers at the same FFEBW.

Animals↗

Physical activity and body composition in 10 year old French children: linkages with nutritional intake?

OBJECTIVES: To investigate the relationships between physical activity, dietary intake and body composition in children. DESIGN: A cross-sectional study on physical activity, nutritional intakes and body composition conducted in 86 healthy 10 y old French children. In addition, growth parameters and nutritional intakes were available from the age of 10 months. MEASUREMENTS: Physical activity level (using a validated activity questionnaire over the past year), nutritional intake (dietary history method), anthropometric measurements (body weight, height, arm circumference, triceps and subscapular skinfolds, Body Mass Index (BMI), arm muscle and arm fat areas calculated from these measurements) at the age of 10 y. Anthropometric measurements and nutritional intakes were recorded in the same children at the age of 10 months and every 2 y from the age of 2 y. RESULTS: At the age of 10 y, active children ingested significantly more energy than less active children, mostly due to higher energy intake at breakfast and in the afternoon. This higher energy intake was accounted for by increased consumption of carbohydrates (281 g vs 246 g; 49.6% vs 47.4% of total energy). Even if the amounts of fat consumed were similar in both groups (90 g vs 84 g; P = 0.09), the percentage of fat intake was lower in active children (35.4% vs 37.4%; P = 0.04). The percentage of protein was not different (14.9% vs 15.3%; P = 0.33). In spite of a higher energy intake in the active group, active and less active children had similar BMI at the age of 10 y. However, their body composition differed significantly: active children had a higher proportion of fat-free mass, a lower proportion of fat-mass as measured in the arm and they had a later adiposity rebound. Fatness was significantly and positively associated with the time spent watching television and video games. CONCLUSIONS: Physical activity was associated with improved body composition and growth pattern. This association may be related to nutritional changes: active children consumed more energy by increasing carbohydrate, thus reducing the relative fat content of their diet. These results provide support to encourage physical activity during childhood.

Age Factors↗

Body composition in adults with Type 1 diabetes at onset and during the first year of insulin therapy.

AIMS: To describe body composition in patients with Type 1 diabetes at diagnosis and during the first year after initiation of insulin therapy. RESEARCH DESIGN AND METHODS: In 10 (eight male and two female) newly onset Type 1 patients, age 31.5 +/- 3.2 years (27-37 years) (sd and range), body mass index (BMI) 20.8 +/- 1.6 (19.2-23.4) kg/m2, body composition was estimated by means of dual-energy X-ray absorptiometry (DXA) whole body scanning supplemented by estimation of total body water (TBW) (isotope dilution technique with 3H2O) at diagnosis and after 1, 3, 6 and 12 months of insulin therapy. RESULTS: During the first year after onset of diabetes body weight (BW) increased 4.3 +/- 2.9 (0.1-8.3) kg (P = 0.0012) distributed as a 13.3% (1.6 kg) increase in total fat mass (FM) and 4.9% (2.5 kg) increase in lean body soft tissue mass (LBM). The self-reported weight loss at onset was 6.3 +/- 2.5 kg (1.5-10.0 kg). Compared with two reference populations the Metropolitan Life Insurance Co. and a healthy age and sex-matched local DXA scanned group the initial body composition data demonstrated BW 6.2 kg below ideal weight and a significant reduction of the FM (25% or -0.87 sd), whereas LBM was within the expected range. CONCLUSIONS: During the first year after onset of Type 1 diabetes the mean increase in BW is 6.5% with a 13.3% increase in FM and a 4.9% increase in LBM. Self-reported data on premorbid BW suggest an approximately 10% reduction in BW at onset of Type 1 diabetes. Compared with a healthy reference population initial body composition data demonstrate a 25% reduction of the FM, whereas only a minor and non-significant reduction in the LBM is encountered. These data indicate that uncontrolled diabetes is rather a fat catabolic state than, as previously believed, a protein catabolic state.

Absorptiometry, Photon↗

Effects of four years' treatment with biosynthetic human growth hormone (GH) on body composition in GH-deficient hypopituitary adults.

Short-term trials of growth hormone (GH) substitution in hypopituitary adults have shown beneficial effects on body composition. To evaluate the long-term effects on body composition, we followed thirteen GH-deficient adults (GH < 6 mU/l following standard provocative tests) for 4 years of GH replacement. At yearly intervals, serum insulin-like growth factor I (IGF-I), body weight, body mass index (BMI), waist, waist-to-hip circumference ratio (WHR) and resting systolic (SBP) and diastolic blood pressure (DBP) were determined, and body composition was assessed using three independent methods: total body potassium (TBK), bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). Compared to baseline, IGF-I levels increased significantly at 1 (p = 0.0001), 2 (p = 0.0004), 3 (p = 0.006) and 4 years (p = 0.002). Body weight and BMI changed minimally at 1, 2 and 3 years and increased significantly only at the fourth year (p = 0.012 and p = 0.0009, respectively) of GH therapy. Waist and WHR decreased significantly at 1, 2 and 4 years (waist: p = 0.0009, p = 0.0004, p = 0.049; WHR: p = 0.0025, p = 0.012, p = 0.047, respectively). Neither resting SBP nor DBP changed significantly. Fat-free mass (FFM) derived from TBK and BIA increased significantly at 1 (p = 0.004; p = 0.004), 2 (p = 0.003; p = 0.05), 3 (p = 0.005; p = 0.04) and 4 years (p = 0.02; p = 0.002). Using DXA, the increase in FFM was significant at 1 (p = 0.007) and 2 years (p = 0.008) but not at 3 and 4 years. Percentage body fat measured by TBK, BIA and DXA decreased significantly at 1 (p = 0.008; p = 0.003; p = 0.03), 2 (p = 0.018; p = 0.06; p = 0.049) and 4 years (p = 0.03; p = 0.002; p = 0.04). A rise in total body water, calculated from BIA, was observed at 1 year (p = 0.004) and was maintained throughout the treatment period. These data demonstrate that 4 years of GH treatment in hypopituitary adults is associated with sustained improvement in body composition.

Absorptiometry, Photon↗