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Fetal body composition.

PURPOSE OF REVIEW: The purpose of this review is to highlight recent developments in the evaluation of fetal growth, focusing on the determination of fetal body composition. The ultimate goal of this area of investigation is to improve predictions of perinatal morbidity and mortality beyond that achieved employing estimated fetal weight as the primary discriminator of the risk associated with abnormal fetal growth. RECENT FINDINGS: Several validated techniques have emerged which appear capable of quantifying fetal lean body mass and fat mass. Preliminary investigations suggest that these body composition parameters do distinguish, with a higher degree of precision than estimates of fetal weight alone, clinical influences that contribute to abnormal fetal growth. Studies linking estimates of fetal body composition to improved prediction of perinatal morbidity and mortality are currently limited. SUMMARY: Quantitative estimates of fetal body composition can currently be achieved with recently developed and validated ultrasound tools. Their utility for the improved prediction of perinatal morbidity and mortality has not yet been rigorously examined.

Adult↗

Effects of training on weight, food intake, and body composition in aging rats.

This study investigated the effect of endurance training on body weight, food intake, and body composition in female rats age 6, 15, and 27 mo. Animals underwent 12 wk of treadmill running. There was a significant increase in percent body fat associated with age. Training induced significant reductions in body fat which were of the same relative magnitude in all age groups. The 6-mo and 15-mo exercising rats significantly increased their food intake in response to the training stimulus; the 27-mo trained animals were unable to increase their food consumption relative to controls. It was concluded that 27-mo old animals are capable of changes in body composition similar to those of their younger counterparts, however, physiological mechanisms responsible for these shifts are age dependent. Older animals do not compensate their dietary intake for the increased energy expenditure of exercise as do the younger animals.

Aging↗

Anthropometric evaluations of body composition of undergraduate students at the University of La Reunion.

A positive correlation is well established between obesity and the susceptibility to develop metabolic syndrome, a multifactorial disease dramatically associated with an enhanced mortality risk in the developed world. A high prevalence of obesity has recently been described at La Réunion Island, a French department in the Indian Ocean. Anthropometry is generally considered as the single most easily obtainable, inexpensive, and noninvasive method that reflects body composition. At the University of La Réunion, a laboratory course involving students was designed to teach anthropometric measurements for the determination of body composition. Using skin fold thickness equations, students determined the fat and total muscular masses of their body composition. The influences of sex and their physical activity or inactivity on these different parameters were compared and interpreted at the end of the course. Positive and significant correlations were established between the students' body mass indexes values and their fat mass percentages and between their fat-free and muscular masses as well. A higher fat mass percentage was found in sedentary students compared with more active ones. Therefore, this laboratory makes the students practice and understand the use of classical techniques to evaluate the body composition of a person. It also alerts them to the correlation between a sedentary attitude and higher body fat content. This laboratory course constitutes an active introduction to a following lesson on more recent and actual techniques used to evaluate body composition.

Adult↗

Menopause, energy expenditure, and body composition.

OBJECTIVES: The effects of menopause transition on metabolic and cardiovascular disease risk in women are unclear. It is unknown whether estrogen deficiency, aging, or a combination of both factors are independent contributors to a worsening health profile in women. We considered the effects of menopause transition and hormone replacement therapy on body composition, regional body fat, energy expenditure, and insulin sensitivity. METHODS: A brief review of current literature that has considered the role of menopause transition and hormone replacement therapy on body composition, energy expenditure, and insulin sensitivity with an emphasis on longitudinal investigations. RESULTS: Preliminary evidence suggests that natural menopause is associated with reduced energy expenditure during rest and physical activity, an accelerated loss of fat-free mass, and increased central adiposity and fasting insulin levels. Hormone replacement therapy has been shown to attenuate these changes. Longitudinal and longer intervention studies are needed to confirm these initial findings. CONCLUSIONS: Menopause transition may represent a risky period in a woman's life, 'triggering' adverse metabolic and cardiovascular processes that predispose women to a greater incidence of obesity-related comorbidities. Dietary, exercise, and hormonal interventions specifically targeted at premenopausal women may help mitigate the worsening cardiovascular and metabolic risk profile associated with menopause.

Body Composition↗

Marginal malnutrition in school-aged Colombian boys: body composition and maximal O2 consumption.

Do changes in body composition account for the changes in O2 consumption during maximal exercise (VO2max) in nutritionally deprived boys? School age urban and rural boys with no deficits (N) or with significant deficits (W-H) in weight for age and for height were studied. Percentage lean body mass was higher in W-H than in N boys. By contrast percentage intracellular water, the creatinine excretion coefficient and percentage arm muscle mass were not higher in W-H boys. Thus nutritional compromise decreased more the cellular than the support tissues of the body. VO2max per unit body weight was higher in W-H than in N boys. In the rural group, this was accounted for by the higher percentage lean body mass in W-H boys. In the urban group, VO2max/lean body mass was also higher in most W-H boys. Thus W-H urban boys had higher levels of aerobic training than N urban boys, reflecting perhaps a relative increase in daily physical activity as the same tasks have to be performed with less muscle by W-H boys.

Adolescent↗

Energy expenditure and body composition during weight reduction in hyperplastic obese women.

The energy expenditure and body composition changes in out-patients during a long-term weight reduction with a diet recommended to provide 1100 kcal were studied in eight hyperplastic obese women. The study was focused on finding plausible explanations for the decreasing weight loss rate after several weeks of successful weight reduction. Using a heart rate monitoring method, the energy expenditure was measured four times at selected intervals during the study. Then, the energy intake was calculated on the basis of three dietary recordings lasting from 4 to 7 days. The recorded energy intake increased at the end of the weight reduction, but no changes in daily energy expenditure were found. The oxygen consumption during standardized cycling, walking, and domestic work decreased, but when the patient was at rest, no changes occurred during the weight reduction. The weight loss predicted from the energy balance and body composition changes was considerably greater than the actually determined weight loss. Large discrepancies were found after 5 weeks on the weight reducing regimen between the recorded dietary intake and what could be calculated from urinary nitrogen losses. With the available methods for determining energy intake and expenditure, it was considered impossible to fully explain the reason for the weight plateau observed after long-term weight reduction in out-patients.

Adipose Tissue↗

Bioelectrical impedance measurements at various frequencies to estimate human body compositions.

Bioelectrical impedance analyses (BIA) operating at various frequencies were used to estimate body composition parameters and compared with the biochemically determined parameters by using isotopic dilution method in 22 healthy adult (30-50 years old) male human subjects. BIA instruments, operating at 50,100 KHz and 5 to 500 KHz range, were used to measure body compositions, namely total body water (TBW), fat free mass (FFM), and fat mass (FM). TBW of these subjects was also determined by deuterium dilution method. BIA methods measured at 100 KHz and using multifrequencies appear to be more accurate than at 50 KHz when compared with isotopic dilution method as standard. This accuracy could be attributed due to measurements made at higher frequencies that falls in the region where current passes through both extra- and intracellularly, thereby giving an appropriate measure of TBW. All the subjects participated in this study belong socioeconomically to the middle class and do not apparently look obese or fatty. However, the mean of their body fat, as estimated by the standard deuterium dilution method, was about 30% which is suggestive of an unapparent obesity prevailing in this class of people in Bangladesh.

Adult↗

Trophic factor supplementation: effect on the age-associated changes in body composition.

Many of the changes in body composition associated with aging are similar to those found in states of growth hormone deficiency. Elderly people have also been found to have significant abnormalities in several trophic factor systems including growth hormone/insulin-like growth factors, and both male and female sex hormones. This has led to intense interest in the clinical effects of trophic factor supplementation in older individuals. This article reviews the age-related alterations in the growth hormone and sex steroid axes, as well as the effects of supplementation. In addition, important questions about the use of trophic factors in the elderly that must be addressed in future research are put forth.

Aged↗

[Estimation in vivo of the body composition of the ewe by measuring the diffusion space of heavy water].

Relationships for estimating body lipids, energy and proteins from the deuterium-oxide (D2O) diffusion space have been determined using 38 dry, pregnant or lactating ewes. The animals were fed as usual and had free access to water up to slaughter. They were injected with deuterium-oxide in the morning, half an hour to 3 hours after being fed the whole daily ration or half of it. Blood samples were collected between 1 and 24 h after injection. The deuterium-oxide content of blood water was determined by infra-red spectrophotometry. The ewes were slaughtered 24 h after injection and their body water, protein, ash and energy were chemically determined. Different blood samples were used to measure the deuterium-oxide diffusion space (theoretical initial concentration Co method). The closest relationship between measured body water (ECM) and D2O diffusion space (ECD2O) was found when the blood sample collected 8 h after injection was discarded. Ewe body composition was estimated using a linear relationship in which ewe body weight and D2O diffusion space were two independent variable (relationship number 5). The best ewe body weight to use was the weight measured at injection time. The estimation of body lipid was significantly affected by physiological status when slaughter weight and true body water, measured at slaughter, were used. The effect of this physiological status decreased when the water content of the digestive tract was taken into account and it was no longer significant when the water content of the uterus and conceptus was considered. Body composition could always be predicted by estimating the water content; the standard error was nearly 1.4 kg. However, the method was not accurate enough to obtain a significant effect of physiological status on lipid estimation. Thus, at present we have proposed identical equations for dry, pregnant or lactating ewes.

Adipose Tissue↗

Body composition and energy metabolism in normotensive and hypertensive pregnancy.

OBJECTIVE: To determine whether the insulin resistance syndrome and altered body composition are features of hypertensive pregnancy. DESIGN: Women were recruited in the third trimester of pregnancy from the antenatal clinic, day assessment unit, and maternity ward of St George Hospital, Sydney. POPULATION: Women with pre-eclampsia (n = 12), gestational hypertension (n = 12), essential hypertension in pregnancy (n = 11), and normotensive pregnancy (n = 10). METHODS: Energy metabolism was assessed by indirect calorimetry to measure basal metabolic rate and diet-induced thermogenesis. Body composition was measured as lean body mass, total body water and fat mass by bio-electrical impedance. Blood was collected for measurement of glucose, insulin and lipid profiles. Insulin resistance was indirectly assessed by the insulin and glucose concentrations and diet-induced thermogenesis. RESULTS: Women with essential hypertension and gestational hypertension were heavier than women with normotensive pregnancies both pre-pregnancy and in the third trimester, whereas women with pre-eclampsia were similar to those with normotensive pregnancy. Women with essential hypertension were otherwise similar to normotensive pregnancy but women with gestational hypertension had a reduced diet-induced thermogenesis and almost double insulin levels. Women with pre-eclampsia had a similar body composition and insulin levels but reduced basal metabolic rate, diet-induced thermogenesis and glucose levels compared with normotensive pregnancy. CONCLUSIONS: Women who develop gestational hypertension, but not pre-eclampsia, are more likely to be overweight. Women with essential hypertension are similar to women with normotensive pregnancy throughout pregnancy. Both gestational hypertension and pre-eclampsia appear to be associated with some degree of insulin resistance, greater than that occurring in normal pregnancy.

Adult↗

Onset of lay related to multiphasic growth and body composition in White Leghorn pullets provided ad libitum and restricted diets.

Growth of the body as a whole and of parts of the reproductive tract of White Leghorn pullets that ate ad libitum and restricted diets were analyzed by a multiphasic growth function. Parameter estimates were related to onset of lay. Chemical body compositions at defined stages of pubertal growth were related to the development of the reproductive organs. Data of pullets that had been restricted in one of two rearing periods (0 to 6 and 7 to 18 wk of age) were used. In each period, pullets were fed a low-lysine diet or a daily restricted amount of feed, on a pair-gain basis. In all mathematical fits, a well distinguishable "pubertal body growth spurt" at around 19 wk of age was found. About 40 to 70% of total growth within this phase consisted of growth of the reproductive tract (the ovary covered 19 to 35%, the oviduct 15 to 23%, and the uterus 7 to 11% of total growth). Age at maximum gain of the pubertal body growth spurt was 20.1 wk for lysine-restricted pullets and 19.6 wk for feed-restricted pullets. This difference reflected differences in onset of lay (50% rate of lay) between lysine- and feed-restricted birds (22.3 and 21.6 wk, respectively). An interval of 14 to 15 d existed between maximum gain of the pubertal body growth spurt and onset of lay. It was suggested that the occurrence of the pubertal body growth spurt can serve as a predictor for subsequent onset of lay. Body composition at defined moments during the pubertal body growth spurt was calculated by interpolation from chemical analyses of Weeks 15, 18, 20, 22, and 24. Crude fat content in the body at start of the pubertal body growth spurt varied considerably between the feeding regimens (112 to 179 g). The fat-free body (consisting of CP, ash, and water) showed less variation between the treatments at this stage (807 to 870 g). It is concluded that a particular amount of fat-free tissue is critical in pullet development and may be required before sexual organ development starts.

Age Factors↗

Effects of metformin on the body composition in subjects with risk factors for type 2 diabetes.

OBJECTIVES: To measure the effect of metformin on the body composition, insulin resistance and sensitivity in subjects with risk factors for type 2 diabetes mellitus (type 2 DM). DESIGN: Placebo-controlled clinical trial. MATERIAL AND METHODS: Twenty-three subjects with risk factors for type 2 DM were randomly assigned to receive 850 mg of metformin or a placebo twice a day for 2 months. Before and after the treatment, the body mass index and waist/hip ratio were calculated, the body composition was measured through bioelectric impedance and the fasting levels of blood glucose, insulin, triglycerides and cholesterol were measured. The level of insulin resistance was calculated by the homeostatic model and the level of sensitivity by the quantitative insulin sensitivity check index method. The Wilcoxon rank test was used. RESULTS: Twenty-one subjects completed the study, 12 of the metformin group and nine of the placebo group. In the metformin group, there was a decrease in fat weight from 25.9 +/- 9.4 to 20.8 +/- 9.2 kg, p < 0.01, an increase in lean weight from 57.05 +/- 13.6 to 61.9 +/- 16.5 kg, p < 0.01, an increase in basal metabolism from 1735 +/- 413 to 1878 +/- 505 calories/day, p < 0.05 and an increase in body water, p < 0.05. There was no significant decrease in insulin resistance. In the placebo group, the blood glucose increased from 84.7 +/- 13 to 96.7 +/- 16 mg/dl, p < 0.05. There were no significant modifications in lipids. CONCLUSIONS: The administration of metformin for 2 months improves the parameters of body composition and insulin dynamics in subjects with risk factors for type 2 DM.

Adult↗

The capabilities of artificial neural networks in body composition research.

When estimating in vivo body composition or combining such estimates with other results, multiple variables must be taken into account (e. g. binary attributes such as gender or continuous attributes such as most biosignals). Standard statistical models, such as logistic regression and multivariate analysis, presume well-defined distributions (e. g. normal distribution); they also presume independence among all inputs and only linear relationships, yet rarely are these requirements met in real life. As an alternative to these models, artificial neural networks can be used. In the present work, we describe the pre-processing and multivariate analysis of data using neural network techniques, providing examples from the medical field and making comparisons with classic statistical approaches. We also address the criticisms raised regarding neural network techniques and discuss their potential improvement.

Body Composition↗

Determinants of bone mineral density in older men and women: body composition as mediator.

This study aimed to assess the relative importance of several determinants of bone mineral density (BMD) and to examine to what extent these potential determinants influence total hip BMD through body composition. The study population consisted of 522 participants (264 women and 258 men) of the Longitudinal Aging Study Amsterdam (LASA), aged 65 years and over, and living in Amsterdam and its vicinity. BMD of the total hip was measured using dual-energy X-ray absorptiometry (DXA). Potential determinants of BMD were age, weight change since age 25 years, lifestyle factors, chronic diseases, medication use, and hormonal factors. Potential mediators between the possible determinants and BMD were two measures of body composition: fat mass (FM) and appendicular muscle mass (AMM). Multiple regression analyses including all potential determinants in one model without body composition identified age, weight change, walking activity, and sex hormone-binding globulin (SHBG) as independent determinants for total hip BMD in women. In men, current smoking, participation in sports, and parathyroid hormone (PTH) concentration were independently associated with total hip BMD. When total hip BMD was regressed on the potential determinants and each measure of body composition, it appeared that FM, and to a lesser extent, muscle mass (MM), were independently related to BMD. In women, adjustment for FM reduced the strength of the associations of weight change, walking activity, and SHBG with total hip BMD. Adjustments for MM did not influence the associations between the determinants and BMD. In men, neither FM nor MM appeared to play a mediating role between the determinants and BMD. It can be concluded that (1) FM and MM are strong independent determinants of total hip BMD and that (2) FM possibly plays a mediating role in the association of weight change, walking activity, and SHBG with total hip BMD in women.

Adipose Tissue↗

Energy expenditure and body composition in patients with anorexia nervosa.

Blood biochemistry, body composition, and resting energy expenditure were studied in 25 patients with anorexia nervosa admitted to hospital during a period of 18 months. The patients' ages ranged from 12.9 to 17.2 years, and the abnormal feeding history from 3 to 12 months. Blood chemistry values were in the normal range, but fat body mass and lean body mass were reduced and extracellular water volume was expanded beyond normal values. Resting energy expenditure was reduced to 49% to 91% of values predicted by the Harris-Benedict equations. Substrate use after overnight fast indicated an abnormally high use of carbohydrates. Significant correlations were found between extracellular water volume and triceps skin-fold thickness, mid-arm muscle circumference and lean body mass, and substrate use and weight loss as a percentage of initial weight. We suggest that these simple anthropometric measurements can be used to assess and monitor the refeeding of patients with anorexia nervosa.

Adolescent↗

Evaluation of body composition and nitrogen content of renal patients on chronic dialysis as determined by total body neutron activation.

Total body protein (nitrogen), body cell mass (potassium), fat, and water were measured in 15 renal patients on maintenance hemodialysis (MHD). Total body nitrogen was measured by means of prompt gamma neutron activation analysis; total body water was determined with tritium labeled water; total body potassium was measured by whole body counting. The extracellular water was determined by a technique utilizing the measurement of total body chloride and plasma chloride. When compared with corresponding values of a control group of the same age, sex, and height, the protein content, body cell mass, and total body fat of the MHD patients were within the normal range. The only significant change was an increase in the extracellular water/body cell mass ratio in the male MHD patients compared to the controls. The lack of significant difference of the nitrogen values of the MHD patients compared to matched controls suggests that dialysis minimizes any residual effects of uremic toxicity or protein-calorie malnutrition. These findings further suggest that there is a need to reevaluate the traditional anthropometric and biochemical standards of nutritional status for MHD patients. It was concluded that it is particularly important to measure protein stores of MHD patients with low protein intake to ascertain nutritional status. Finally, in vivo measurement of total body nitrogen and potassium for determination of body composition provides a simple, direct, and accurate assessment of the nutritional status of MHD patients.

Adipose Tissue↗

Body composition and energy expenditure: relationship and changes in obese subjects before and after biliopancreatic diversion.

Changes in total and segmental body composition were studied in 101 obese women before and 2, 6, 12, and 24 months after biliopancreatic diversion (BPD) and data 24 months after surgery were matched to 53 control subjects. The patients were studied by anthropometry, indirect calorimetry, and double-emission x-ray absorptiometry (DXA). The combination of calorimetry and body composition analysis allowed estimation of visceral and muscle lean mass. We observed a significant (analysis of variance [ANOVA]: P <.05) progressive reduction of fat and lean body mass (LBM) following BPD, with stabilization of both parameters between 12 and 24 months at levels not different from controls. Fat loss was significant in the arms, legs, and trunk segments. After 24 months, there was no significant difference in segmental fat mass between post-BPD patients and controls. Calorimetric data seem to confirm lean body mass (LBM) reduction. Visceral lean mass (kg) was significantly reduced from 8.1 +/- 2.2 in obese subjects to 6.5 +/- 1.8 in post-BPD patients at 24 months (P <.05); the control value was 7.2 +/- 1.8. Muscular lean mass (kg) was also significantly reduced, from 50.2 +/- 5.8 to 39.8 +/- 5.7 in the same subjects (P <.05), with a control value of 42.5 +/- 5.9. The decrease in muscle and visceral LBM reached control values without significant differences. Viscera/muscle ratio in pre-BPD patients was preserved in post-BPD patients at 24 months, but it was reduced during weight loss. Body composition studies showed a logarithmic relationship between fat and lean mass and a physiological contribution of lean mass to weight loss in the BPD patients. In conclusion, weight loss after BPD was achieved with an appropriate decline of LBM and with all parameters reaching, at stable weight, values similar to weight-matched controls.

Adipose Tissue↗

In vivo validation of whole body composition estimates from dual-energy X-ray absorptiometry.

We validated whole body composition estimates from dual-energy X-ray absorptiometry (DEXA) against estimates from a four-component model to determine whether accuracy is affected by gender, race, athletic status, or musculoskeletal development in young adults. Measurements of body density by hydrostatic weighing, body water by deuterium dilution, and bone mineral by whole body DEXA were obtained in 172 young men (n = 91) and women (n = 81). Estimates of body fat (%Fat) from DEXA (%FatDEXA) were highly correlated with estimates of body fat from the four-component model [body density, total body water, and total body mineral (%Fatd,w,m); r = 0.94, standard error of the estimante (SEE) = 2.8% body mass (BM)] with no significant difference between methods [mean of the difference +/- SD of the difference = -0.4 +/- 2.9 (SD) % BM, P = 0.10] in women and men. On the basis of the comparison with %Fatd,w,m, estimates of %FatDEXA were slightly more accurate than those from body density (r = 0.91, SEE = 3.4%; mean of the difference +/- SD of the difference = -1.2 +/- 3.4% BM). Differences between %FatDEXA and %Fatd,w,m were weakly related to body thickness, as reflected by BMI (r = -0.34), and to the percentage of water in the fat-free mass (r = -0.51), but were not affected by race, athletic status, or musculoskeletal development. We conclude that body composition estimates from DEXA are accurate compared with those from a four-component model in young adults who vary in gender, race, athletic status, body size, musculoskeletal development, and body fatness.

Absorptiometry, Photon↗