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Association of body composition and weight history with breast cancer prognostic markers: divergent pattern for Hispanic and non-Hispanic White women.

Body composition and weight gain are breast cancer risk factors that may influence prognosis. The Health, Eating, Activity, and Lifestyle Study was designed to evaluate the relations of body composition, weight history, hormones, and lifestyle factors to prognosis for women with breast cancer. In the cross-sectional analysis of this cohort study specific to 150 Hispanic and 466 non-Hispanic White women in New Mexico diagnosed between 1996 and 1999, the authors hypothesized that obesity measures are associated with baseline prognostic markers and that these associations are modified by ethnicity. Ethnic-stratified multiple logistic regression analyses showed divergent results for a tumor size of 1.0 cm or more and, to a lesser extent, positive lymph node status. Among Hispanics, the highest quartile for body mass index (29.5 vs. <22.5 kg/m2: odds ratio (OR) = 0.16, 95% confidence interval (CI): 0.03, 0.84) and for waist circumference (> or =95.0 vs. <78.5 cm: OR = 0.09, 95% CI: 0.01, 0.78) was significantly associated with a reduced tumor size. In contrast, for overweight and obese non-Hispanic White women, there was an increased association with obesity-related measures, particularly striking for the highest quartile of waist circumference (OR = 2.76, 95% CI: 1.45, 5.26). These findings suggest that Hispanics may have a different breast cancer phenotype than non-Hispanic Whites, which associates differently with body composition and weight history.

Adult↗

Bioelectrical impedance and zoometry for body composition analysis in domestic cats.

Zoometric measurements and bioelectrical impedance analysis were evaluated as methods of body composition determination in healthy cats. Zoometric and impedance measurements were taken on 22 anesthetized adult cats of various ages, genders, breeds, and body weights. The cats were then euthanatized. The bodies were processed through a tissue homogenizer and free-catch specimens were taken, freeze-dried, and analyzed for total body water, protein, fat, potassium, and ash content. Stepwise regression analysis was implemented to identify statistically significant relationships between the chemically determined dependent variables (total body water, protein, potassium, fat-free mass, fat mass, and percent body fat) and the zoometric measurements, with or without bioelectrical impedance analysis. Statistical analysis revealed high correlations between the dependent variables and the corresponding predicted values of those variables. Body weight alone was a poor predictor of body composition in these cats. On the basis of these findings, we suggest that zoometric and bioelectrical impedance measurements may serve as practical, noninvasive, simple, and accurate methods for estimating body composition in domestic cats.

Animals↗

Serum leptin levels and bioelectrical impedance assessment of body composition in patients with Graves' disease and hypothyroidism.

We investigated whether thyroid status modulates serum leptin concentrations and body composition as determined by bioelectric impedance analysis (BIA). The percent body fat mass (%FM) in male Graves' disease was significantly lower than that in age- and sex- matched normal subjects, at the levels of 11.4+/-6.4% (mean+/-SD) vs 19.9+/-9.2% for men (n=12, P<0.05) but not for women (22.6+/-7.6% vs 24.9+/-13.1%, n=28). In contrast, in female hypothyroidism (n=11) %FM was significantly higher than that in normal subjects (32.9+/-11.5%, P<0.01). Among other body composition parameters, the percentage of body water (%BW), and lean body mass (LBM) were significantly lower in hypothyroid patients, and the ECM (extracellular mass)/BCM (body cell mass) ratio was significantly (P<0.0001) increased in Graves' disease which was the result of marked depletion of BCM with concomitant expansion of ECM. The serum leptin levels were significantly decreased in male Graves' patients (2.3+/-0.7 ng/ml, P<0.05), whereas in female Graves' patients (8.8+/-5.9 ng/ml) and patients with hypothyroidism (9.5+/-7.6 ng/ml), the levels were not different from those of normal controls matched for BMI or %FM. There was a positive correlation between serum leptin levels and %FM in female Graves' patients (r=0.635, P=0.001) and in hypothyroid patients (r=0.801, P=0.014) but not in male Graves patients. There was no significant relationship between serum leptin levels and thyroid hormones, TRAb, or TSAb. In euthyroid obese subjects there was a positive relationship between serum leptin levels and serum TSH levels (r=0.37, P<0.01). These results suggest that hyperthyroidism is characterized by the decreased fat mass and serum leptin levels in men, but female patients appear to be resistant to the effect of thyroid hormones. Together with previous reports, thyroid status has a minor role in the regulation of serum leptin levels.

Adult↗

Body composition in infants with chronic lung disease after treatment with dexamethasone.

UNLABELLED: The aim of this study was to study the effect of chronic lung disease (CLD) and dexamethasone treatment on body composition in preterm infants (birthweight < 1500 g). In addition, anthropometric measurement of body composition were compared with dual-energy X-ray absorptiometry (DXA). Fourteen preterm infants with CLD and a comparison group of 18 preterm infants were studied until 3 mo corrected age. CLD infants received approximately 20 kcal kg-1 per day extra nutritional intake during dexamethasone treatment until term. At term no differences were found between CLD and no CLD infants for percentage bone mass (1.4 +/- 0.2 vs 1.4 +/- 0.1%), fat mass (18.7 +/- 4.5 vs 17.4 +/- 3.5%), lean body mass (79.9 +/- 4.6 vs 81.2 +/- 3.5%) or bone mineral density (0.15 +/- 0.02 vs 0.15 +/- 0.01%). At 3 mo corrected age both groups were also similar for bone mass (1.6 +/- 0.1 vs 1.6 +/- 0.2%), fat mass (22.6 +/- 5.5 vs 24.5 +/- 5.7%), lean body mass (75.8 +/- 5.7 vs 74.0 +/- 5.8%) and bone mineral density (0.20 +/- 0.02 vs 0.20 +/- 0.01%). All anthropometric measurements showed a high correlation with body composition. However, calculated fat mass was 56.7 +/- 8.8% lower than fat mass measured with DXA. CONCLUSION: Body composition at term and 3 mo corrected age in preterm infants treated with dexamethasone for CLD, who received extra caloric intake until term, did not differ from that in preterm infants without CLD.

Absorptiometry, Photon↗

[The relationship between body composition and bone mineral density in college women].

PURPOSE: To investigate body compositons and bone mineral density(BMD) in college women and to find the relationship between them. METHOD: From January to March of 2001, BMD at four parts(forearm, lumbar, femur and whole body), body mass index(BMI), body fat mass(BFM), lean body mass(LBM) and body fat percentage(%Fat) were measured with the Dual Energy X-ray Absorptiometry. Other physical characteristics were measured with a scale, a height measurer, and questionnaires. RESULT: Grouping by the BMI, 43.2% showed low weight, and 5% over weight. When applying the percent Fat, 43.8 % was diagnosed as obesity group. The fact indicate that a majority of college women have unbalanced body composition with high percent Fat, compared to their body weight. Assessing the BMD with the WHO standards, 91.4-95.7% of the BMD of forearm and whole body was normal. But, 40.3% and 33.1-43.9% showed osteopenia at lumbar and femur, and 1.4 %, 0.7-7.2% showed osteoporosis. The BMD at all parts showed significant correlation each other(r=.29-.89, p=.001-.000). Body weight and BMI showed correlations to with BMDs at all parts of the body(r=.19-.46, p=.025-.000; r=.18-.45, p=.039-.000). But the percent Fat had a correlation with only femur neck BMD(r=.19, p=.024). CONCLUSION: This study showed a majority of healthy college women were exposed to the risk for osteoporosis. Additional study is required to develop nursing interventions to remove the risk factors of osteoporosis. In particular, the acquisition of balanced body composition is necessary, increasing body weight and BMI through the increase of LBM, not through the quantitative increase of BFM.

English Abstract↗

Associations of body composition with physical performance and self-reported functional limitation in elderly men and women.

To understand how body composition relates to functional impairment, the authors examined cross-sectional associations of absolute and relative measures of fat and lean mass with physical performance and self-reported functional limitation. The sample consisted of a community-based cohort of 1,655 older women and men from Sonoma, California, who had complete baseline data in 1993-1994 on body composition, physical performance, and functional limitation. Physical performance was assessed by walking speed and grip strength, while global functional limitation, across several domains, was assessed by self-report using standard questions. Lean mass and fat mass were estimated from bioelectric impedance using population-specific prediction equations derived from dual x-ray energy absorptiometry. Higher fat mass was associated with slower walking speed and greater likelihood of functional limitation, while higher lean mass was generally associated only with increased grip strength. A higher lean mass-to-fat mass ratio, a relative measure of body composition, was associated with faster walking speed and less limitation. These findings suggest that fat mass negatively impacts some domains of physical performance and overall functioning, while lean mass is less significant in absolute terms but is important relative to amount of body fat.

Adipose Tissue↗

Body composition and metabolic features in women with adrenal incidentaloma or Cushing's syndrome.

The aim of this study was to evaluate body composition and metabolic features in women with nonhypersecretory adrenal cortical incidentaloma (AI) and women with Cushing's syndrome (CS) compared with healthy control (C) women matched for age, menopausal status, and body mass index. We examined 15 females with CS, 22 with AI, and 20 C. We evaluated anthropometric, hormonal, and metabolic parameters in all subjects. Body composition was measured by dual-energy x-ray absorptiometry for total body (TB); in addition, abdominal fat was measured between L2 and L4 vertebrae. Women with CS and AI were overweight; waist to hip ratio mean values showed that women with CS and AI had a central fat distribution. TB fat was significantly higher in CS than in C women, however, AI women also had high fat values. Abdominal fat was significantly more increased in CS than in AI and C women. Eighty percent of CS women and 50% of AI women were hypertensive. High density lipoprotein cholesterol levels were lower and triglyceride levels were higher in CS and AI women than in C. The area under the curve for glucose after oral glucose tolerance test was significantly higher in CS and AI than in C. AI had urinary free cortisol values slightly higher than C and than the normal range. In conclusion, these data indicate that AI are at an intermediate state between normal and pathological. These alterations suggest that a subtle cortisol hypersecretion is probably present in AI and it may be the factor promoting alterations of body composition and metabolic parameters.

Absorptiometry, Photon↗

The effects of long-term, moderate intensity, intermittent exercise on aerobic capacity, body composition, blood lipids, insulin and glucose in overweight females.

OBJECTIVE: To test the hypotheses that the accumulation of 30 min of moderate intensity, intermittent exercise, 5d/week-1, for 32 weeks, will increase aerobic capacity, alter body composition and improve blood lipids, insulin and glucose. Secondly, to identify individuals who may respond to moderate intensity, intermittent exercise. SUBJECTS: Thirteen sedentary, moderately obese females, aged 43 +/- 11 (y), body mass index (BMI) 32.7 +/- 7.7 (kg/M2), body fat 40.6 +/- 8.8 (%), VO2max 24.0 +/- 4.6 (ml/kg-1/min-1). MEASUREMENTS: Aerobic capacity, body composition, blood lipids, fasting insulin and glucose, energy intake. RESULTS: Group data showed no significant changes for aerobic capacity, body composition, blood lipids, insulin or glucose. However, 7 of the 13 subjects increased aerobic capacity, lost fat weight and improved insulin. Adherence to the exercise regimen was excellent with 82.6 +/- 10.0% of the exercise completed. CONCLUSIONS: Moderate intensity, intermittent exercise for a total of 30 min, 5d/week,-1 for 32 weeks duration, was not a sufficient stimulus to significantly increase aerobic capacity, and alter weight, body composition or improve blood lipids, insulin or glucose for the entire group. However, those subjects who increased aerobic capacity and decreased fat weight were significantly older, had lower maximal aerobic capacity and greater body fat at baseline compared to the six subjects who did not increase aerobic capacity and decrease fat weight. For both groups, moderate intensity, intermittent exercise showed excellent adherence and this may be a useful model for future research studies.

Adult↗

Changes in body composition of malnourished children after dietary supplementation as measured by bioelectrical impedance.

Body composition was measured with bioelectrical impedance in 35 malnourished children aged 24-59 mo to investigate the effect of a 3-wk feeding supplementation. Twenty children received a high-protein diet with 15% of total energy as protein, whereas 15 children received an isoenergetic standard-protein diet with 7.5% of energy as protein. Bioelectrical impedance analysis and anthropometry were done before and after 21 d of dietary supplementation. The children fed the high-protein diet gained significantly more body weight than those receiving the standard-protein diet (1.33 +/- 0.54 vs 0.88 +/- 0.47 kg, P < 0.02). The total body water and fat-free mass determined by bioelectrical impedance analysis showed that the group fed the high-protein diet increased significantly more (0.92 vs 0.58 kg) than those on the standard-protein diet (P < 0.02). Results of this study suggest that feeding a high-protein diet accelerates catch-up growth and restores the reference body composition in children recovering from malnutrition.

Body Composition↗

Body composition in affective disorder before, during, and after lithium carbonate therapy.

The body composition of three unipolar and 17 bipolar patients, studied during the depressive state, was compared with that of 48 controls. The ratio of extracellular to intracellular water content was significantly less in male patients than in male controls: the difference between female patients and female controls was not statistically significant. In patients of both sexes, residual sodium concentration was greater in patients than in controls. The intracellular content of potassium was the same in patients as in controls. In six patients, body composition was studied prior to lithium carbonate therapy, after 17 days of treatment, and 17 days after discontinuing administration of the drug. The significant changes were a decrease in body weight during therapy, and a decrease in body water content and an increase in residual sodium concentration after drug treatment was discontinued.

Adipose Tissue↗

Body composition of African American and white children: a 2-year follow-up of the BAROC study.

OBJECTIVE: To evaluate the 2-year changes in body composition of white and African American boys and girls. RESEARCH METHODS AND PROCEDURES: A total of 114 boys and girls ages 12 to 14 years with equal sex and ethnic distribution between African American and white races participated in measurements of body composition using DXA, underwater weighing (densitometry), skinfold thickness, corporal diameters, circumferences, isotope dilution (H(2)(18)O), and bioelectric impedance. RESULTS: Sixty-eight of the 114 children advanced from Tanner Stages 1 and 2 to Tanner Stages 3 to 5 over a 2-year period. More than 50% of the children were in the top 15th percentile according to normative data for body mass index but not for triceps skinfold. All measures except for percentage of fat, density, and four of the six skinfolds increased significantly during the 2 years, with no differences between races, genders, or fat group. The boys who advanced in Tanner Stage reduced their percentage of fat and a number of skinfolds and increased their lean body mass, but the girls did not. The percentage of water was significantly higher in the fatter children and declined significantly over 2 years. Most children remained in the same quartile of body fat, lean body mass, and bone mineral content over 2 years. DISCUSSION: The data are consistent with the hypothesis that over 2 years, growth is the major determinant of changing body composition, with body-fat group and sexual maturation being additional variables.

Absorptiometry, Photon↗

Postpartum body composition changes in lactating and non-lactating primiparas.

The objective of this study is to evaluate the postpartum body composition changes in lactating versus non-lactating or formula-feeding primiparas during the first 12 wk. Twenty primiparous females (age range 17-35 y) who decided to nurse or formula feed their infant were studied. The non-lactating mothers (n = 6) were younger (21 versus 29 y) and had a lower prepregnancy weight (55 kg versus 63 kg) than the lactating mothers (n = 14). Body weight, height, waist and hip measurements, 3-d dietary and activity records, skin-fold thickness from triceps, suprailiac, midthigh, and midupper arm circumference, and total body composition were evaluated at three time periods (at delivery, at 6 wk, and at 12 wk postpartum). Total body composition for bone mineral, lean, and fat mass was measured by dual energy x-ray absorptiometry. At delivery and 6 wk postpartum, the weights and heights were similar between the two groups. By 12 wk postpartum, the formula-feeding group had a weight loss that was different from delivery, 66 +/- 10 kg to 59 +/- 8 kg, P < 0.03. There was no significant weight change in the lactating group during the study. The weight loss consisted of more lean mass than fat mass. The total body bone mineral content did not differ between the two groups during the study. Both groups had reduction in their waist size from delivery to 12 wk postpartum. But only the non-lactating mothers had reductions in their hip and midthigh measurements. There were no changes between the two groups in the skin-fold measurements. Lactating mothers had a higher total daily calories (1974 +/- 318 versus 1464 +/- 178 calories, P < 0.002) and fat intake (63 +/- 14 versus 47 +/- 9 g, P < 0.02) than the non-lactating mothers. The energy expenditure was similar between both groups. In conclusion, during the first 12 wk postpartum, non-lactating mothers who were younger and weighed less prepregnancy lost body weight and had more waist, hip, and midthigh size reductions compared to lactating mothers.

Adolescent↗

The effects of high altitude trekking on body composition and resting metabolic rate.

Resting metabolic rate (RMR) and body composition were evaluated in 12 healthy volunteers before and after 16 days of high altitude trekking and climbing. RMR was measured by indirect calorimetry and body composition by electrical impedance. A 29% reduction in energy intake during high altitude exposure was observed. Fat mass loss averaged about 2.2 kg (p < 0.05) and lean body mass about 1.1 kg, which was almost significant (p = 0.07). As expected, estimated RMR at the end of the expedition--calculated by predictive formulae including body fat and lean body mass as covariates--was significantly reduced by 119 kcal/day as a consequence of the reduction in body weight. Measured RMR values, on the contrary, did not show any significant decline. In conclusion our study showed that high altitude trekking induced a weight loss due approximately 2/3rds to fat mass and 1/3rd to lean body mass. Decreased energy efficiency, which was still present several days after returning to sea level, may have helped contribute to weight loss due to reduced energy intake.

Adult↗

Body composition by DXA: tried and true?

Dual-energy x-ray absorptiometry (DXA) is unquestionably the method of choice for the assessment of bone mass. Recent generations of DXA instruments also have the capability of assessing soft tissue mass, thereby providing a three-compartment model of body composition, i.e., bone mineral, fat, and bone-free lean masses. Although hydrodensitometry has long been considered the reference method of assessing body composition, assumptions regarding the constancy of the constituents of fat-free mass may compromise its validity in some populations. Because DXA appears to be less dependent on assumptions regarding biological consistency, it is possible that it has the potential to provide a more accurate assessment of body composition across populations than does hydrodensitometry, and that it should be considered the reference method. DXA has been shown to provide precise measures of body composition, but it remains questionable as to whether those measures are accurate. Contributing to the uncertainty regarding validity is the variability among manufacturers of DXA instruments in the methods of calibration, data acquisition, and data analysis. Although DXA holds great promise in becoming the criterion method of assessing body composition, and has been promoted as such by some investigators, available data indicate that this endorsement is premature.

Absorptiometry, Photon↗

Does laparoscopic gastric bypass result in a healthier body composition? An affirmative answer.

BACKGROUND: Bariatric surgery results in sustained weight loss. While weight loss is the goal of bariatric surgery, fat loss and muscle conservation are germaine goals. This study investigated the hypothesis that body composition would significantly change after laparoscopic Roux-en-Y gastric bypass (LRYGBP). METHODS: Patients undergoing LRYGBP were studied. Percent fat and percent water were calculated via bioelectrical impedance analysis (BIA). Waist and hip circumference were measured in all patients as well. Measurements were taken preoperatively, and at 1 month, 3 months, 6 months, and 1 year. Non-parametric ANOVA was utilized for statistical analysis. RESULTS: There were 151 patients included in this study. Fat percentage (48.6 +/- 10.0 vs 34.6 +/- 10.8; P<0.001), total fat mass (141 +/- 37 vs 67 +/- 30; P<0.0001) and total water mass (108 +/- 27 vs 93 +/- 23; P<0.0001) decreased postoperatively at 1 year. Water percentage increased postoperatively at 1 year (37.0 +/- 6.6 vs 52.5 +/- 3.3; P<0.001). Waist:hip ratio improved from preoperatively to 1 year postoperatively (0.895 +/- 0.115 vs 0.811 +/- 0.076; P<0.001). CONCLUSIONS: Bariatric surgery results not only in fat loss but also in a change in body composition. Improved waist:hip ratio, fat percentage decreases, and water percentage increases all indicate an overall healthy body composition. While weight loss is important, improvement in body composition should be another recognized benefit of bariatric surgery.

Adipose Tissue↗

Effect of maternal metabolism on fetal growth and body composition.

The objective of this work is to examine the various maternal metabolic and parental anthropometric and demographic factors that affect fetal growth and body composition. These data are a review of previously published data evaluating 1) demographic and anthropometric factors associated with fetal growth; 2) differences in male and female neonatal body composition; 3) anthropometric and maternal metabolic factors correlated with neonatal birth weight, fat-free mass, and fat mass using stepwise logistic regression analysis; and 4) the relationship between maternal weight gain and birth weight in women with normal glucose tolerance (control subjects) and gestational diabetes mellitus (GDM). We estimated body composition in 186 neonates using anthropometry. Fat-free mass, which comprised 86% of mean birth weight, accounted for 83% of the variance in birth weight, and fat mass, which comprised only 14% of birth weight, accounted for 46% of the variance in birth weight. Male neonates were, on average, 175 g heavier than females. There was significantly (P = 0.0001) greater fat-free mass in males than in females but no significant difference in fat mass. Using stepwise logistic regression, we accounted for 29% of the variance in birth weight, 30% in fat-free mass, and 17% in fat mass. Independent variables included maternal height, pregravid weight, weight gain during pregnancy, education, parity, paternal height and weight, neonatal sex, and gestational age. Including maternal glucose insulin sensitivity in 16 additional subjects, we explained 48% of the variance in birth weight, 53% in fat-free mass, and 46% in fat mass. There was a positive (P = 0.0007) correlation between weight gain and birth weight in control subjects, but a negative (P = 0.34) correlation in women with GDM. In control subjects, the correlation was strongest in women who were lean before conception and became progressively weaker as pregravid weight for height increased. In women with GDM, there were no significant correlations between maternal weight gain and birth weight, irrespective of pregravid weight for height. The assessment of fetal/neonatal body composition may improve our understanding of the effect of differential factors on fetal growth. Factors associated with accretion of fetal adipose tissue in late gestation are less well understood in comparison with birth weight and fat-free mass. Additional studies of maternal glucose and lipid metabolism are needed to better evaluate fetal growth.

Birth Weight↗

Birth weight and body composition in young adult men--a prospective twin study.

OBJECTIVES: To evaluate the association between birth weight and adult body composition in twins, controlling for maternal and genetic influences. DESIGN: Twins were randomly selected from the East Flanders Prospective Twin Survey, a population-based historic twin cohort. SUBJECTS: Male members of 229 twin pairs between 18 and 34 y of age who participated in the Prenatal Programming Twin Study. MEASUREMENTS: Adult body mass, height, BMI, lean body mass, sum of skinfolds and waist-to-hip-ratio. Lean body mass, sum of skinfolds and waist-to-hip-ratio were also adjusted for body mass. Intra-pair difference in adult anthropometric measures between the heaviest and the lightest twin at birth. RESULTS: Per kg increase in birth weight, body mass (4.2 kg), height (3.3 cm), lean body mass (3.1 kg) and to a lesser extent BMI (0.49 kg/m(2)) increased, whereas waist-to-hip-ratio (-1.4%) and sum of skinfolds (-0.11 s.d.) decreased, when adjusted for body mass. In a pair-wise analysis, the heavier twin at birth was taller and heavier as an adult, but, when adjusted for body mass, he had a lower waist-to-hip-ratio, less subcutaneous fat, and more lean body mass, compared to his lighter sib. Intra-pair difference in body composition was associated with intra-pair birth weight difference in monozygotic and dizygotic twins. CONCLUSIONS: An adverse intra-uterine environment, as measured by birth weight, is associated with more subcutaneous and abdominal fat and less lean body mass in adulthood. This association is independent of maternal and genetic influences. However, we cannot exclude the existence of genes that act on both birth weight and adult body composition.

Adolescent↗

Evaluation of fetal growth by estimation of neonatal body composition.

To characterize the variation in normal fetal growth by body composition analysis, 188 neonates from uncomplicated singleton term pregnancies were evaluated within 24 hours of birth. Anthropometric measures used to estimate lean body mass and body fat included the following: birth weight 3553 +/- 462 g, lean body mass 3060 +/- 377 g (86.3%), fat mass 495 +/- 196 g (13.7%), and ponderal index 2.65 +/- 0.25. There was a significant linear correlation between birth weight and lean body mass (r2 = 0.83, P = .0001), fat mass (r2 = 0.46, P = .0001), and ponderal index (r2 = 0.22, P = .001). Although the ponderal index has been used as an index of corpulence, the correlation between ponderal index and percent body fat was poor (r2 = 0.15). These results suggest that although neonatal fat mass constitutes only 14% of total birth weight, it explains 46% of its variance. In contrast, the ponderal index explains only 22% of the variance in birth weight and correlates poorly with percent body fat. Body composition analysis explains a significant amount of the variance in normal birth weight.

Anthropometry↗