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PubMed2002

Early evolution of nutritional status and body composition after kidney transplantation.

BACKGROUND: Previous series have dealt with nutritional status after kidney transplantation. However, few studies have described the outcome of body composition after kidney transplantation. METHODS: A total of 44 cadaver kidney transplant recipients (28 men and 16 women) were followed prospectively during the first post-transplant year. Biochemical nutritional markers, dietary records, anthropometric measurements, and body composition were assessed at kidney transplantation and 3, 6, and 12 months later. RESULTS: By the end of the first year, serum albumin level was not significantly different from initial values. Prealbumin and retinol binding protein decreased from 42.3 +/- 10.2 mg/dL to 30.4 +/- 6.3 mg/dL and from 1.96 +/- 0.61 g/dL to 0.65 +/- 0.2 g/dL (P < 0.0001). Separating patients by gender showed that dietary caloric and protein intake increased in women only. At the end of the follow-up period, mean weight change was +5.4 kg in women (P = 0.009) and -0.9 kg in men (not significant). Body composition analyses showed that in women total fat and lean masses increased (+2.1 kg, P = 0.05, and +2.4 kg, P = 0.006), whereas in men total fat mass decreased (-1.4 kg, P = 0.04), and total lean mass tended to increase (+0.5 kg, not significant). Percentage change in total bone mass was +1.4% in women (not significant) and -2.1% in men (P = 0.05). In multivariate analyses, an independent impact of female gender on weight gain was observed, although increased fat mass was related only to energy intake. Increased total lean mass was related to low steroid doses and the absence of acute rejection and delayed graft function. Bone loss was related to male gender and high steroid doses. CONCLUSION: Changes in body composition during the first year after kidney transplantation are modulated by gender, energy intake, steroid doses, the occurrence of acute rejection, and delayed graft function.

Absorptiometry, Photon↗

PubMed2006

Growth hormone status in morbidly obese subjects and correlation with body composition.

Morbidly obese subjects are characterized by multiple endocrine abnormalities and these are paralleled by unfavorable changes in body composition. In obese individuals, either 24-h spontaneous or stimulated GH secretion is impaired without an organic pituitary disease and the severity of the secretory defect is proportional to the degree of obesity. The GHRH+arginine (GHRH+ARG) test is likely to be the overall test of choice in clinical practice to differentiate GH deficiency (GHD) patients. Similarly to other provocative tests, GHRH+ARG is influenced by obesity per se. Therefore, a new cut-off limit of peak GH response of 4.2 microg/l in obese subjects has been recently assumed. The aim of the present study was to investigate the reciprocal influence between decreased GH secretion and body composition in a group of 110 morbidly obese subjects, using the new cut-off limit of peak GH response to GHRH+ARG test for these subjects. In our study, GHD was identified in 27.3% of the obese subjects, without gender difference. In GDH obese subjects body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), fat mass (FM), and resistance (R) were higher while reactance (Xc), phase angle, body cell mass (BCM), IGF-I, or IGF-I z-scores were lower than in normal responders (p<0.001). In all obese subjects, GH peak levels showed a negative correlation with age, BMI, waist circumference and FM, and a positive correlation with IGF-I. In the stepwise multiple linear regression, waist circumference and FM were the major determinants of GH peak levels and IGF-I. In conclusion, using the new cut-off limit of peak GH response to GHRH+ARG test for obese subjects, about 1/3 morbidly obese subjects were GHD. GHD subjects showed a significantly different body composition compared with normal responders, and the secretory defect was correlated to different anthropometric variables with waist circumference and FM as the major determinants.

Adipose Tissue↗

PubMed2002

Body composition in ambulatory women with multiple sclerosis.

OBJECTIVE: To compare whole-body fat mass and fat-free mass (FFM) in ambulatory patients with multiple sclerosis (MS) and control subjects without MS. DESIGN: Nonrandomized controlled trial or cross-sectional study. SETTING: An exercise physiology laboratory at a medical school. PARTICIPANTS: Seventeen ambulatory patients with MS and 12 control subjects (all subjects were women). The median Expanded Disability Status Scale (EDSS) score was 4.0 for the individuals with MS. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Whole-body percentage of fat-free mass (%FFM), percentage of body fat (%BF), FFM, and fat mass. RESULTS: A significant difference in age was observed between the groups; thus, age was used as a covariate in the body composition analyses. No significant differences were observed between the groups in %BF: 32.5+/-13.9 and 27.8+/-5.6 (P=.54) for MS and controls, respectively, or %FFM, 67.1+/-14.9 and 71.3+/-12.4 (P=.42) for MS and controls, respectively. For individuals with MS, no significant relation was observed between EDSS score and %BF (P=.24) or between EDSS score and %FFM (P=.24). CONCLUSION: No significant differences were observed in body composition between ambulatory MS patients and controls. Furthermore, the EDSS score was not a significant predictor of %BF or %FFM for people with MS.

Activities of Daily Living↗

PubMed1995

Dietary factors affecting the maximum feed intake and the body composition of pre-ruminant kid goats of the Granadina breed.

An experiment was carried out with kid goats of the Granadina breed to identify the dietary factors affecting voluntary feed intake of the kid goat and those that additively could determine its body composition. The animals used were from birth to 61 d of age, fed ad lib. on different milk replacers containing 200, 240 and 280 g crude protein/kg DM and 200, 240 and 280 g fat/kg DM, thus giving nine dietary treatments. The utilization of the milk replacers and the animals' body composition were determined by balance and slaughter trials. There were significant positive effects of protein concentration of the milk replacers on component digestibilities, energy metabolizability, feed intake, empty-body weights, empty-body composition and protein and fat retention. The concentration of fat in the milk replacers also had a significant positive effect on the digestible and metabolizable energy concentration of the diets and on fat retention. The relationships existing between feed intake and diet composition (concentration of digestible protein, metabolizable energy and digestible protein:metabolizable energy ratio) as well as between empty-body composition or protein and fat retention and diet composition, were examined. From these it was deduced that feed intake was significantly influenced by the digestible protein concentration of the diets. The higher the digestible protein concentration the higher the feed intake up to a maximum digestible protein concentration value. As the digestible protein concentration of the diets was the dietary factor which significantly influenced feed intake, this also significantly influences the body composition and the protein and fat retention. The protein concentration of the feed at which metabolizable energy intake in these animals would be greatest was estimated to be 347 g/kg DM.

Analysis of Variance↗

PubMed2006

Body composition of patients with hypertensive complications during pregnancy.

OBJECTIVE: To determine the body composition of women with the diagnoses of gestational hypertension or preeclampsia. METHODS: Cross-sectional study, including four groups of patients who were in the third trimester: those with an uncomplicated pregnancy (n = 110), those with a diagnosis of gestational hypertension (n = 38), those with mild preeclampsia (n = 8), and those with severe preeclampsia (n = 11). Their fat mass, fat-free mass, and total body water were estimated by bioelectric impedance. RESULTS: The fat mass was 20 +/- 7 kg in the control group and 26 +/- 13 kg in the group with gestational hypertension (p < 0.05). The total body water was 36 +/- 6 L in the control group, 50 +/- 10 L in the patients with gestational hypertension, 52 +/- 10 L in those with mild preeclampsia, and 48 +/- 9 L in those with severe preeclampsia (p < 0.05). CONCLUSION: The results suggest that maternal body composition shows significant differences in patients with hypertensive complications during pregnancy. These data may be related to a possible inadequate distribution of the volume of water as a result of alterations in capillary permeability.

Adult↗

PubMed1982

Steps toward the development of generalized equations for predicting body composition of adults.

The estimation of body density from anthropometric variables is often used to measure body composition. The purpose of this report was to review the development of early published equations and follow the transition from population specific equations to generalized equations for adults. The accuracy of population specific equations were improved and refined with the addition of circumference and diameter measures in combination with skinfolds and the use of populations of varied ages and degrees of body fatness. The major weakness of the population specific equations was their inability to account for aging and the non linear relationship between subcutaneous fat and body density. Regression models using the quadratic sum of skinfolds and age have been developed to account for these sources of variation. Cross-validation research has shown that these generalized regression models are accurate for adult males and females varying greatly in age and body fatness.

Adolescent↗

PubMed1999

Hydration of fat-free body mass: review and critique of a classic body-composition constant.

The assumed "constancy" of fat-free body mass hydration is a cornerstone in the body-composition research field. Hydration, the observed ratio of total body water to fat-free body mass, is stable at approximately 0.73 in mammals and this constancy provides a means of estimating total body fat in vivo. This review examines both in vitro and in vivo data that support the hydration constancy hypothesis and provides a critique of applied methodology. Biological topics of interest are then examined and critical areas in need of future research are identified. These are important issues because water dilution is the only method currently available for estimating body fat in all mammals, which range in body mass by a factor of 10(4).

Absorptiometry, Photon↗

PubMed1998

Qualitative human body composition analysis assessed with bioelectrical impedance.

Body composition is generally aiming at quantitative estimates of fat mass, inadequate to assess nutritional states that on the other hand are well defined by the intra/extra cellular masses proportion (ECM/BCM). Direct measures performed with phase sensitive bioelectrical impedance analyzers can be used to define the current distribution in normal and abnormal populations. Phase angle and reactance nomogram is directly reflecting the ECM/BCM pathways proportions and body impedance analysis (BIA) is also validated to estimate the individual content of body cell mass (BCM). A new body cell mass index (BCMI) obtained dividing the weight of BCM in kilograms by the body surface in square meters is confronted to the scatterplot distribution of phase angle and reactance values obtained from controls and patients, and proposed as a qualitative approach to identify abnormal ECM/BCM ratios and nutritional states.

Body Composition↗

PubMed2000

Body composition during the first 2 years of life: an updated reference.

Normative body composition during the first 2 y of life was derived from a prospective study of 76 children. We present 1) fat free mass (FFM) and its components, and fat mass (FM), 2) incremental growth rates partitioned into chemical components, and 3) age-specific and gender-specific constants for converting chemical and physical components into FFM for children during the first 2 y of life. A multicomponent model based on measurements of total body water (TBW), total body potassium (TBK) and bone mineral content (BMC) was used to estimate FFM and FM at 0.5, 3, 6, 9, 12, 18, and 24 mo of age. TBW was determined by deuterium dilution, TBK by whole body counting, and BMC by dual energy x-ray absorptiometry. FFM was higher in boys than girls between 0.5-18 mo of age (p < or = 0.05). Percent FM increased on average from 13 to 31% between 0.5 and 3-6 mo, and then gradually declined. Percent FM was significantly higher in girls than in boys at 6 and 9 mo of age (p < or = 0.02). The components of FFM on a percentage basis changed with age (p = 0.001), but not gender. The protein content of FFM increased gradually with age, while TBW declined (p = 0.001). As a percentage of FFM, osseous mineral increased from 2.0 to 3.4% in boys and from 2.1 to 3.3% in girls between 0.5 and 24 mo (p = 0.001). Density and potassium content of FFM increased gradually with age (p = 0.001). These normative body composition data provide an updated reference upon which to assess normal growth and nutritional status of pediatric populations representative of mixed feeding groups during the first 2 y of life.

Absorptiometry, Photon↗

PubMed1994

The effect of alterations in physical and chemical characteristics on TOBEC-derived body composition estimates: validation with non-human models.

The measurement of total-body electrical conductivity (TOBEC) has become one of the standard methods for the estimation of body composition in infants. We investigated, using non-human models, the effect on the accuracy of TOBEC-derived body composition estimates of alterations in physical and chemical characteristics of the fat-free mass (FFM). The effect of electrolyte type, concentration and volume on TOBEC was determined using 2, 3 and 51 solutions of six different chlorides and sodium bicarbonate. Equimolar concentrations yielded TOBEC values in accordance with known ion conductivities: H+ >> Ca2+ > Mg2+ > K+ > Na+ > Li+ and Cl- > HCO3-. The behaviour of these solutions was described very accurately over a wide range of concentrations (1-200 mM) by a simple exponential law. Dissolved egg-white protein, glycine and L-glutamine elicited no TOBEC signal. In vitro, using polyethylene bottles filled with physiologic saline, in the interval of 2-45 degrees C a linear relation was observed between temperature and TOBEC. Below the freezing point no TOBEC signal was elicited. The effect of tissue autolysis and body temperature on TOBEC was examined by repeated measurements of TOBEC and temperature in seven fresh infant minipig cadavers. Five minipigs were allowed to cool. Shortly after death TOBEC decreased by 2.5% per degrees C. Two animals were kept at constant temperature. The TOBEC signal showed a gradual increase of 9% after 7 h due to autolysis. We conclude that in vivo TOBEC measurements are affected by ion concentration (e.g. non-isotonic hydration changes), geometry (e.g. deviations in body shape), temperature (e.g. fever, skin cooling) and tissue autolysis (measurements after death). Proteins, molecules with strong dipole moments and ions trapped in crystalline structures do not significantly affect the TOBEC reading.

Animals↗

PubMed2004

Development of a model based on body composition to predict drug kinetics-1 evaluation in healthy volunteers.

A kinetic model for widely used drugs, based on body composition analysis, was developed and evaluated in young and elderly healthy individuals. Body composition was studied by body impedance analysis (BIA). Antipyrine, amlodipine, digoxin and tobramycin kinetics, liver microsomal activity enzyme (lidocaine/MEGX test), and appropriate clinical and laboratory tests were carried out. Major variables (V(d), AUC, t(1/2), C(max), Cl) for these drugs were calculated, and the possible relationships with the other clinical and biochemical data were analyzed by the Pearson's moment correlation, forecasting models being then obtained by a multiple linear regression method. Major kinetic parameters, particularly for the mixed elimination drugs (liver/renal), i.e. digoxin and amlodipine, proved to be well correlated to data collected during the study, in particular with body structure parameters. Results were less satisfactory in the case of the mainly renally handled tobramycin. Mathematical models to forecast the kinetic behaviors of the three chosen drugs, using readily accessible data, showed both in the young and the elder, as well as in the whole examined population, very satisfactory correlations in the case of digoxin (R(2) ranging from 0.89 to 0.85) and amlodipine (R(2) between 0.81 and 0.91), less satisfactory (with a wide range of R(2), from 0.65 to 0.94), in the case of tobramycin.

Adult↗

PubMed1998

Growth and body composition of preterm infants: influence of nutrient fortification of mother's milk in hospital and breastfeeding post-hospital discharge.

We examined the influence of multi-nutrient fortification of mother's milk (MM + MNF) compared to supplementation with calcium and phosphorus (MM + CaGP) alone in hospital (in a randomized trial), and of breastfeeding (post-MM) compared to formula feeding (post-FF ) after hospital discharge with a descriptive analysis of growth and body composition to 1 y corrected age in preterm infants. Anthropometry, nutrient intakes and whole body bone mineral content, lean and fat mass were determined at four time points in the first year after term corrected age. Body composition was determined with dual energy X-ray absorptiometry. MM + MNF compared to MM + CaGP for preterm infants in the early neonatal period did not appear to influence growth or body composition in the first year. Growth in post-MM and post-FF groups was within the normal range of growth references derived from term infants fed mother's milk. Post-MM infants had lower whole body bone mineral content (132.3 +/- 10.4 g) at 6 months corrected age when compared to post-FF infants (159.4 +/- 14.1 g) and greater percent fat mass to 12 months corrected age. These differences may result from the lower calcium, phosphorus and protein intakes in post-MM compared to post-FF infants. Our findings demonstrate that dietary practices after hospital discharge likely have a greater impact on body composition in prematurely born infants than dietary practices in hospital. Whether the observed differences in body composition between breastfed and formula-fed preterm infants have any long-term consequences requires further investigation.

Body Composition↗

PubMed1993

Effects of the Iditarod Sled Dog Race on serum thyroid hormones and body composition.

Cold exposure, activity and energy deficit have been associated with changes in body composition and/or changes in serum thyroid hormones. Because these conditions are present during the Iditarod Sled Dog Race, 10 volunteer participants were studied before and after the race. Body composition, total thyroxine (TT4), free thyroxine (FT4), total triiodothyronine (TT3), and free triiodothyronine (FT) levels were determined. There was a significant decrease in body weight (p < 0.05) and a decrease in body fat (p < 0.01). There were no significant changes in TT4, FT4, TT3 or FT3. On the basis of this study, it can be concluded that the strenuous activity of the Iditarod mitigates against the classic perturbation in thyroid axis brought on by the hypocaloric state.

Body Composition↗

PubMed2003

Comparison of bone mineral density and body composition measurements in women obtained from two DXA instruments.

Information is lacking regarding the comparison of bone mineral and body composition measurements obtained from the different dual energy X-ray absorptiometry (DXA) systems. The purpose of this study is to compare body composition and whole body bone mineral density (BMD) measurements from the hologic QDR-4500 W (DXA H) and the lunar (DXA L) systems. Seven women older than 40 years of age, were scanned on the same day by using DXA H and DXA L by the same observer. Measured total fat mass, percentage fat, whole body fat free soft tissue mass and BMD were similar between machines, but body mass was significantly higher with DXA L than with DXA H (P=0.0156). This was due to a higher bone mineral content obtained with DXA L. Agreement between the two DXA systems was quantified by using the Bland and Altman method. For each variable, all pairs of measurements were within the 95% confidence limits. These results suggested that we could use the two measurement methods interchangeably. However, due to the bone mineral inter-machine differences, comparisons of DXA measurements from different machines should be interpreted with caution.

Absorptiometry, Photon↗

PubMed2000

Body composition in hemodialysis patients--is it different from that of normal subjects?

OBJECTIVE: Body composition assessment is an important method of evaluating nutritional and metabolic status in hemodialysis patients. PATIENTS AND METHODS: To assess the body composition of hemodialysis patients, we used dual-energy X ray absorptiometry to test 40 stable chronic hemodialysis patients and 40 normal subjects. The patients were from 38 to 70 years old, and all without diabetic mellitus. Comparing with the hemodialysis patients, the normal subjects were selected on a one-to-one base with the same sex and about the same age, body weight and height. RESULTS: The lean body mass/body weight (LBM/BW) ratio had no significant statistical difference between hemodialysis patients and normal subjects in this study (63.02 +/- 8.42% vs 64.80 +/- 7.92%, p =0.3308). The male LBM/BW ratio was higher than that of the female (71.07 +/- 4.63% vs 59.30 +/- 6.35%, p < 0.0001). According to the multiple linear regression analyses, the LBM of hemodialysis patients had positive correlation with gender (p < 0.0001), height (p = 0.0360) and weight (p < 0.0001). The total bone mineral density (BMD) of hemodialysis patients was found to be lower than that of the normal subjects (0.90 +/- 0.10 g/cm vs 0.97 +/- 0.08 g/cm, p = 0.0092). The BMD had been found to be low in the hemodialysis patients with serum intact parathyroid hormone (iPTH) > 1,700 pg/ml. The BMD had negative correlation with age in the female hemodialysis patients (r = 0.63, p = 0.0009), but no correlation in the male hemodialysis patients and in the female or male normal subjects. With the multiple linear regression analyses, the BMD of hemodialysis patients had positive correlation with weight (p = 0.0329) and negative correlation with age (p = 0.0183) and serum iPTH (p = 0.0231). CONCLUSION: We concluded that: the LBM/BW ratio of hemodialysis patients was not different from that of normal subjects. Severe secondary hyperparathyroidism hemodialysis patients had low BMD. The BMD had negative correlation with age in the female hemodialysis patients.

Adult↗

PubMedDate not supplied

Prediction of body composition in elderly men over 75 years of age.

A comprehensive number of body composition predictions (involving weight, height, skinfold thicknesses, bioelectrical impedance and near-infrared interactance-NIRI) were evaluated against total body water (TBW from isotope dilution), in 23 randomly selected men over 75 years old, and dual-energy X-ray absorptiometry (DXA), in 15 volunteers from this group. Comparisons were made between anthropometric and impedance methods for estimating limb muscle mass (obtained using DXA). Bias and 95% limits of agreement between measured TBW and DXA estimates were -2.1 kg and 3.1 kg, respectively (for fat, 5.4% and 6.1% body weight). Agreement between TBW predictions and reference measurements was remarkably variable, irrespective of whether TBW was predicted from TBW-specific equations or indirectly from estimates of fat or fat-free mass: for predictions using anthropometry, bias ranged from -4.7 kg to 1.6 kg and 95% limits of agreement from bias +/- 3.8 kg to +/- 5.0 kg; using impedance, bias was -8.8 kg to 3.2 kg and 95% limits of agreement were bias +/- 3.6 kg to +/- 7.8 kg; corresponding values for NIRI were -5.3 kg and +/- 5.4 kg. Although some non-age-specific equations appeared valid, age-specific equations generally predicted TBW better. Limb muscle mass (DXA) was predicted better using the segmental impedance method, from indices of limb muscle area (r = 0.76; SEE = 1.9 kg) and volume (r = 0.86; SEE = 1.6 kg), than by anthropometry alone (r = 0.61 and 0.71; SEE = 2.3 kg and 2.1 kg, respectively). In conclusion, some body composition predictions are unacceptable (at least for TBW) in older men, and care is recommended when selecting from these methods or equations. Also, the segmental impedance method is as good as, if not better than, anthropometry alone in predicting limb muscle mass (DXA) in older men.

Absorptiometry, Photon↗

PubMed1999

Comparison of air-displacement plethysmography with hydrostatic weighing and bioelectrical impedance analysis for the assessment of body composition in healthy adults.

BACKGROUND: Over the past decade, considerable attention has been paid to accurately measuring body composition in diverse populations. Recently, the use of air-displacement plethysmography (AP) was proposed as an accurate, comfortable, and accessible method of body-composition analysis. OBJECTIVE: The purpose of this study was to compare measurements of percentage body fat (%BF) by AP and 2 other established techniques, hydrostatic weighing (HW) and bioelectrical impedance analysis (BIA), in adults. DESIGN: The sample consisted of healthy men (n = 23) and women (n = 24). %BF was measured by AP, HW, and BIA. RESULTS: In the total group, %BF(AP) (25.0+/-8.9%) was not significantly different from %BF(HW) (25.1+/-7.7%) or %BF(BIA) (23.9+/-7.7%), and %BF(AP) was significantly correlated with %BF(HW) (r = 0.944, P < 0.001) and with %BF(BIA) (r = 0.859, P < 0.01). Compared with HW, AP underestimated %BF in men (by -1.24+/-3.12%) but overestimated %BF in women (by 1.02+/-2.48%), indicating a significant sex effect (P < 0.05). The differences in estimation between AP and BIA and between BIA and HW were not significantly different between the sexes. CONCLUSION: AP is an accurate method for assessing body composition in healthy adults. Future studies should assess further the cause of the individual variations with this new method.

Adipose Tissue↗

PubMed1997

The effect of smoking tobacco on neonatal body composition.

OBJECTIVE: Our purpose was to examine the differences in body composition in infants of women who smoke compared with those of nonsmokers. STUDY DESIGN: Within 24 hours of birth anthropometric measurements and total body electrical conductivity estimates of body composition were obtained on 129 term infants (30 born to women who smoked tobacco during pregnancy and 99 born to women who did not smoke). Anthropometric measurements included weight, skinfolds, circumferences, and crown-heel and extremity lengths. RESULTS: There was a significant decrease in weight in the infants of smokers (3145 +/- 414 gm vs 3354 +/- 525 gm, p = 0.05). There was a decrease in crown-heel length (49.2 +/- 2.0 cm vs 50.1 +/- 2.2 cm, p = 0.03), the length of the lower leg (7.9 +/- 0.6 cm vs 8.4 +/- 0.6 cm, p = 0.0001), upper leg (9.1 +/- 0.7 cm vs 9.9 +/- 0.8 cm, p = 0.0001), and the lower arm (7.2 +/- 0.5 cm vs 7.5 +/- 0.4 cm, p = 0.0001). There were no significant differences in the skinfold and limb circumference measurements. Infants of smokers had significantly decreased fat-free mass as estimated by total body electrical conductivity (2799 +/- 292 gm vs 2965 +/- 359 gm, p = 0.02) but no significant difference in fat mass (343 +/- 164 gm vs 387 +/- 216 gm, p = 0.32). CONCLUSIONS: The decrease in birth weight in infants of women who smoked is primarily due to a decrease in fat-free mass.

Adult↗