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PubMed2001

The influence of zygosity and chorion type on fat distribution in young adult twins consequences for twin studies.

An adverse intra-uterine environment has been associated with abdominal fat distribution in singletons. Twins often have a low birth weight and a short gestation. Therefore, they may have an increased risk to develop abdominal obesity. Furthermore, monozygotic monochorionic twins (MZ MC) have a larger intra-pair birth weight difference compared to monozygotic dichorionic twins (MZ DC). If adult anthropometry is programmed in utero, this may affect the intra-pair correlations in adulthood and, consequently, also the results from the classic twin method to estimate genetic and environmental influences. In the present study, we compared the absolute values, the intra-pair differences, and the intra-pair correlations of body mass, height, BMI, and abdominal fat distribution of 424 MZ MC, MZ DC and dizygotic (DZ) twin pairs (aged 18-34 yrs). DZ, MZ DC and MZ MC twins did not differ for most anthropometric characteristics. Only MZ women tended (p = 0.03) to accumulate more abdominal fat compared to DZ twins. Overall, the contribution of zygosity and chorion type to adult anthropometry was rather low (< or = 1.7%). Although the intra-pair birth weight difference of MZ MC pairs (10.5% in men, 12.3% in women) was significantly larger compared to that of MZ DC pairs (6.9% and 9.2% resp.), the intra-pair differences in adult anthropometry were similar for both MZ twin types. Also the intra-pair correlations of MZ MC and MZ DC pairs were strikingly alike, suggesting no significant influence of the prenatal environment on adult concordance. In conclusion, the substantial difference in the prenatal environment of MZ MC and MZ DC twins did not result in a difference in intra-pair concordance of adult anthropometry and fat distribution. Therefore, we suggest that the chorion type of MZ twins does not bias the twin design and the estimation of the genetic contribution to adult anthropometry.

Adipose Tissue↗
PubMedDate not supplied

Influence of fluid status on techniques used to assess body composition in peritoneal dialysis patients.

OBJECTIVE: A reliable assessment of nutritional state in peritoneal dialysis (PD) patients is of great importance. Nevertheless, techniques used to assess body composition in patients on PD may be affected by abnormalities in fluid status. The primary aim of the present study was to compare different techniques used to evaluate body composition and to assess the influence of fluid status on the assessment of body composition. The secondary aim was to assess the relevance of handgrip muscle strength in the nutritional evaluation of the patient. METHODS: In 40 PD patients, dual-energy x-ray absorptiometry (DEXA), multifrequency bioimpedance analysis (MF-BIA), and anthropometry were compared with respect to the evaluation of body composition [fat mass and lean body mass (LBM; by DEXA), and fat-free mass (FFM; by MF-BIA, anthropometry]. The influence of fluid status on the measurement of LBM/FFM by the various techniques was assessed by their relation to left ventricular end-diastolic diameter (LVEDD), assessed by echocardiography, and by estimating the ratio between extracellular water (ECW) and total body water (TBW), assessed by bromide and deuterium dilution, with LBM (DEXA). The relevance of handgrip muscle strength as a nutritional parameter was assessed by its relation to LBM and other nutritional parameters. RESULTS: Despite highly significant correlations, wide limits of agreement between the various techniques were present with respect to assessment of body composition (expressed as % body weight) and were most pronounced for anthropometry: LBM (DEXA) - FFM (MF-BIA) = 3.4% +/- 12.2%; LBM (DEXA) - FFM (anthropometry) = -5.7% +/- 7.8%; fat mass (DEXA - MF-BIA) = -4.2% +/- 7.9%; fat mass (DEXA - anthropometry) = 2.9% +/- 7.2%. The ratio between ECW and LBM (DEXA) was 0.36 +/- 0.08 L/kg (range 0.25 - 0.67 L/kg), and the ratio between TBW and LBM was 0.75 +/- 0.06 L/kg (range 0.63 - 0.86 L/kg), which shows the variability in hydration state of LBM/FFM between individual patients. LBM/FFM measured by all three techniques was significantly related to LVEDD, suggesting an important influence of hydration state on this parameter. Handgrip muscle strength was significantly related to LBM/FFM, as measured by all three techniques, but not to other nutritional parameters. CONCLUSION: Wide limits of agreement were found between various techniques used to assess body composition in PD patients. The assessment of body composition was strongly influenced by hydration state. The handgrip test is related to body composition, but not to other nutritional parameters.

Adult↗
PubMed1989

Meaning of biodistance statistics: a test case using adult monozygotic twins.

Anthropometry, historically one of the primary research techniques in physical anthropology, has been widely utilized in biodistance studies. The complex genetic and environmental interaction that governs the expression of anthropometric dimensions, together with concerns over measurement error, have sometimes clouded the interpretation of biodistances based upon anthropometry. In this study, 51 pairs of adult monozygotic twins were analysed using discriminant analysis and Mahalanobis' generalized distance. Both male and female twins, grouped by first- versus second-born, displayed very small, statistically insignificant distances between groups. When literature estimates of intra-observer measurement errors were used as a frame of reference, the average absolute differences between the twin pairs were approximately twice the size of the measurement error estimates. The results of this study suggest that, first, the environmental effect upon the genetically influenced traits measured by anthropometry is not large enough to bring about significant multivariate differences between identical twin pairs; and, second, biodistance studies based upon anthropometry can be reliable so long as measurement error is minimized.

Adult↗
PubMed2004

Nutritional status among adult patients admitted to an university-affiliated hospital in Spain at the time of genoma.

BACKGROUND: Although malnutrition in hospitalized patients is generally associated with increasing morbidity and mortality, it is yet a widely unknown problem in hospitals. OBJECTIVES: The aim of this study was to assess the nutritional status of patients admitted to a university-affiliated hospital in Spain using anthropometry measurements and the Subjective Global Assessment (SGA) technique. METHODS: We enrolled 400 patients selected at random using a computer software program. The primary end-point was nutritional status determined within 48 h of admission by anthropometric data (body mass index, triceps skinfold thickness, and upper arm muscle circumference) and by the SGA technique. Using anthropometric data, patients were considered to have normonutrition or malnutrition. Those with malnutrition, were subdivided in patients with low (undernutrition) or high (overnutrition) body weight. Through SGA patients were classified as having normonutrition or malnutrition (moderate and severe). Secondary end-points were hospital length of stay (LOS), mortality, and readmissions (total and non-elective readmissions) over the next 6 months. Overall population, patients scheduled admitted, patients admitted from emergency room, and those with any cancer were individually analyzed. RESULTS: The frequency of malnutrition varied from 72.7% assessed by anthropometry (undernutrition in 26.7% and overnutrition in 46.0%), to 46% using SGA. Malnutrition was not related to the type of admission neither to the diagnosis of cancer. Of 400 patients analyzed, two patients died (0.5%). Using SGA, LOS was significantly higher in patients with malnutrition vs. those with normonutrition, in the overall population and in patients scheduled admitted, and there were more total and non-elective readmissions in patients with malnutrition than in patients with normonutrition in the overall population, in patients scheduled admitted and in those with cancer. When we used anthropometric data, LOS was superior in undernutrition compared to normo and overnutrition in scheduled admitted patients alone. Although there were more total readmissions in undernutrition than in normonutrition and overnutrition in overall population, no significant differences were observed with the non-elective readmission rate. CONCLUSIONS: A high prevalence of malnutrition was found in this study. At a time, a high prevalence of overnutrition was observed. Anthropometric data and SGA technique are not concordant, reflecting the limitations of markers of nutritional status. While with SGA malnutrition was detected in patients with normal to high BMI, with anthropometry overnutrition was diagnosed. SGA seems to be more accurate than anthropometry to anticipate hospital LOS and readmission rate. Due to the increased LOS and readmission rates found in patients with malnutrition, further steps among health care professionals are warranted to identify and control them.

Adolescent↗
PubMed2006

Bone mineral density in adults transplanted in childhood for liver disease.

INTRODUCTION: It remains unclear whether bone mineral density (BMD) is compromised in adult life after liver transplantation (LT) during childhood. METHODS: This was a cross-sectional study of total body (TB) and lumbar spine (LS) dual-energy X-ray absorptiometry, anthropometry, and data collected, which included a physical activity questionnaire. RESULTS: Fifteen patients were enrolled. Mean age at LT was 10.6 (4.5) years (range 1.6 to 18.4). The mean posttransplant period was 12.0 (4.1) years (range 4.4 to 16.7); six were men. The mean TB BMD, 1.11 (0.12) g/cm2, was similar to LS BMD, 1.15 (0.17) g/cm2 (P=.82). The Z-score mean was lower for TB BMD, -0.92 (1.2), and LS BMD, -0.41 (1.2) (P=.22). There was no effect from gender, pretransplant cholestasis (9/15 cases), age at LT, and time since LT. BMD (Z-score) was better for those on corticosteroids (9/15 cases): TB BMD -0.42 (1.20) versus -1.77 (0.86) (P=.04); LS BMD 0.14 (1.00) versus -1.54 (1.03) (P=.03). Anthropometry Z-scores were height -0.04 (0.70), weight -0.33 (0.39), and BMI -0.32 (0.37). There was no correlation between Z-scores for BMD and any of the anthropometry parameters. CONCLUSION: Although the mean TB BMD was lower in transplanted patients than would be expected for the general population, overall BMD and anthropometry were with the normal adult ranges for adults who had undergone LT in childhood.

Adolescent↗
PubMed1999

Anthropometric measurement error and the assessment of nutritional status.

Anthropometry involves the external measurement of morphological traits of human beings. It has a widespread and important place in nutritional assessment, and while the literature on anthropometric measurement and its interpretation is enormous, the extent to which measurement error can influence both measurement and interpretation of nutritional status is little considered. In this article, different types of anthropometric measurement error are reviewed, ways of estimating measurement error are critically evaluated, guidelines for acceptable error presented, and ways in which measures of error can be used to improve the interpretation of anthropometric nutritional status discussed. Possible errors are of two sorts; those that are associated with: (1) repeated measures giving the same value (unreliability, imprecision, undependability); and (2) measurements departing from true values (inaccuracy, bias). Imprecision is due largely to observer error, and is the most commonly used measure of anthropometric measurement error. This can be estimated by carrying out repeated anthropometric measures on the same subjects and calculating one or more of the following: technical error of measurement (TEM); percentage TEM, coefficient of reliability (R), and intraclass correlation coefficient. The first three of these measures are mathematically interrelated. Targets for training in anthropometry are at present far from perfect, and further work is needed in developing appropriate protocols for nutritional anthropometry training. Acceptable levels of measurement error are difficult to ascertain because TEM is age dependent, and the value is also related to the anthropometric characteristics of the group of population under investigation. R > 0.95 should be sought where possible, and reference values of maximum acceptable TEM at set levels of R using published data from the combined National Health and Nutrition Examination Surveys I and II (Frisancho, 1990) are given. There is a clear hierarchy in the precision of different nutritional anthropometric measures, with weight and height being most precise. Waist and hip circumference show strong between-observer differences, and should, where possible, be carried out by one observer. Skinfolds can be associated with such large measurement error that interpretation is problematic. Ways are described in which measurement error can be used to assess the probability that differences in anthropometric measures across time within individuals are due to factors other than imprecision. Anthropometry is an important tool for nutritional assessment, and the techniques reported here should allow increased precision of measurement, and improved interpretation of anthropometric data.

Anthropometry↗
PubMed2005

Body fat measurement in Indian men: comparison of three methods based on a two-compartment model.

UNLABELLED: Obesity is a major risk factor for diabetes and related disorders. The current classification of obesity is based on body mass index (BMI, kg/m(2)), which is a surrogate for the total body fat. Since the relationship between BMI and body fat varies in different populations, an independent validation of the BMI-body fat relationship in the population of interest is desirable. OBJECTIVES: (1) To study the validity of field methods of measuring body fat (multiple skinfolds and bioimpedance) against a criterion method (deuterium dilution) and (2) To compare the prevalence of obesity (WHO 2000 criteria for BMI) with adiposity (body fat >25%) in middle-aged Indian men in rural and urban Pune. DESIGN: Community-based multistage stratified random sampling of middle-aged men from rural and urban Pune for study of body composition and cardiovascular risk. A third of these men, selected to represent wide BMI distribution, were studied for body fat measurements by specific methods. SUBJECTS: A total of 141 healthy men, approximately similar number from rural, urban slums and middle class from Pune. They were 39.3 (+/-6.2) y old and had a BMI of 21.9 (+/-3.7) kg/m(2). MEASUREMENTS: Anthropometry (height, weight and multiple skinfold thicknesses) by trained observers using standardised technique to calculate body fat by Durnin and Womersley's equation. Total body water and body fat by bioelectrical impedance analysis (BIA) and deuterium oxide dilution (D(2)O). RESULTS: Mean total body fat was 14.3 kg (23.0%) by anthropometry, 16.5 kg (26.0%) by BIA and 15.3 kg (24.6%) by D(2)O method. Although there was a good correlation between fat estimation by three methods (r= approximately 0.9, P<0.001 all), compared to D(2)O method anthropometry underestimated body fat by 1.0 kg and BIA overestimated fat by 1.2 kg (P<0.001 both). Using the standard cut-point of 25% body fat for 'adiposity' 29.5% rural, 46.0% slum and 75.0% middle class men were adipose. These proportions were considerably higher than the number of men who were 'preobese' (BMI> or =25-29.9 kg/m(2), 9.0% rural, 22.0% urban slums and 27.0% urban middle class) and 'obese' (BMI >30 kg/m(2), 4.0% urban slums, none in rural and urban middle class). CONCLUSION: We recommend that future studies assessing risk for chronic diseases in Indians should measure adiposity by anthropometry (multiple skinfolds) or BIA (calibrated for Indians) rather than relying only on BMI cut-points.

Adult↗
PubMed1999

Measurement of body fat in healthy elderly men: a comparison of methods.

BACKGROUND: Nutritional evaluation of elderly people is of great importance. Two-component methods for body composition assessment, such as anthropometry and bioelectrical impedance (BIA), are widely used in clinical practice, but their fundamental assumptions may be invalid in older people. Dual-energy X-ray absorptiometry (DXA) is a relatively new method for reliable and direct measurements of body mass in its three basic components: total body bone mineral content (TBBMC), mineral free lean tissue mass (LTM), and fat. In this study, percent body fat (%BF) estimates from anthropometry and BIA in men of various ages were compared with corresponding measurements by DXA. METHODS: Body fat percentage was estimated in 67 men aged 20-95 by anthropometric measurements (skinfold thickness, body mass index, or BMI), BIA, and DXA. Age-specific equations were used for anthropometry and BIA. Limits of agreement were calculated between DXA and the other methods. RESULTS: The equations based on BMI and BIA systematically overestimated %BF with respect to %BF measured by DXA in people of all ages. Intermethod difference between DXA and skinfold thicknesses was less marked, but in over-80-year-olds %BF predicted by skinfold measurements underestimated %BF measured by DXA. Interindividual and age-related variation in TBBMC and in fat-free mass mineralization could partly explain the intermethod differences found between DXA and the other methods. CONCLUSIONS: Because of practical constraints, anthropometry and BIA are often the only available options for body composition assessment in clinical routine; therefore, further research on the validity and improvement of these methods in older people is indicated.

Absorptiometry, Photon↗
PubMed2006

Reliability of anthropometric measurements in the WHO Multicentre Growth Reference Study.

AIM: To describe how reliability assessment data in the WHO Multicentre Growth Reference Study (MGRS) were collected and analysed, and to present the results thereof. METHODS: There were two sources of anthropometric data (length, head and arm circumferences, triceps and subscapular skinfolds, and height) for these analyses. Data for constructing the WHO Child Growth Standards, collected in duplicate by observer pairs, were used to calculate inter-observer technical error of measurement (TEM) and the coefficient of reliability. The second source was the anthropometry standardization sessions conducted throughout the data collection period with the aim of identifying and correcting measurement problems. An anthropometry expert visited each site annually to participate in standardization sessions and provide remedial training as required. Inter- and intra-observer TEM, and average bias relative to the expert, were calculated for the standardization data. RESULTS: TEM estimates for teams compared well with the anthropometry expert. Overall, average bias was within acceptable limits of deviation from the expert, with head circumference having both lowest bias and lowest TEM. Teams tended to underestimate length, height and arm circumference, and to overestimate skinfold measurements. This was likely due to difficulties associated with keeping children fully stretched out and still for length/height measurements and in manipulating soft tissues for the other measurements. Intra- and inter-observer TEMs were comparable, and newborns, infants and older children were measured with equal reliability. The coefficient of reliability was above 95% for all measurements except skinfolds whose R coefficient was 75-93%. CONCLUSION: Reliability of the MGRS teams compared well with the study's anthropometry expert and published reliability statistics.

Anthropometry↗
PubMed1998

Routine protein energy supplementation in adults: systematic review.

OBJECTIVES: To determine whether routine oral and enteral nutritional supplementation can improve the weight, anthropometry, and survival of adult patients. DESIGN: Systematic review of randomised controlled trials of oral or enteral protein supplementation in adults. Trials were identified from Medline (Silver Platter 3.11, 1966-96), reference lists of identified studies and review articles, and communication with feed manufacturers. SUBJECTS: Randomised controlled trials comparing oral or enteral protein supplementation with no routine supplementation. All trials of adult subjects were included except those addressing nutrition in pregnancy. MAIN OUTCOME MEASURES: Change in body weight and anthropometry (mid-arm muscle circumference), and all cause case fatality recorded at the end of scheduled follow up. Body weight and anthropometry were analysed as the weighted mean difference and 95% confidence intervals of the percentage change in these variables. Case fatality was analysed with odds ratio and 95% confidence intervals. RESULTS: 32 eligible reports (2286 randomised patients) published between February 1979 and July 1996 were identified, of which 30 (93.8%) (2062 randomised patients) reported outcomes of interest. Case fatality data were available for 1670 (81%) patients, and continuous variable data for up to 1607 (78%) patients. The treatment group receiving routine nutritional supplementation showed consistently improved changes in body weight and anthropometry compared with controls; weighted mean difference 2.06% (95% confidence interval 1.63% to 2.49%) and 3.16% (2.43% to 3.89%) respectively. The pooled odds ratio for death in the treatment group was 0.66 (0.48 to 0.91, 2P<0.01). Apparent benefits were observed in several prespecified subgroups of patients, treatment settings, and interventions, but were not evident if trials with less robust methodology were excluded. CONCLUSIONS: Routine oral or enteral supplementation seems to improve the nutritional indices of adult patients, but there are insufficient data in trials which meet strict methodological criteria to be certain if mortality is reduced. Benefits were not restricted to particular patient groups. Further large pragmatic randomised controlled trials of routine nutritional supplementation are justified.

Administration, Oral↗
PubMed2006

New percentage body fat prediction equations for Japanese males.

Anthropometry is simple, cheap, portable and non-invasive method for the assessment of body composition. While the Nagamine and Suzuki body density prediction equation has been frequently used to estimate %BF of Japanese, the equation was developed more than 40 years ago and its applicability to the current Japanese population has not been studied. This study aimed to compare %BF results estimated from anthropometry and dual energy X-ray absorptiometry (DXA) in order to examine applicability of the Nagamine and Suzuki equation. Body composition of 45 Japanese males (age: 24.3+/-5.5 years, stature: 171.6+/-5.8 cm, body mass: 62.6+/-7.1 kg, %BF: 15.7+/-5.6%) were assessed using whole-body DXA (Hologic QDR-2000) scan and anthropometry using the protocol of the International Society for the Advancement of Kinanthropometry (ISAK). From anthropometric measurements %BF was calculated using the Nagamine and Suzuki equation. The results showed that the Nagamine and Suzuki equation significantly (p<0.05) underestimated %BF of Japanese males compared to the DXA results. There was a trend towards greater underestimation as the estimated %BF values using DXA increased. New %BF prediction equations were proposed from the DXA and anthropometry results. Application of the proposed equations may assist in more accurate assessment of body fatness in Japanese males living today.

Absorptiometry, Photon↗
PubMedDate not supplied

One year follow up study of term babies born at Kathmandu medical college teaching hospital.

OBJECTIVE: To study the mean, standard deviation and centiles for anthropometry and haemoglobin in healthy term infants followed up to 12 months of age. DESIGN: Cohort study. SETTINGS: Kathmandu Medical College Teaching Hospital (KMCTH) in Kathmandu. SUBJECT: Consecutive healthy term newborns Method: 100 consecutive healthy term newborns were enrolled at birth.19 babies were lost in follow up. So, 81(45 male, 36 female) healthy, full term infants were followed up from birth to 12 months of age. Anthropometry (weight, length, and head circumference) and haemoglobin were measured at birth, 6 weeks, 6 months, 9 months and 12 months of age. Haemoglobin was estimated by Hemocue microcuvette method. The data so obtained was subjected to statistical analysis by using SPSS computer package. MAIN OUTCOMES: Mean, centile and standard deviation score values for weight (Kgs), infant length (cms), head circumference (cms) and haemoglobin (gm/dl) at birth, 6 weeks, 6 months, 9 months and 12 months of age. RESULTS: Out of 100 babies enrolled, data presented here is for the remaining 81 babies. Among 81 babies, 76 were appropriate for gestational age (AGA) and 3 were small for gestation (SFD). The mean, standard deviation and percentile values are presented for anthropometry (weight, length and head circumference) and haemoglobin at birth, 6 weeks, 6 months, 9 months and 12 months of age. The mean birth weight was 3.05 kg (SD 0.41). The mean infant length and head circumference at birth were 49 cm (2.28) and 33.8 cm (SD1.4) respectively. The mean haemoglobin at birth was 15.7 gm/dl (SD 2.29). At 12 months of age mean weight, length, head circumference and haemoglobin were 9 kg (SD 0.81), 73.5 cm (SD 2.9), 45 cm (SD 1.2 ) and 11.1 gm/dl (SD 1.41) respectively. Almost 50% of the babies at 6 weeks, 9 months and 12 months of age were found to be anaemic (Hb < 11 gm/dl). Among the babies, 49% were exclusively breast fed for 6 months of age. Other feeding practices seen were, mothers breast feed with water supplementation (25%), mothers breast feeding with formula feed (16%) and formula feeding only (5%). National and international comparisons of anthropometry and haemoglobin data are shown in table.

Anthropometry↗
PubMed1987

Anthropometric and computerized tomographic measurements of lower extremity lean body mass.

The loss of lean muscle mass is one of the hallmarks of protein-calorie malnutrition. Anthropometry is a standardized technique used to assess the response of muscle mass to nutrition therapy by quantifying the muscle and fat compartments. That technique does not accurately reflect actual limb composition, whereas computerized tomography does. Twenty lower extremities on randomly chosen men and women patients were evaluated by anthropometry and computerized tomography. Total area, muscle plus bone area, total volume, and muscle plus bone volume were correlated, using Heymsfield's equation and computerized tomography-generated areas. Anthropometrics overestimated total and muscle plus bone cross-sectional areas at almost every level. Anthropometry overestimated total area and total volume by 5% to 10% but overestimated muscle plus bone area and muscle plus bone volume by as much as 40%. Anthropometry, while easily performed and useful in large population groups for epidemiological studies, offers a poor assessment of lower extremity composition. On the other hand, computerized tomography is also easily performed and, while impractical for large population groups, does offer an accurate assessment of the lower extremity tissue compartments and is an instrument that might be used in research on lean muscle mass.

Adipose Tissue↗
PubMed1995

Relationship between mothers' and newborns' nutritional and blood lipid variables.

OBJECTIVE: To study the relation between anthropometry, diet and blood lipids during pregnancy and anthropometry and cord blood lipids in newborns. DESIGN: Longitudinal study during pregnancy. SETTING: Population study. SUBJECTS: A group of 70 volunteer pregnant women attending the Maternity Advisory Service were recruited at the 1st trimester and studied during pregnancy. By the end of the study 17 women had dropped out of anthropometry and diet assessments and 21 had left blood lipid analysis. Anthropometric measurements and cord blood lipid determinations were carried out respectively on 43 and 28 newborns. INTERVENTIONS: Diet history; current methods for anthropometry and blood lipid determinations. RESULTS: The highest values for energy and other nutrient intakes were observed at the 2nd trimester. According to the recommendations usually made, protein and fat intakes were high, and carbohydrate intake too low. This was observed especially at the 3rd trimester. Significant relationships between protein, fat and carbohydrate intake (as a percentage of energy) during pregnancy and anthropometric variables in newborns and cord blood lipids (particularly for boys) were found in the group of mothers and their respective newborns. Few correlations between mothers' and newborns' levels of blood lipids were observed for girls. CONCLUSIONS: The results do not show considerable diet changes during pregnancy. The impact of mothers' diet on fat deposition in newborns and cord blood lipids seems to be sex-linked and more important for boys.

Adult↗
PubMed1985

Measurement of body fat and hydration of the fat-free body in health and disease.

Body fat mass, fat-free body mass and body water are basic components of body composition which are used in nutritional and metabolic studies and in patient care. A method of measuring total body fat (TBF), fat-free mass (FFM) and its hydration (TBW/FFM) involving prompt gamma in vivo neutron activation analysis (IVNAA) and tritium dilution has been compared with the more traditional methods of densitometry and skinfold anthropometry in 36 normal volunteers, and with skinfold anthropometry in 56 patients presenting for nutritional support. While the mean values of TBF were in reasonable agreement for the three methods in normals it was founds that skinfold anthropometry underestimated TBF relative to the IVNAA/tritium method by, on average, 3.0 kg (19%) in patients. Furthermore, the ranges of values in normals of the ratio TBW/FFM for the anthropometric (0.62 to 0.80) and densitometric (0.65 to 0.80) methods were much wider than the range for the IVNAA/tritium method (0.69 to 0.76), in which TBW was measured by tritium dilution in all cases. In the patients, the ranges of this ratio were 0.52 to 0.90 for the anthropometric method and 0.67 to 0.82 for the IVNAA/tritium method; clearly anthropometry yields values of TBW/FFM which are outside accepted biological limits. On the basis of these findings, ranges of TBW/FFM are suggested for both normal adults (0.69 to 0.75) and patients requiring nutritional support (0.67 to 0.83). Finally it is concluded that the IVNAA/tritium method is a suitable method for measuring TBF and FFM and particularly so when body composition is abnormal.

Adipose Tissue↗
PubMed2006

Reduced body protein in children with spastic quadriplegic cerebral palsy.

BACKGROUND: No studies have directly measured body protein or validated skinfold-thickness anthropometry and dual-energy X-ray absorptiometry (DXA) to assess body protein in children with spastic quadriplegic cerebral palsy (SQCP). OBJECTIVE: We aimed to measure and evaluate body protein and to determine whether skinfold-thickness anthropometry and DXA can predict body protein in children with SQCP. DESIGN: This was a cross-sectional study of 59 children (22 girls, 37 boys) aged 3.9-19.5 y with SQCP. The children underwent measurements of anthropometric indexes, lean tissue mass by DXA (LTM(DXA)), and total body protein by neutron activation analysis (TBP(NAA)). In addition, TBP was estimated from both skinfold-thickness anthropometry (TBP(SKIN)) and DXA (TBP(DXA)). The agreement of TBP(SKIN) and TBP(DXA) was tested against TBP(NAA) by using Bland and Altman plot analysis. RESULTS: Height and weight SD scores (x +/- SD: -3.1 +/- 1.6 and -4.8 +/- 5.3, respectively) were significantly lower than reference data in the children with SQCP (P < 0.001). TBP(NAA) for age and height was low in the children with SQCP (P < 0.001): 56.1 +/- 17.3% and 81.5 +/- 15.7%, respectively, of the values predicted from control data. TBP(SKIN) and TBP(DXA) were both highly correlated with TBP(NAA): r = 0.90, P < 0.001, and r = 0.91, P < 0.001, respectively. Despite these significant correlations, agreement analyses showed wide variation of up to 33.3% of the mean for both methods. CONCLUSIONS: Body protein in children with SQCP is significantly reduced for age and height. Skinfold anthropometry and DXA show wide variation in estimation of body protein compared with NAA in this group of children.

Absorptiometry, Photon↗
PubMed1993

Can bioelectrical impedance improve the prediction of body fat in patients with eating disorders?

Prediction equations for percentage body fat have been derived for a group of 93 female patients being treated for eating disorders, using fat measured by dual-energy X-ray absorptiometry (DXA) as the reference method. Separate bioelectrical impedance analysis (BIA) prediction equations were derived for patients with a body mass index above and below 16 kg/m2. This provided an improvement compared with the equations supplied by the manufacturer. The standard error of the estimate (SEE) for the entire group was 3.2% (r = 0.922). However, an alternative prediction equation based on anthropometry alone gave an SEE of 4.2% (r = 0.861). The ability of BIA and anthropometry alone to measure changes in percentage fat was assessed in a separate group of 24 females during treatment for eating disorders. The SEEs using the BIA and anthropometry prediction equations were 2.6% (r = 0.931) and 2.7% (r = 0.901) respectively. We conclude that in patients with eating disorders BIA does not provide any significant improvement over simple anthropometry prediction equations for the assessment of percentage fat or its changes. The apparently reasonable agreement between fat predicted by BIA and that measured by DXA is largely due to the inclusion of body habitus parameters in the BIA prediction equations.

Absorptiometry, Photon↗
PubMed2000

A new recommendation for maternal weight gain in Chinese women.

OBJECTIVE: To characterize the distribution of maternal weight gain in Chinese women living in a well-nourished community, to recommend target weight gains from quartile values derived from women with good pregnancy outcomes, and to quantify the risk for adverse pregnancy outcomes encountered among subjects with weight gain outside these recommendations. DESIGN: A retrospective study on maternal anthropometry and pregnancy outcomes was conducted among Chinese women who delivered a singleton pregnancy in a university hospital in Hong Kong. SUBJECTS: Nine hundred eight women who delivered during the study period were identified. Among them, 754 (83%) had complete anthropometry data. The normative distribution of maternal weight gain was derived from 504 women who had a good pregnancy outcome. STATISTICS: Analysis of variance was used to compare total weight gain among women of different prepregnancy weight. Fisher exact test was used in the univariate analysis of the association between risk factors and corresponding adverse pregnancy outcomes. Adjusted odds ratios for adverse outcomes were determined by multiple logistic regression models controlling for the following factors: maternal age, duration of gestation, prepregnancy body mass index (BMI), height, parity, and smoking. RESULTS: A maternal weight-gain chart and recommendations for total weight gains in Chinese women were derived from the distribution of weight gain in subjects with good pregnancy outcomes. The recommended total weight gain was 13 to 16.7 kg, 11 to 16.4 kg, and 7.1 to 14.4 kg respectively for women of low (BMI < 19), moderate (BMI: 19 to 23.5), and high (BMI > 23.5) prepregnancy BMI. Women who did not achieve the lower quartile value had more than twice the risk of having low-birth-weight infants. Those with excessive weight gain were at risk for needing assisted delivery. APPLICATIONS: As maternal anthropometry differs across ethnic groups, different recommendations should be made for specific populations.

Adult↗